Abstracts

RATIONALE: Estimates of the prevalence of nonepileptic seizures (NES) range from 3 to 20% of outpatient epilepsy populations. Simultaneous video-EEG monitoring has greatly facilitated the identification and diagnosis of NES in recent years. Currently, there are few studies examining the treatment outcome of NES. The first step in treating NES is to present the diagnosis to patients and their families in a way that is understandable and facilitates treatment of the underlying disorder. In fact, there is some literature to suggest that after being presented with the diagnosis and some basic educational information, NES resolve without further treatment in a portion of patients. Further study on how to present the diagnosis to patients, as well as the short and long-term outcome of NES is needed.
Objective: Based on this poster presentation participants should be able to discuss one approach to presenting the diagnosis of nonepileptic seizures to patients and its likely acute effects on seizure frequency.
METHODS: In the current study, we examined the frequency of seizures captured while individuals were hospitalized for video-EEG recording. We compared the number of NES within the 24-hour period prior to diagnosis, with the number of events that occured within the 24-hour period after patients have been presented with the diagnosis. The protocol used to present the diagnosis followed the detailed and comprehensive protocol developed by Shen et al. (Neurology, 1990; 40).
RESULTS: During the 24-hour period prior to diagnosis, the individuals in this study had, on average, 2-3 NES. Seven of nine patients had no further NES within the 24-hour period after they had been presented with the diagnosis. Our clinical findings demonstrate that there is a significant reduction in the number of NES within the acute 24-hour period after presentation of diagnosis.
CONCLUSIONS: Results suggest that at least acutely, the provision of a diagnosis of NES using the Shen et al. protocol appears to be useful in reducng the frequency of NES. The presentation of the diagnosis is likely to be an important first-step in the long-term remediation of NES. Future research should examine outcome on a more long-term basis and attempt to identify factors that distinguish individuals who go on to continue having NES versus those who do not.