Which tests should be performed in the evaluation of psychogenic nonepileptic seizures (PNES)?

Updated: Jul 26, 2018
  • Author: Selim R Benbadis, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Laboratory studies are useful only in excluding metabolic or toxic causes of seizures (e.g., hyponatremia, hypoglycemia, drugs).

Prolactin and creatine kinase (CK) levels rise after generalized tonic-clonic seizures and not after other types of episodes. However, sensitivity is too low to be of any practical value (i.e., lack of elevation does not exclude epileptic seizures).

Although imaging findings are normal in psychogenic nonepileptic seizures (PNES), images should be obtained to exclude organic pathology.

Incidental abnormalities are occasionally seen on imaging. However, they should not confound the diagnosis if results of EEG video monitoring firmly establish PNES.

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