Diagnostic Yield of 8-Hour Video-EEG in Detecting Psychogenic Non-Epileptic Spells (PNES): An Interim Analysis
Abstract number :
2.003
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2019
Submission ID :
2421454
Source :
www.aesnet.org
Presentation date :
12/8/2019 4:04:48 PM
Published date :
Nov 25, 2019, 12:14 PM
Authors :
Roohi Katyal, University of Oklahoma Health Sciences Center; Claire Delpirou Nouh, University of Oklahoma Health Sciences Center; Sarah P. Whitson, Oklahoma University College of Medicine; Austin Clanton, Oklahoma University College of Medicine; Chao Xu,
Rationale: PNES are characterized by paroxysmal episodes resembling epileptic seizures yet lacking electrical correlation as measured by the gold-standard diagnostic approach, video- electroencephalography (vEEG). Delay in the diagnosis of PNES is often more than several years after initiating treatment for epilepsy. Additionally, there is a high cost to this delay in diagnosis. Methods: We performed a retrospective chart review of all patients with age ≥ 4 years who were admitted to the Epilepsy Monitoring Unit (EMU) (adult and pediatric) at our institution over a 3-year period (n=261). We calculated the incidence of patients diagnosed with PNES within the first eight hours of EEG recording and measured a rate by comparing it to the total incidence of patients diagnosed with PNES during entire EMU admission. Additionally, we also studied associated risk factors for patients diagnosed with PNES as compared to epileptic seizures. Our final analysis will include a larger sample size from data collected over a 7-year period. Results: Out of a total of 261 patients included in the study, 26% (n=68) had at least one PNES event during their entire EMU admission. 11.5% patients (n=30) had a PNES event within the first eight hours of EEG recording. The incidence rate of diagnosing PNES with 8-hour EEG was 44% (30 out of 68 patients). Patients with PNES had higher association with chronic pain (42.6% vs. 20.2%; p = <0.001) and prior psychiatric diagnosis (67.6% vs. 50.3%; p = 0.02). Among patients who had PNES within first eight hours, there was a higher percentage associated with chronic pain compared to patients who had PNES after eight hours of EEG recording, however, the association was not statistically significant (57.1% vs. 44.3%; p = 0.14). Conclusions: Our interim analysis suggests a good diagnostic yield of 8-hour video-EEG in diagnosing PNES as nearly half of the patients who had a PNES event, had an event in the first eight hours of EEG recording. Our final analysis with a larger sample size will further help validate these findings. Funding: No funding
Neurophysiology