Abstracts

RATIONALE: To determine whether patients with both epileptic seizures and non-epileptic seizures (ES-NES) differ from patients with non-epileptic seizures only (NES) with regard to semiology, EEG, MRI and neuropsychological findings.
METHODS: Between 1991 and 2001, 882 patients were admitted to the Epilepsy Monitoring Unit at Ghent University Hospital for long-term video-EEG monitoring. Seventy-four patients (8.4%) were diagnosed with NES. 15/74 (20.3%) presented with ES-NES. In these patients both ES and NES were documented with video-EEG monitoring. NES and ES-NES patients were compared by assessing the indication for referral (diagnostic versus presurgical), age at first seizure, medical and psychiatric history, AED treatment, interictal and ictal EEG, ictal semiology, MRI and IQ-score.
RESULTS: Clinical characteristics of non-epileptic events did not differ between patients with NES only and ES-NES patients. AED treatment was not different in both groups either. However, NES patients had older age at onset, no MR abnormalities, and were more likely to show depression or other psychiatric problems. All NES patients had normal IQ-scores Several variables were found to be specifically associated with patients who suffered from ES-NES: specific referral for presurgical evaluation, presence of abnormal EEG and MRI findings and high prevalence of mental retardation (IQ[lt]80).
CONCLUSIONS: Although the golden standard for diagnosing genuine ES remains long-term video-EEG-monitoring, the ictal semiology of NES in a particular patient gives little information about whether this patient suffers from NES or ES-NES. However certain aspects of the medical history such as recent seizure onset, co-existance of depression or other psychiatric problems, normal intelligence, normal interictal EEG and normal MRI are associated with the appearance of NES only.
Support: Grants BOZF-01104495 and 011A0996 from Ghent University Hospital, by a grant from the Fund for Scientific Research - FWO Flanders.