Abstracts

Rationale: Over the last decades, adults and children with PNES have substantially been studied by VEEG monitoring to determine the clinical features of PNES (Brown RJ et al., 2011; Hema Patel et al., 2007). However, a small number of studies have focused on annual presentation of PNES and how soon, after VEEG recording initiation, the first PNES occurred (Parra J et al., 1998; Lobello K et al., 2006; Friedman DE et al., 2009; Margaret W et al., 2010). Our aims are: (1) to compare time from admission to first PNES in adults and teenagers and (2) to identify annual variations in the presentation of PNES in adults and teenagers. Methods: We retrospectively reviewed charts adults and teenagers diagnosed with PNES between 7/1/2010 and 6/30/2011 in the Epilepsy Monitoring Unit of University Hospitals Case Medical Center and Rainbow Babies and Children's Hospital. Forty patients (27 adults and 13 teenagers) were eligible for analysis. Time from onset of EEG recording to first PNES and month of the first PNES were the variables studied. Results: 66.7% (18 of 27) of adults and 92.3% (12 of 13) of teenagers were able to report the month of PNES onset. Peak months of presentation for teenagers were March and October (23% each) followed by July and September (15% each). For adults, peak of presentation were June (22%) followed by August, September and December (16% each). Time from admission to first PNES recorded was different between adults and teenagers (Figure 1). 59% of the adults have first event after 6 hours of admission whereas 50% of teenagers have the first event in less than 5 minutes from recording and 100% had the event before 6 hours. Conclusions: In our study, the PNES in adults peaked around approaching summer months (June) and remained high at the onset of fall (August) and remained at the same level until the end of the year. We do not know what life events provoked these changes in adults. One explanation could be the onset of fall season as it has been described in other psychiatric conditions. PNES in teenagers peaked around spring break (March) as well as the end (June) and onset (September-October) of academic year. It seems that onset and end of the academic year are obvious stressor in teenagers. We found a significant difference regarding time to admission to first event in teenager compared to adults. Half of the teenager group had the first PNES within the first 5 minutes of VEEG recording whereas more than half had of the adults had it after 6 hours of recording. More data regarding the nature of the stressors will be needed to interpret this data.