Abstracts

Rationale: Non-epileptic seizures (NES) are defined as paroxsysmal episodes of altered consciousness, behavior, or repetitive movement which may resemble epileptic seizures (ES) but do not result from abnormal neuronal discharges. The prevalence of NES is unclear, but studies suggest that up to 10-20% of children and adults with epilepsy have NES. Distinction between (ES) and NES can be difficult and misdiagnosis is quite common. Accurate diagnosis can reduce administration of unnecessary treatments, shorten or avoid hospital admissions and decrease healthcare-related expenses. The purpose of this study was to evaluate whether medical students can be taught to differentiate ES from NES using an interactive workshop with a neurology resident as an educational tool.Methods: Twenty-two third year medical students on their neurology clerkship participated in a 2 hour interactive epilepsy workshop. The workshop included a PowerPoint presentation and a 25 minute video discussing the classification of seizures and epileptic syndromes, including actual footage depicting complex partial, tonic-clonic, absence, tonic, atonic, and myoclonic seizures. Participants also received a PowerPoint presentation about NES, including video footage of several examples of NES. Time was allotted for questions and discussion with the lecturer. Participants were then shown video footage of ten seizures and were asked to identify them as ES or NES.Results: Participants identified ES and NES with 89% accuracy. They more often misdiagnosed ES as NES (64% of errors). Misdiagnosis of complex partial seizures with secondary generalization as NES accounted for 87.5% of these errors. Ninety-five percent of participants correctly identified absence seizures.Conclusions: Medical students can accurately identify ES and distinguish them from NES using an interactive epilepsy workshop as a teaching tool. The workshop, however, is time consuming and is not always available to students who are training at satellite locations. A web-based, self-study module could be used to make the learning experience more accessible and more standardized. The current study can serve as a pilot study for future research that will evaluate whether students can learn to distinguish ES from NES as accurately using a self-study, web-based teaching module as an instructional epilepsy workshop.