Abstracts

Rates of childhood abuse, especially sexual, have been assumed higher in-patients with non-epileptic seizures (NES) as compared to people with epilepsy (PWE). Recently this assumption has been questioned by several studies showing no significant differences in childhood sexual abuse between patients with NES and those with epileptic seizures (ES). This study is meant to reexamine the hypothesis that childhood trauma is more prevalent in patients diagnosed with NES compared with PWE. One-hundred sixty-one patients with intractable seizures admitted for differential diagnosis were evaluated during video EEG monitoring at Stanford University[apos]s Comprehensive Inpatient Epilepsy Unit. Childhood trauma and psychopathology were assessed using the Childhood Trauma Questionnaire-short form (CTQ). The CTQ has five sub-scales that measure physical/emotional abuse, physical/emotional neglect, and sexual abuse. Other scales used for evaluation were the Beck Depression Inventory (BDI), Dissociative Experiences Scale (DES), and Symptom Checklist-90 (SCL-90). Patients were classified according to ictal recordings as ES (N=42; events captured with EEG abnormalities), NES (N=66; events captured with no EEG abnormalities), BOTH (N=5; events meeting definition for both NES and ES), UNCLEAR (N=26; events not captured by EEG). Only those patients clearly classified as ES or NES were used in the following analyses, and the number of subjects per analyses varied due to missing data. NES patients (54 women and 12 men) had significantly higher Somatization scores on the SCL-90 than did ES patients (21 women and 21 men), t (78) = -4.32, p[lt] .001. They also had significantly higher scores on the Anxiety and Phobic Anxiety subscales, t(78) = -2.15, p = . 03; t (78) = -3.12, p = .003; respectively. Comparisons of CTQ subscale scores using the Mann-Whitney U test revealed that the two groups differed only on the CTQ sexual abuse subscale (z = -2.03, p= .04), with NES patients endorsing a greater degree of sexual abuse (mean rank = 49.6) than ES patients (mean rank = 39.6). However, a subsequent logistic regression analysis controlling for gender revealed no significant association between childhood sexual abuse and seizure type. The lack of discernable differences between NES and ES groups is surprising, and may reflect the acuity of both groups of seizure patients in this study. Trauma and psychopathology may be risk factors for the development of both intractable epilepsy and non-epileptic seizures. The association between sexual abuse and NES may be also be confounded by the fact that more women than men report histories of childhood sexual abuse, and the NES group was comprised of more women than men. (Supported by Office of Technology and Liscensing Research Incentive Award)