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Table 4 Table of PNES diagnosis certainties, adapted from the work by LaFrance et al. (2013) for the ILAE Nonepileptic Seizures Task Force (with permission) [9]

From: The first-line management of psychogenic non-epileptic seizures (PNES) in adults in the emergency: a practical approach

 Suspicious historyAnalysisElectroencephalography
Degree of diagnostic certaintyPossible+Based on witness or self-report/descriptionRoutine or sleep-deprived EEG without epileptiform abnormalities
Probable+Clinical features typical of PNES, objectively witnessed by the physician or reviewed on a homemade videoRoutine or sleep-deprived EEG without epileptiform abnormalities
Clinically established+Clinical features typical of PNES, objectively witnessed by an epileptologist (or epilepsy experienced neurologist) or reviewed on a homemade video, without EEG recordingRoutine EEG (or ambulatory EEG) without epileptiform discharges during a typical episode that, for ES, should be associated with evident EEG ictal epileptiform activity
Documented+Clinical features typical of PNES events, objectively identified on video-EEG by a clinician experienced in diagnosis of seizure disordersNo epileptiform activity immediately before, during or after ictus captured on ictal video-EEG with typical PNES semiology
  1. ES epileptic seizure, PNES psychogenic non-epileptic seizure, EEG electroencephalography. Additional tests may affect the certainty of the diagnosis—for instance, self-protective maneuvers or forced eye closure during unresponsiveness or normal postictal prolactin levels with convulsive seizures