In cases undergoing epilepsy surgery, postoperative psychogenic nonepileptic seizures
(PNES) may be underdiagnosed complicating the assessment of postsurgical seizures'
outcome and the clinical management. We conducted a survey to investigate the current
practices in the European epilepsy monitoring units (EMUs) and the data that EMUs
could provide to retrospectively detect cases with postoperative PNES and to assess
the feasibility of a subsequent postoperative PNES research project for cases with
postoperative PNES.We developed and distributed a questionnaire survey to 57 EMUs.
Questions addressed the number of patients undergoing epilepsy surgery, the performance
of systematic preoperative and postoperative psychiatric evaluation, the recording
of sexual or other abuse, the follow-up period of patients undergoing epilepsy surgery,
the performance of video-electroencephalogram (EEG) and postoperative psychiatric
assessment in suspected postoperative cases with PNES, the existence of electronic
databases to allow extraction of cases with postoperative PNES, the data that these
bases could provide, and EMUs' interest to participate in a retrospective postoperative
PNES project.Twenty EMUs completed the questionnaire sheet. The number of patients
operated every year/per center is 26.7 (+19.1), and systematic preoperative and postoperative
psychiatric evaluation is performed in 75% and 50% of the EMUs accordingly. Sexual
or other abuse is systematically recorded in one-third of the centers, and the mean
follow-up period after epilepsy surgery is 10.5 ± 7.5 years. In suspected postoperative
PNES, video-EEG is performed in 85% and psychiatric assessment in 95% of the centers.
An electronic database to allow extraction of patients with PNES after epilepsy surgery
is used in 75% of the EMUs, and all EMUs that sent the sheet completed expressed their
interest to participate in a retrospective postoperative PNES project.Postoperative
PNES is an underestimated and not well-studied entity. This is a European survey to
assess the type of data that the EMUs surgical cohorts could provide to retrospectively
detect postoperative PNES. In cases with suspected PNES, most EMUs perform video-EEG
and psychiatric assessment, and most EMUs use an electronic database to allow extraction
of patients developing PNES.
