Treatment of veterans with psychogenic nonepileptic seizures (PNES) using video telehealth is associated with significant seizure reduction, according to study results published in Epilepsia.

While manual-based treatment was reported to be effective for patients with PNES, limited access to care is a major challenge. The objective of the current study was to determine the benefits of cognitive behavioral therapy-informed psychotherapy for seizures with clinical video telehealth.

This single-arm, prospective, observational, cohort study included 32 veterans (27 men; mean age, 49.1 years) with video-electroencephalography-confirmed PNES diagnosis. A psychotherapy consisting of 12 manual based sessions was given once per week, through clinical video telehealth. The primary outcome was seizure frequency according to a patient-kept 1-week diary sheet.

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Seizures decreased by a mean of 45.7 percent per month of treatment. There was also a significant improvement in depression (mean Beck Depression Inventory, 25.6 at baseline vs 15.0 at the end of follow-up; P =.0024), anxiety (mean Beck Anxiety Inventory, 25.5 at baseline vs 16.7 at the end of follow-up; P =.0034), psychosocial functioning, quality of life (mean Quality of Life in Epilepsy, 36.7 at baseline vs 46.8 at the end of follow-up; P <.0001), and global function (mean Global Assessment of Functioning, 50.8 at baseline vs 60.3 at the end of follow-up; P <.0001).

The study had several limitations, including the unblinded treatment, observational design, lack of a control group, sample limited to video-electroencephalography-confirmed PNES, use of a single therapist, and unmasked weekly seizures count.

“These results suggest that psychotherapy via telehealth for PNES is a viable option for patients across the nation, eliminating one of the many barriers of access to mental health care,” concluded the study researchers.


LaFrance WC Jr, Ho WLN, Bhatla A, Baird GL, Altalib HH, Godleski L. Treatment of psychogenic nonepileptic seizures (PNES) using video telehealth. Epilepsia. Published online October 4, 2020. doi:10.1111/epi.16689