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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(11): 1112-1118
DOI: 10.1055/s-0042-1759759
Original Article

Frequency and economic burden of psychogenic non-epileptic seizures in patients applying for disability benefits due to epilepsy

Frequência e impacto econômico das crises psicogênicas não epilépticas em pacientes requerentes de aposentadoria por invalidez devido a epilepsia
Mehmet Taylan Peköz 
1   Çukurova University, Faculty of Medicine, Department of Neurology, Epilepsy Unit, Adana, Türkiye.
,
Kezban Aslan-Kara 
1   Çukurova University, Faculty of Medicine, Department of Neurology, Epilepsy Unit, Adana, Türkiye.
,
Turgay Demir 
1   Çukurova University, Faculty of Medicine, Department of Neurology, Epilepsy Unit, Adana, Türkiye.
,
Gulfem Aktan 
2   Çukurova University, Faculty of Medicine, Department of Neurology, Adana, Türkiye.
,
Mehmet Balal 
1   Çukurova University, Faculty of Medicine, Department of Neurology, Epilepsy Unit, Adana, Türkiye.
,
Soner Cakmak 
2   Çukurova University, Faculty of Medicine, Department of Neurology, Adana, Türkiye.
,
Hacer Bozdemir 
1   Çukurova University, Faculty of Medicine, Department of Neurology, Epilepsy Unit, Adana, Türkiye.
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Abstract

Background Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures and are often misdiagnosed as epilepsy.

Objective To investigate the frequency of PNES and to calculate the economic burden of the patients who admitted to video-electroencephalographicmonitoring (VEM) to obtain a diagnosis of epilepsy in order to apply for disability retirement.

Methods The present retrospective study included 134 patients who required disability reports between 2013 and 2019 and had their definite diagnoses after VEM. Following VEM, the patients were divided into three groups: epilepsy, PNES, and epilepsy + PNES.

Results In total, 22.4% (n = 30) of the patients were diagnosed with PNES, 21.6% (n = 29) with PNES and epilepsy, and 56% (n = 75), with epilepsy. The frequency of PNES among all patients was of 44% (n = 59). In patients with PNES alone, the annual cost of using anti-seizure medication was of 160.67 ± 94.04 dollars; for psychostimulant drugs, it was of 148.3 ± 72.48 dollars a year; and the mean direct cost for diagnostic procedures was of 582.9 ± 330.0 (range: 103.52–1601.3) dollars.

Conclusions Although it is challenging to determine the qualitative and quantitative total cost in these patient groups, early diagnosis and sociopsychological support will reduce the additional financial burden on the health system and increase the quality of life of the patients.

Resumo

Antecedentes As crises psicogênicas não epilépticas (CPNE) se assemelham a crises epilépticas, e muitas vezes são diagnosticadas erroneamente como epilepsia.

Objetivo Investigar a frequência de CPNE e calcular o impacto econômico dos pacientes internados para serem submetidos a monitoramento videoencefalográfico (MVE) para obter um diagnóstico de epilepsia e requerer aposentadoria por invalidez.

Métodos Este estudo retrospectivo incluiu 134 pacientes que solicitaram laudo médico de incapacidade entre 2013 e 2019, e obtiveram seus diagnósticos definitivos após serem submetidos a MEV. Os pacientes foram divididos em três grupos: epilepsia, CPNE, e epilepsia + CPNE.

Resultados Após o MEV, 22,4% (n = 30) dos pacientes foram diagnosticados com CPNE, 21,6% (n = 29), com CPNE + epilepsia, e 56%, com epilepsia. A frequência de CPNE entre todos os pacientes foi de 44% (n = 59). Em pacientes somente com CPNE, o custo anual do uso de anticonvulsivantes foi de US$ 160,67 ± 94,04; para os psicoestimulantes, o custo anual foi de US$ 148,3 ± 72,48; e a média do custo direto de procedimentos diagnósticos foi de US$ 582,9 ± 330,0 (variação: 103,52–1601,3).

Conclusões Embora seja um desafio determinar o custo total qualitativo e quantitativo nesses grupos de pacientes, o diagnóstico precoce e o apoio sociopsicológico reduzirão o impacto financeiro adicional ao sistema de saúde e aumentarão a qualidade de vida dos pacientes.

Keywords

Psychogenic Nonepileptic Seizures - Epilepsy - Retirement - Electroencephalography - Financial Stress

Palavras-chave

Convulsões Psicogênicas não Epilépticas - Epilepsia - Aposentadoria - Eletroencefalografia - Estresse Financeiro


Publication History

Received: 01 December 2021

Accepted: 29 May 2022

Article published online:
28 December 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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