Abstracts

Rationale: Artwork by patients with known psychogenic non-epileptic seizures (PNES) has been found to have a significantly greater use of colors to depict their seizure experiences on a body outline compared to patients with epileptic seizures. Our previous research "A blinded pilot study of artwork in a comprehensive epilepsy center population" (Epilepsy Behav. 2005 Mar;6(2):196-202.) has indicated an increasing positive predictive value for PNES; 80% positive prediction if 10 colors of the 12 available were used. If these artistic traits are specific to PNES patients, it may become a simple but useful tool to help identify patients with a likelihood of having psychological events. Our primary objectives are: 1) to confirm the relationship between the number of colors used and PNES diagnosis, 2) observe the positive predictive value at higher number of colors used, and 3) to validate our body outline art as a unique clinical aid in the diagnosis of neurological versus psychogenic non-epileptic seizures. Methods: From March 2009 to May 2010, patients between the ages of 18 and 70 years undergoing continuous video-EEG monitoring at St. Charles Hospital (Port Jefferson, NY) were invited to participate. The subjects were given a standard box of 24 colored pencils, a blank sheet of paper with a sex appropriate front- and back-view body outline, and directions to express how your seizures make you feel . The subject s diagnosis was acquired after completion of the study. Logistic regression was used in prediction of the number of colors the patients used in their drawings to have PNES. Results: Currently, 31 subjects have completed this study. There were 5 cases of PNES, 15 cases of epileptic seizures, 6 non-psychogenic non-epileptic events, 5 inconclusive diagnoses, and 1 pending diagnosis. Epilepsy diagnoses included: partial onset seizures (3), complex partial seizures with temporal focus (9), and generalized seizures (3). One subject presented with both PNES and complex partial seizures, and was included in both PNES and epilepsy groups. Subjects with non-psychogenic non-epileptic events (including sleep myoclonus, hypoglycemia, and one time seizure), inconclusive or pending diagnoses were not included in our analysis at this time. Preliminary results based on the current population (n = 20) indicated that no statistical significance has been attained between the number of colors used and PNES diagnosis (P = 0.366; odds ratio = 1.17). Conclusions: Preliminary results show no significant difference between the PNES and epilepsy groups. These findings differ from our previous similar study. This may be due to a smaller sample size or from a difference in patient population. A stronger conclusion is expected with the enrollment of more subjects.