Abstracts

Rationale: Psychogenic Non-Epileptic Seizure (PNES) patients are seen frequently in both outpatient epilepsy clinics and inpatient epilepsy monitoring units. Factors linked to PNES often include significant psychological distress characterized by depression and anxiety, a strong focus on somatic symptoms, and poor coping skills. Providing counseling to patients regarding their expected clinical course remains challenging. No clear method exists to clinically stratify PNES patients. Validated scales exist to measure clinical severity and seizure frequency in epilepsy patients and can help to predict outcome. No such widely used metric exists for PNES patients. This study is a preliminary analysis with the eventual goal to develop a metric for PNES patients to predict outcome and guide treatment. We planned this initial analysis to determine which psychosocial variables correlate with seizure frequency with the goal in future studies to correlate these findings with outcome data. Methods: We enrolled 46 PNES patients seen in our Epilepsy Center from 2006-2013. We correlated 26 variables derived from 8 psychosocial scales known to be relevant in PNES with psychogenic seizure frequency data. A significant correlation was measured as a<0.05. Results: Higher seizure frequency is correlated with more somatic symptoms on the Brief Symptom Inventory (r=.344, p=.026), lower self efficacy performing ADLs on the Lorig (r= -.311, p=.048), and worse self-reported physical functioning on the SF-12 (r= -.416, p=.006).Conclusions: We have identified 3 psychosocial variables which may be clinically useful markers of PNES severity in addition to seizure frequency. Because PNES is a disorder involving an abnormality of behavior, the identified somatic or physical variables may be equally or more important than seizure frequency in stratifying disorder severity in this patient population. This finding may be useful to predict outcome and plan treatment strategies and will be tested in our subsequent planned correlations of these data with outcome.