Abstracts

Limited information is available on phenomenology of childhood non-epileptic seizures (NES) by developmental stages. We have studied the clinical characteristics of non-epileptic seizures (NES) in children to determine if the clinical manifestations are different in children younger than 13 years age as compared to the older children., Retrospective review of medical records and video-EEGs of all patients with NES confirmed on video-EEG monitoring at Indiana University from April 2002 to December 2005., 1,967 patients were monitored in the video-EEG unit during this period. 68 patients (3.5%) had a clinical diagnosis of NES. We present data on 59/68 patients who had their habitual event recorded during the video-EEG monitoring; 9 patients did not have their habitual event during the Video-EEG study. Mean age at the time of the video-EEG diagnosis was 13.3 years (range 5years 6 months to 19 years 6 months). Mean duration of symptoms prior to the diagnosis of NES was 6.8 months (range 3days to 3 years). In our study 37 of the 59 patients (62%) were females. 22 patients were less than 13 years of age (group A) and 37 were 13 years and older (group B). In group A male to female ratio was equal (11 patient each) while in group B there were more females (26 females and 11 males). Interpersonal conflicts, school related stress and family discord were the most frequent stressors in both groups. Sexual abuse was the least frequent. Cognitive dysfunction was present in 15/22 (68%) in group A and 7/37 (19%) in group B. 2/22 (9%) in group A had depression as compared to 13/37 (35%) in group B who were depressed. 15/22 (68%) in group A had epilepsy (partial epilepsy in 80%) in contrast to 11/37 (29%) in group B (partial in 45%). Prominent motor activity was more likely with NES in group B (32/37, 86%)., We found that there were more females with NES in the older than 13 yrs age group while this gender difference was not seen in the younger children. In addition the clinical characteristics of NES are different in younger children as compared to older children. Distinct risk factors for the younger age group included cognitive dysfunction and diagnosis of epilepsy, whereas for the older children, depression and prominent motor activity were associated with NES. These findings have implications for the identification of non-epileptic seizures in children and their management in this age group.,