Abstracts

Rationale: Non-Epileptic Seizures (NES) are a common neurological presentation with a prevalence of 2 to 33 per 100,000, numbers similar to Multiple Sclerosis! They are highly refractory form of seizures and antiepileptic medications are ineffective. Treatment options are limited, and while the evolving standard of care is Cognitive Behavioral Therapy, barriers persist including poor access/high cost, poor insight of the patient, high stigma, and few mental health providers comfortable taking on conversion disorder patients. Acupuncture is felt to be safe and cost effective, and Auricular Acupuncture has specifically been studied in cocaine dependence, smoking cessation, dental anxiety, and PTSD. Acupuncture has also been used to treat other conversion disorders, including psychogenic erectile dysfunction, and psychogenic movement disorders. There are no available studies examing the use of acupuncture in a NES population, and this pilot study was implemented to inform the design of a future efficacy study. Methods: Baseline seizure frequency was recorded in diary for 1 month following enrollment. Active treatment of NADA protocol was delivered by PI twice weekly for 8 consecutive weeks (16 treatments). Diary data was collected at each visit and entered into REDCap. Final visit was 1 month washout. Inclusion/Exclusion: Age ≥ 18 to 75, Diagnosis of NES by EEG/EMU, Freq ≥ 2 sz per month Statistical Method: Simple statistics were used to assess demographic data, tolerability of treatment protocol, defined as completion of 12/16 treatments, compliance with diary entries, and seizure count changes. Results: A total N = 23 patients enrolled between 11/2012 to 5/2014. Five withdrew from study prior to first treatment. Three patients are currently enrolled but not completed, resulting in 15 patients for analysis. Mean age 41 ± 11, males 6 (26%) female 17 (74%). Race breakdown: White 21 (92%) Black 1 (4%) Other 1 (4%). Hispanic Ethnicity 11 (48%). The number of patients completing 12/16 treatments was 13/15 (87%). The average percent of diary dates completed 85% ± 21%. Seizure Count reduction from baseline through treatment period occurred in 14/15 (93%). Adverse Events include: Nausea (5), Dizziness (4), Headache (6), Pain/Tenderness (8), Skin Irritation (1) Weakness (0), Panic (3), Seizure (9), Hospital Visit (2). Conclusions: •The results of this pilot study suggest the acupuncture protocol and treatment scheme are tolerable and produce minimal side effects. •The diary completion rates suggest that this patient population can be compliant with typical antiepileptic therapeutic trial design. •The results suggest a trend toward decreasing NES frequency during active treatments with auricular acupuncture. •Taken together, these findings may be used to inform the design of a large efficacy trial investigating the use of auricular acupuncture for NES