Paroxysmal Nonepileptic Events in Children
A Video Gallery and a Guide for Differential Diagnosis
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Abstract
Purpose of Review Paroxysmal nonepileptic events (PNEEs) are a heterogenous group of time-limited events, characterized by changes in motor or behavioral activity beginning abruptly and ending in a short time. Owing to their manifestation, these conditions can clinically simulate seizures.
Recent Findings These episodes belong to different categories, including syncopal events, psychiatric disorders, and movement disorders. PNEEs are a common cause of diagnostic mistakes and families' concerns, and the risk of useless and sometimes even injurious treatment is considerable. The high frequency of these manifestations in clinical practice makes PNEEs a diagnostic challenge for clinicians.
Summary This review is focused on the distinctive clinical findings and treatment of PNEEs. Illustrative video recordings of the PNEEs and a video collection as a support tool for differential diagnosis are provided.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
Search strategy and selection criteria: We searched PubMed for articles published in English up to December 1, 2020, with the search terms “nonepileptic events,” “pseudoseizures,” “seizure differential diagnosis,” “non-epileptic attacks,” “paroxysmal nonepileptic events,” “psychogenic seizures,” AND “children” OR “adolescents.” Retrospective studies, case reports, review articles, and observational studies were included. The reference list was generated based on originality and relevance to the broad scope of this review.
Submitted and externally peer reviewed. The handling editors were former Deputy Editor Elaine Jones, MD, FAAN, and current Deputy Editor Kathryn Kvam, MD.
- Received April 21, 2021.
- Accepted March 15, 2022.
- © 2022 American Academy of Neurology
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