Can multiple drug allergies predict the final diagnosis in patients undergoing video-EEG monitoring?
Abstract number :
3.285
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2010
Submission ID :
13297
Source :
www.aesnet.org
Presentation date :
12/3/2010 12:00:00 AM
Published date :
Dec 2, 2010, 06:00 AM
Authors :
Derrick Robertson and A. Bozorg
Rationale: To determine if there is an association between an increased number of medication allergies and psychogenic non-epileptic attacks (PNEA). Methods: We retrospectively reviewed the charts of all adult patients (older than 18 years) admitted to the long-term VEM unit at Tampa General Hospital (TGH) in Tampa, FL from January 1st 2009 to December 31st 2009. All the VEM were interpreted by an attending epileptologist prior to inclusion for the study. We recorded the number of medication allergies documented on the chart along with the final diagnosis upon the completion of VEM recording. Patients with concurrent diagnosis of PNEA and ES were excluded. We divided the patients arbitrarily into three groups: A) patients with 2 or 3 drug allergies B) patients with 4 or 5 drug allergies C) patients with 6 or more drug allergies. Results: Eighty-three patients met the inclusion criteria. Forty-seven patients fell into group A, 49% (n=23) of whom were conclusively diagnosed with PNEA. Nine patients (19%) in group A were diagnosed with ES. Fifteen patients (32%) had a non-diagnostic study. Twenty-five patients fell into group B, 68% (n=17) of whom were diagnosed with PNEA on VEM. Five patients (20%) in group B were diagnosed with ES. Three patients (12%) had a non-diagnostic study. Lastly, eleven patients fell into group C, 82% of whom (n=9) were diagnosed with PNEA, and the remaining 18% (n=2) were diagnosed with ES. Eight patients were excluded owing to concurrent diagnosis of ES and PNEA on VEM. The p-values revealed the results were not statistically significant. Conclusions: Increased number of documented allergies appears to be an independent predictor of PNEA. We observed a clear trend of increasing likelihood of diagnosis of PNEA when the number of drug allergies increased. This information can be used to screen patients for admission to the VEM unit. Patients with 4 or more allergies can undergo an outpatient VEM with activation in hopes of obtaining the correct diagnosis, before proceeding to inpatient VEM.
Cormorbidity