Abstracts

Rationale: The economic burden of non-epileptic seizures (NES) on the health care system is poorly understood. We hypothesize that delay in the diagnosis of NES results in significant unnecessary costs.Methods: Retrospective study of 50 NES patients admitted to the Epilepsy Monitoring Unit (EMU) at London Health Sciences Centre over 4 years. All the patients underwent video-EEG telemetry.Results: Thirty-eight patients (76%) were females and 12 patients (24%) were males (mean age= 35.3, range 16-67). Eighteen patients (36%) were on disability and 7 patients (14%) were unemployed. Times from the onset of NES to the diagnosis were as following: <1year 13 patients (26%), 1-3 years-13 patients (26%), 3-5 years-4 patients (8%), 5-10 years-6 patients (12%), >10 years-13 patients (26%), undetermined-1 patient (2%). Forty-three patients (86%) were taking antiepileptic drugs (AEDs) but 21/43 patients (42%) had neither epileptiform discharges nor history of epilepsy. From those, 8 patients (16%) were taking 1 AED, 9 patients (18%)- 2 AEDs, 1 patient (2%) - 3 AEDs, and 3 patients - >3 AEDs. The patients were extensively investigated before the diagnosis of NES was made; in particular, 22 patients (44%) had 1 MRI study, 10 patients (20%) had 2 MRIs, 6 patients (12%) had 3 MRIs and 3 patients (6%) had > 3 MRIs.Conclusions: Delay in the diagnosis of NES was common, which led to extensive investigations, unnecessary administration of AEDs, prolongation of the illness, and higher rates of disability and unemployment. Therefore, early diagnosis of NES would avoid unnecessary costs.