Abstracts

Rationale: Psychogenic non-epileptic seizures is an area of increasing interest in the field, with estimates of 1 to 9% among children with suspected epilepsy. Increased attention has been given to research with this group, to aid assessment and treatment planning. Previous research has focused on emotional and psychological factors likely contributing to such, including a tendency for somatization and co-morbid signs of depression, anxiety, behavioral disorders, and ADHD. Little research however has focused on the cognitive functioning of these children. This is important as they often present with academic difficulties. Plioplys et al, 2014 found average levels of cognitive and academic functioning, using the WASI and the WRAT. Cvitanovic-Sojat et al, 2010 found significant differences between children with epilepsy versus non-epileptic seizures; however, no data was given on the levels of functioning for the latter. Lancman et al., 1994 found signs of normal IQ for most cases. This study examines cognitive functioning among children with PNES in greater depth, focusing on IQ and academic skills as well as attention, memory, and executive functions. Parental measures are also examined. Potential impact on academic functioning is discussed. Methods: A total of 18 cases of children with a diagnosis of PNES based on VEEG monitoring and neuropsychological assessment were included in the study, with 6 males and 12 females. The age range was 8 to 15 years. Children completed the WISC-IV, CVLT-C, BYI-2, and certain subtests of the NEPSY-II, CMS, D-KEFS, and WIAT-III. Parents completed the CBCL to obtain measures of mood, anxiety, and ADHD symptoms. Means, standard deviations, ranges, and percentages were computed using Excel. Results: Means of IQ scores were consistently at low average to average levels. Means on tasks of attention, memory, and executive functioning were consistently at low average to average levels. Means on measures of academic skills were consistently at low average to average levels. Means on parental measures of ADHD symtptoms were consistently at borderline to clinical levels. Means on self-report measures of mood and anxiety were consistently at non-clinical levels. Means on parental measures of mood and anxiety symptoms were consistently at borderline to clinical levels. Conclusions: These findings demonstrated no consistent signs of impairment for cognitive functioning or academic functioning for children with PNES. Findings of normal functioning regarding IQ and academic skills were consistent with prior research. This study provided new findings however regarding a lack of impairment for attention, memory, and executive functions. These findings were supportive of the notion that any academic issues are more related to school absences or emotional factors than any underlying learning disorders or cognitive dysfunction. These findings suggested a different cognitive pattern for children with PNES than with epilepsy, which suggests some clinical utility. However, a limitation of the study was the low subject number. A future study comparing means, with greater numbers, may provide more information regarding different patterns of the two groups, which may also be used in development of a battery for assessment and aiding diagnosis and of treatment recommendations. Findings of significant ADHD, mood, and anxiety symptoms by parental report were also consistent with prior findings. In contrast, there were no signs of clinical levels of mood or anxiety symptoms by self report, raising concerns regarding lack of awareness, denial, or under-reporting by these children. This underscores a need for using both parental and self-report measures, not only for diagnostic purposes but also for charting progress. Funding: N/A