Abstracts

Rationale: Paroxysmal nonepileptic events (PNEs) are frequently encountered in pediatric neurologic fields. But the diagnosis is often confusing. And there is little information about their clinical characteristics. We report out experience with PNEs in pediatric patients who were evaluated with long-term video-EEG monitoring (VEM).Methods: During a 4 year 6-month period, 204 pediatric patients were admitted to the epilepsy monitoring unit and 25 patients (12.3%) were diagnosed as PNEs on the basis of a history and typical events recorded during VEM. A retrospective analysis was done on their medical records and videotapes of the events.Results: Mean age of symptom onset was 8.5 years (4 months~15 years of age) and the patients were divided into two age groups: 1) the infant, toddler, and preschool age group (4 months~6 years) that consisted of 9 patients (36%). The most common findings were normal infant behaviors, hypnic jerks, and normal sleep movements. One patient had the history of hypocalcemic seizure and developmental delay and another perinatal distress associated with preterm delivery, and the others did not have any neurologic problems. 2) The school age and adolescent group (7~15 years) comprised 16 patients. The most frequent diagnoses were pseudo-seizure associated with somatoform disorders (8 patients, 50%) and vasogenic syncope (3 patients). One patient had the history of early onset absence epilepsy and two had concomitant epilepsy.Conclusions: In our study, the pseudo-seizure associated with somatoform disorder were the most common PNEs which were seen in ≥ 9 years of age and its frequency were increasing with age, becoming the most common type of PNEs in adolescents. The physiologic or organic disorders predominated in infant and toddler age group. The concomitant epilepsy and neurologic problems were relatively low in their incidence.