Video-EEG Semiological Patterns in PNES

Distinct Semiological Clusters of Psychogenic Non-Epileptic Seizures Identified by Video-EEG Monitoring

This retrospective observational study evaluates semiological and electroclinical characteristics of psychogenic nonepileptic seizures (PNES) in adult patients who underwent video-EEG monitoring. The study aims to identify distinct semiological patterns and classify PNES events based on observable ictal features recorded during video-EEG monitoring.

Study Overview

• Status: Completed
• Conditions: Pnes

Detailed Description

Psychogenic nonepileptic seizures (PNES) are paroxysmal events that resemble epileptic seizures but are not associated with ictal epileptiform activity on electroencephalography (EEG). Video-EEG monitoring is the gold standard for diagnosis.

In this retrospective observational study, video-EEG recordings and clinical data of 52 adult patients diagnosed with PNES were reviewed. Semiological features observed during recorded events were systematically evaluated and coded as binary variables.

Hierarchical cluster analysis (Ward's method with squared Euclidean distance) was used to identify semiological patterns. The aim was to define clinically meaningful clusters of PNES events and to describe their demographic and clinical correlates.

• Study Type: Observational
• Enrollment (Actual): 50

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Izmir, Turkey (Türkiye)
    • Tepecik EAH

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This study population consists of adult patients diagnosed with psychogenic nonepileptic seizures (PNES) who underwent long-term video-EEG monitoring in a tertiary epilepsy center. All included patients had at least one recorded PNES event and sufficient clinical data available for retrospective analysis. Patients were identified through medical records and video-EEG databases, and no interventions were performed as part of the study.

Description

Inclusion Criteria:

Adults aged 18 years and older Diagnosis of psychogenic nonepileptic seizures (PNES) confirmed by video-EEG monitoring Availability of complete video-EEG recordings capturing at least one typical event Availability of sufficient clinical and demographic data in medical records for retrospective evaluation

Exclusion Criteria:

Patients younger than 18 years Incomplete or poor-quality video-EEG recordings Absence of recorded typical PNES events during video-EEG monitoring Insufficient clinical documentation for retrospective analysis

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
patients; patients with pnes underwent video eeg monitoring

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Semiological cluster classification of PNES events	Classification of PNES events into semiological clusters (pauci-kinetic, hyperkinetic, hyperventilation-eye closure) based on ictal features identified during video-EEG monitoring.	Baseline (retrospective video-EEG analysis)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pnes events	Eye closure during PNES events Hyperventilation during PNES events Abrupt onset of PNES events Abrupt termination of PNES events Hyperkinetic motor activity Presence or absence of excessive motor activity (e.g., thrashing movements). Tremor during PNES events Dystonic posturing Axial extension Axial immobility Pelvic thrusting Presence or absence of pelvic thrusting.	baseline

Collaborators and Investigators

• Sponsor: Tepecik Training and Research Hospital
• Investigators: Principal Investigator: irem fatma uludag, Tepecik EAH

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2025
• Primary Completion (Actual): December 1, 2025
• Study Completion (Actual): April 1, 2026

Study Registration Dates

• First Submitted: April 6, 2026
• First Submitted That Met QC Criteria: April 6, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 6, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: semenaveeg

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No