Abstracts

Rationale: The presence of non-epileptic seizures (NES) in a pediatric neurology clinic has been studied frequently in clinical practice. In patients with documented epilepsy, the coexistence of non-epileptic and epileptic events is still unclear. That is of significant importance, since NES will not benefit from an increase or a change in the dose of antiepileptic drugs (AED). We wanted to analyze the occurrence of both diagnoses (epileptic and non-epileptic seizures) in pediatrics. Methods: We evaluated a child population of 1150 cases with diagnosis of epilepsy who were seen between May 2012 and April 2014 in a pediatric neurology clinic with academic affiliation. All the cases were less than 18 years of age at the time of diagnosis and had at least 1 year of follow up. Results: 14 cases of non-epileptic seizures were collected. Since all the patients had a diagnosis of either generalized or partial epilepsy, all of them were treated with anticonvulsants at 1 year follow up. In all the cases the family members were convinced that the events were related to the main diagnosis of epilepsy. Issues about medication titration were the main family concern at the clinic. The nature of the episodes included breath-holding events in 4 cases, psychogenic non-epileptic seizures (PNES) in 7 cases, and 3 events of syncope. The risk of recurrence was moderate in syncope, high in breath-holding events, and very high in psychogenic non-epileptic seizures. Conclusions: The most frequent form of epilepsy found with patients having PNES was partial events with temporal lobe origin; meanwhile, breath-holding and vasovagal syncope were mostly associated with patients with generalized seizures. In our study, no significant association of generalized epilepsy and psychogenic seizures was identified. We conclude that the association of non-epileptic seizures with pediatric epilepsy cases is not uncommon, and correct identification of the nature of the event is paramount, considering family members will have a tendency to consider any paroxysmal event as part of the underlying epilepsy diagnosis.