Abstracts

Pseudo-epileptic seizures (PES) with prolonged duration and resistance to short-acting antiepileptic drug may sometimes be taken for a status epilepticus.
Ours goal were to examine (i) the frequency of pseudo-epilepticus status admitted on intensive care units (ICU) among patients with pseudo-epileptic seizures, (ii) the clinical and electrophysiological presentations of these patients and (iii) their comorbidity. We researched among the population of patients with PES, followed in our Epilepsy Unit on a period of 28 months, those who were admitted in an intensive care unit. We examined clinical and EEG presentation of their manifestations, and medical history. (i) We identified 13 patients for which the diagnosis of pseudo-epilepticus status was secondarly done, among 64 patients with PES. Patients were aged from 16 to 58 years, 5 males and 8 females. Diagnosis of PES was done in intensive care unit in 1/13 cases.
(ii) Motor activities were present during PES (n=12). In intensive care unit, EEG was not performed (n=6), showed artefacts during the motor activities (n=2) (that were considered as epileptic for 1 patient), slow waves (n=1), fast activities due to medication (n=1) and was normal (n=3). Eight patients received high doses of AED when admitted on intensive care unit, and three where under respiratory assistance.
(iii) Eleven had chronic psychiatric manifestations and 9 had psychogenic precipitating factors. Three patients have a history of epilepsy. Four patients had previous hospitalisations for pseudo-epilepticus status. Pseudo-epileptic statuses admitted in intensive care units are frequent. Clinical presentation and EEG may be misleading. ICU physicians must be aware of this condition and avoid aggressive treatment.