Abstracts

Rationale: Spanish-speaking American patients with epilepsy and/or with psychogenic non-epileptic seizures (PNES) remain an understudied group. Deficits in the areas of language and executive functioning have typically been found among those patients with epilepsy. Deficits have also been seen in the areas of processing speed, naming, verbal recall, and visual recall. Similar to English speaking patients, correlations have been found between site of MRI lesion and material specific memory. Prior research comparing the neuropsychological profiles of English speaking patients with ES and PNES has been variable, with some research demonstrating memory problems to be more prominent among those with ES and attention and executive problems more prominent among those with PNES. No studies to date however have compared neuropsychological functioning for Spanish-speaking patients with epilepsy (PWE) to those with PNES (PWP). The purpose of this study is to compare Spanish-speaking patients with epilepsy to Spanish speaking patients with psychogenic non-epileptic seizures on measures of cognitive functioning. Methods: This is a retrospective study of 80 patients with epilepsy (50 women, 30 men, 2004 to 2017) and 32 patients with PNES (28 women, 4 men, 2004 to 2017). All patients were Spanish-speaking and of Hispanic ethnicity. The diagnosis of epilepsy or PNES was confirmed with video EEG. All patients were administered a full neuropsychological battery in Spanish, including but not limited to: Bateria III Woodcock-Munoz, Color Trails Test, WAIS-III Digit Span subtest, Continuous Visual Memory Test (CVMT), WHO/UCLA Auditory Verbal Learning Test (WUAVLT), and the Test of Memory Malingering (TOMM). Demographic and clinical (psychological trauma, depression, anxiety, seizure frequency, and number of anti-epileptic drugs) data were collected. Patients scoring below 70 on the Woodcock-Munoz were removed from analyses. Scores between the two groups were analyzed using t-tests and chi-square analysis. Results: Patients with epilepsy (x̄ =7.42, SD 1.64) differed significantly from patients with PNES (x̄ = 8.25, SD 2.34); t(-1.9865), p= .049915 on a measure of attention (WAIS-III Digit Span). Otherwise, no significant differences were seen on other measures of effort, attention, or memory. However, it should be noted that in the area of effort, the mean score for PWE was at a level raising questions regarding effort (with 44% scoring below the cut off), whereas the mean score for PNES was not (with 24% scoring below the cut off). Chi square analysis indicated that this difference was not significant. Conclusions: A significant difference was seen between Spanish-speaking, American PWEs and PWPs, with lower scores for the former on a measure of attention. This is somewhat in contrast to prior studies demonstrating attention problems to be more prominent among those with PNES. While more PWEs than PWPs were below the cutoff raising questions regarding effort, the difference between the groups was not significant, both somewhat in contrast to prior research. The other results however were consistent with some prior research demonstrating no differences between the groups. Cross cultural studies such as this one can contribute important information regarding the universality of aspects of PNES even within different ethnicities as well as raise questions for further study. Funding: No funding