To describe the clinical characteristics of patients with autism referred to a pediatric psychogenic nonepileptic events (PNEE) clinic.

Although there is a growing body of research on PNEE, there has been little description of PNEE in pediatric patients with autism. Here we review referrals to our pediatric PNEE clinic and describe six patients with PNEE and comorbid autism.

This is a retrospective review of all patients referred to the PNEE clinic from January 2018-October 2019.  The clinical characteristics were abstracted by chart review.  Follow-up phone calls were made one-month following the PNEE clinic visit.

Out of 164 PNEE referrals, six had autism. The mean age was 13 (range 7-20), 50% were male and 50% had a comorbid diagnosis of epilepsy. This is compared to the larger PNEE cohort without autism that had only 28% males and 18% with comorbid epilepsy. Using International League Against Epilepsy levels of diagnostic certainty, two patients were categorized as documented diagnoses of PNEE, three patients were clinically established diagnoses, and one patient was a probable diagnosis.  At one-month phone follow-up, three patients were seeing a counselor or psychologist and two were on a waitlist. Parental acceptance of the diagnosis was mixed with three accepting and three questioning the diagnosis. It was reported that five patients improved, and one was in remission.

This case series of six patients with autism who developed PNEE reveals unique characteristics in this population. There appears to be a higher rate of epilepsy and male gender compared to other patients with PNEE that do not have autism. Although parental acceptance of the diagnosis of PNEE was not 100%, all patients were improving at one-month.