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• W3120866319 abstract "<h3>Abstract</h3> <h3>Background and objectives:</h3> Misdiagnosis of psychogenic nonepileptic seizures (PNES) and epileptic seizures (ES) is common. In the absence of the diagnostic gold standard (video EEG), clinicians rely on semiology and clinical assessment. However, questions regarding the diagnostic accuracy of different signs remain. This meta-analysis aims to evaluate the diagnostic accuracy of semiology in PNES and ES. <h3>Methods:</h3> We systematically searched PubMed, PsycInfo and Medline for original research publications published before 8 February 2021 with no restriction on search dates to identify studies that compared semiology in ES and PNES in epilepsy monitoring units. Non-English publications, review articles, studies reporting on only PNES or ES and studies limited to patients with developmental delay were excluded. Study characteristics and proportions of ‘event groups’ and ‘patient groups’ demonstrating signs were extracted from each article. Bivariate analysis was conducted, and data were pooled in a random effects model for meta-analysis. The I² statistic was calculated to assess statistical heterogeneity. The QUADAS-2 tool was utilized to assess risk of bias in included studies. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were calculated. A PLR > 10 or an NLR < 0.1 has a large impact on the post-test probability of a diagnosis (ES or PNES) whereas a PLR between 5-10 or an NLR between 0.1- 0.2 has a moderate impact on the post-test probability of a diagnosis (ES or PNES). <h3>Results:</h3> The meta-analysis included 14 studies comprising of 800 patients with ES and 452 patients with PNES. For PNES, ictal eye closure (PLR 40.5 95%CI: 16.2-101.3; I² = 0, from three studies) and asynchronous limb movements (PLR 10.2; 95%CI: 2.8-37.7; I² = 0, from three studies) reached a PLR threshold > 5. No single sign reached a PLR threshold >5 for ES. <h3>Conclusions:</h3> While all signs require interpretation in the overall clinical context, the presence of ictal eye closure and asynchronous limb movements are reliable discriminative signs for PNES." @default.
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• W3120866319 date "2021-01-05" @default.
• W3120866319 modified "2023-10-17" @default.
• W3120866319 title "Prevalence, admission rates and hypoxia due to COVID-19 in patients with rheumatic disorders treated with targeted synthetic or biologic disease modifying antirheumatic drugs or methotrexate: a nationwide study from Iceland" @default.
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• W3120866319 doi "https://doi.org/10.1136/annrheumdis-2020-219564" @default.
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