Psychogenic nonepileptic seizures and mortality

Takeaway

  • Patients with psychogenic nonepileptic seizures (PNES) have a standardized mortality ratio (SMR) 2.5 times that of the general population, with a comparable rate of death to drug-resistant epilepsy patients.

Why this matters

  • Epilepsy is associated with increased mortality, particularly when coupled with psychiatric comorbidity; people with PNES have a significantly higher rate of psychiatric comorbidity versus both those with epilepsy and the general population, and a higher death rate at younger age versus people with epilepsy.

  • A proportion of PNES deaths are potentially avoidable, indicating a need for greater emphasis on prompt diagnosis, identification of risk factors and adoption of appropriate treatment strategies for these patients.