Psychogenic nonepileptic seizures in patients with learning disability: Comparison with patients with no learning disability

Among a consecutive series of patients with psychogenic nonepileptic seizures (PNES), we compared patients with learning disability (LD) (n = 25) with patients with no LD (n = 263), with respect to demographic and clinical variables. A higher proportion of the LD group had epilepsy as well as PNES (P < 0.001) (uncorrected P values are quoted), and a higher proportion were taking antiepileptic drugs at the time of diagnosis of PNES (P = 0.007). Fewer patients with LD had a history of antecedent sexual abuse (P = 0.036). A higher proportion of the LD group had previous pseudostatus (P < 0.001), and a higher proportion had immediate situational or emotional triggers for their attacks (P < 0.001). There were trends toward a higher proportion of men in the LD group (P = 0.056) and a longer delay between onset of PNES and diagnosis (P = 0.072). Our data suggest potentially important clinical differences between PNES populations with and without LD, as well as possible differences in mechanism.