Abstracts

Rationale: The prevalence of patients with non-epileptic seizures (NES) ranges from 2-33 per 100,000 individuals in the general population, and the cost of direct and indirect care for patients with NES are comparable to that of care for patients with intractable epilepsy. Therefore, it is critical that we have reliable indicators for NES in order to establish accurate diagnosis early. Some investigators have proposed observable signs of NES such as ictal eye closure, pelvic thrusting, and "teddy bear" sign. Others have found that patient-reported data including age of first spell, psychiatric disorders, and marital instability provide high predictive value for NES. In this study, we explored the possibility of using number of patient-reported allergies as a potential indicator for NES. The primary goal of this study was to investigate if adults with epileptic seizure (ES) will self-report greater number of allergies compared to adults with NES. The secondary goal was subgroup analysis of self-reported allergies based on gender difference within each ES and NES groups. Methods: This retrospective cohort study collected data from 1,635 epileptic monitoring unit (EMU) reports of adult patients (age ≥18) from the Barrow Neurological Institute, dating from 2006 to 2013. We reviewed the number of allergies reported by each patient and the final conclusion of the EMU admission. Conclusion of each admission was classified either as ES or NES. Patients with ambiguous events, no captured events, and those with both ES and NES were excluded from this study. Patients were divided into four groups: female ES (f-ES), male ES (m-ES), female NES (f-NES), and male NES (m-NES). We used one-tailed T-test when comparing the number of allergies between NES to ES and two-tailed T-test when comparing the gender difference within each ES and NES groups. Results: There was a total of 630 f-NES, and 252 m-NES patients within NES group (n=882), and 443 f-ES and 310 m-ES patients in ES group (n=753). The mean reported number of allergies were 1.91 for f-NES (SD = 2.71), 1.14 for m-NES (SD = 1.56), 0.87 for f-ES (SD = 1.73), and 0.49 for m-ES (SD = 0.99). Number of allergies reported by NES patients was significantly greater than that reported by the ES patients (p < 0.001), regardless of gender. However, clear gender difference was noted within the two diagnosis groups, with females reporting greater number of allergies in NES (p <0.001) and ES (p < 0.001). Conclusions: This study provides evidence that patients with NES self-report greater number of allergies than patients with ES. Furthermore, significantly greater number of allergies was reported by the female than male, regardless of the diagnosis of NES or ES.