Abstracts

Rationale: Benign nonspecific symptoms are commonly misinterpreted as seizures in patients who carry a diagnosis of epilepsy. While these do not have a formal name, they are common and belong in the differential diagnosis of seizures. Methods: We reviewed our database of patients with documented generalized epilepsy, by definite interictal discharges or recorded seizures, using the search term "generalized" from which we then selected patients found to have non-epileptic symptoms using the search term "non-epileptic." Patients with clear psychogenic non-epileptic events were excluded. Results: We identified 9 patients over a 15-month period with a confirmed diagnosis of generalized epilepsy: 7 with idiopathic (genetic) generalized epilepsy (IGE) and 2 with symptomatic generalized epilepsy of the Lennox Gastaut type (LGS). Symptoms for which patients were monitored due to concern from family members or providers for breakthrough "seizures" consisted of following: staring spells (3), abnormal sensations (1), body jerks and transitory speech errors (1), left upper extremity tingling and tightening (1), spells of unresponsiveness (1), sudden screaming (1), arm twitching (1). The aforementioned symptoms were recorded and determined to not represent seizures based on 1) lack of EEG changes; and 2) the nature and context of the symptoms. Conclusions: In patients with epilepsy, various benign nonspecific symptoms can be misinterpreted as (assumed to be) seizures by patients, family members, or providers. This is different from clear "psychogenic" symptoms, and underscores the importance for clarification of these symptoms with video-EEG so as to avoid inappropriate increases in antiepileptic doses. Further, as suggested by the 9 cases in 15 months, we suspect this to be a relatively common issue which likely also occurs in patients with focal epilepsies. Funding: None