Characteristics of psychogenic nonepileptic events among veterans with posttraumatic stress disorder: An association of semiology with the nature of trauma

Various psychiatric disorders can contribute to psychogenic nonepileptic events (PNEEs), including posttraumatic stress disorder (PTSD). We hypothesize that among patients with PNEEs and PTSD, the nature of the traumatic experience leading to PTSD has an association with the clinical manifestations of PNEEs. We found that the presence of PTSD, in general, did not demonstrate significant association with any particular PNEE semiology in a veterans population. However, 11 of 12 (91.7%) subjects with PNEEs and specifically combat-related PTSD showed significant predilection for hypomotor or nonmotor PNEEs, as compared to 5 of 12 (41.7%) subjects with PNEE and non-combat-related PTSD (P = 0.027). Between these two subgroups of subjects with PTSD, there were no statistical differences in the rating of service-connected disability for “seizures,” presence of psychiatric history other than PTSD, marital status, substance abuse history, and use of antiepileptic drugs. Timely diagnosis of PNEEs can be especially relevant to veterans with combat-related PTSD, whose PNEE manifestations may be subtle and erringly overlooked.