Abstracts

Rationale:
Many studies have examined neuropsychological functions among patients with PNES, with mixed results of differences on measures of cognitive functioning, notably when compared to those with ES.  Fewer have examined cognitive functioning among pediatric patients with PNES, particularly regarding comparisons to those with ES or even those in the general population.  
Method:
This is a retrospective study of 27 patients (15 female, 12 male) diagnosed with epilepsy (ES) and 13 patients (8 female, 5 male) diagnosed with PNES. The diagnosis of epilepsy or PNES was confirmed with video EEG. All patients were administered the WISC-IV/V, WRAML-2 subtests, NEPSY-2 subtests, and Conners 3 Self-Report (the latter when age appropriate) during a comprehensive neuropsychological evaluation.  Family were provided with the Conners 3 Parent and Achenbach Child Behavior Checklist (CBCL) to complete.  Demographic data (age, educational level) data were also collected.
Results:
Significant differences were seen on an attention task - WISC Symbol Search (p=0.03), with patients with PNES scoring higher than those with ES ( x1 = 9.62, x2=7.96)   Significant differences were also seen on certain tasks measuring memory - WRAML-2 Verbal Learning (p=.04), Learning Delayed Recall (p=0.01), and Picture Memory Recognition (p=0.00), again with patients with PNES scoring higher than those with ES (VL x1=9.27, x2=7.53); LDR x1=9.91, x2-=7.62; PMR x1=10.1, x2=7.46).  On the other hand, no significant differences were seen on other measures of attention (NEPSY-II Comprehension of Instructions, WISC Digit Span, Picture Span, Coding) or memory (WRAML-2 Story Memory, Story Recall, Design Memory, Design Memory Recognition).  Subjective self-report assessments revealed that parents of children with PNES were more likely than the other parents to endorse significant levels of observed ADHD inattention symptoms (≥6/9 - 44% vs 33%).  Similarly, children with PNES were more likely than children with ES to endorse significant levels of experienced ADHD inattention symptoms (≥6/9 - 50% vs 32%).  
Conclusion:
Pediatric patients with ES and those with PNES often present with concerns about attention and memory, whether by self or parent report.  However, these complaints are not always reflected on objective measures.  While pediatric patients with ES demonstrated more difficulty on certain tasks assessing attention and memory, pediatric patients with PNES and their families reported more difficulty on tasks involving attention and memory in daily life.   These findings illustrate the importance of administering both objective and subjective measures of cognitive difficulties to children with ES or PNES to aid diagnosis and treatment planning.
Funding:
:None.