Abstracts

Psychogenic seizures may be impossible to differentiate from epileptic seizures on the basis of history and clinical features alone. We wondered whether patients were more likely to have non-epileptic seizures if they had a prior close relationship to the medical field. Exposure could be through occupation, education, chronic pain/disability or a family member with epilepsy. Using our database, we performed a retrospective chart review on patients evaluated at the Colorado Neurological Institute Epilepsy center between January 1, 2002 and April 1, 2004. Study subjects underwent inpatient video-EEG monitoring and had psychogenic seizures recorded. Only patients with complete medical, psychiatric, occupational and educational histories were included. A total of 45 patients fulfilled study criteria with 35 females and 10 males. Ages ranged from 16 to 77 years. Seven patients (15.6%) worked in or were trained healthcare related fields. Another twelve (26.7%) were on disability and/or receiving treatment for chronic pain. Five patients (11.1%) had close family members with epilepsy. Ten patients (22.2%) had been sexually/physically abused and four (8.9%) carried psychiatric diagnoses (e.g. bipolar disorder). One patient had undergone successful temporal lobectomy. Two patients were developmentally disabled. Another had concurrent complex partial seizures. Four patients had negative histories and no obvious risk factors. Familiarity with the medical field may be an independent risk factor for the development of psychogenic seizures. This is especially true of the patients without a history of physical/sexual abuse or psychiatric illness. Detailed occupational, educational and family histories can assist in the evaulation of these patients. (Supported by Colorado Neurological Institute)