Abstracts

Rationale: While women constitute the majority of patients with psychogenic non-epileptic seizures (PNES), recent studies have begun to focus on men with this condition. We sought to compare men with PNES to women with regard to demographics, risk factors, psychiatric history, spell frequency and semiology, number of antiepileptic drugs (AEDs) used, and neuropsychological data. Methods: Out of 310 males monitored at a tertiary epilepsy center between 1/2002 and 5/2008, 30 were identified as having likely nonepileptic seizures; of these, 14 with "confirmed" PNES, defined as having at least one typical event, spontaneously recorded and characterized by impaired responsiveness that was not clinically suggestive of frontal lobe epilepsy, and with no corresponding electrographic seizure activity. The remainder had physiological events (3) (i.e., syncope, sleep disorder), both PNES and ES (1), and indeterminate monitoring (12), and were excluded. A control group of 14 women with PNES were identified by choosing the next monitored female patient who met above criteria, from a total of 504 women monitored in the same time period. Nonparametric tests were used to compare groups. Results: Men with PNES were similar to women with PNES regarding age, race, years of education, employment, marital status, history of anxiety or depression, substance abuse, number of AEDs, frequency and semiology of spells, and brain imaging. Men were more likely to have normal as opposed to nonspecifically abnormal electroencephalograms (EEGs) (p <0.05), while women reported a higher prevalence of headaches apart from their episodes (p<0.005). There were no significant differences in scores on the Beck Depression Inventory, Quality of Life in Epilepsy (QOLIE-31), or verbal and performance intelligence quotient. While not significant, there was a trend toward more men with history of psychotic disorders (3/12 men, with data not available for 2, vs. 0/14 women), and with presentations in pseudostatus (3/14 men vs. 0/14 women).