exploring the association between psychogenic non-epileptic seizures and mild traumatic brain injury: a systematic review

Context: this systematic review explores the intersection between mild traumatic brain injury (mtbi) and psychogenic nonepileptic seizures (pnes). evidence acquisition: this review examines the prevalence, risk factors, and diagnostic challenges of pnes in the context of mtbi, while also exploring potential underlying mechanisms and clinical implications. results: from the initial 1,354 studies, 7 were included in the final analysis. la france et al. reported a 44.6% prevalence of traumatic brain injury (tbi) in pnes, with 73% being mtbi (p < 0.001). mokleby et al. found that 83% of pnes patients had minor head trauma, significantly associated with depression and post-traumatic stress disorder (ptsd) (p < 0.01). salinsky et al. highlighted a strong link between mtbi, ptsd, and pnes in veterans (p = 0.002). the studies consistently reported high psychiatric comorbidity rates, including major depression and conversion disorder (p < 0.001). these findings emphasize the need for an integrated neurological and psychiatric approach to pnes in mtbi patients. conclusions: the review concludes with an emphasis on the need for comprehensive care in managing pnes, especially considering the prominent role of psychiatric comorbidities. future research directions include prospective studies, a focus on pediatric populations, and enhanced treatment strategies integrating neurological and psychiatric care.