Abstracts

Rationale: PNES represent an important alternative diagnosis for intractable epilepsy. The relative frequency of PNES ranged from 10-40%. It is less frequent in males. The clinical manifestations in men are not well characterized. Therefore we compared various clinical findings between men and women admitted to the EMU. Methods: Retrospective chart reviews of all patients admitted to the EMU at JFK hospital from 2003 to 2007 were included. Patients >18 years of age with the diagnosis of PNES were included. The demographic information, seizures manifestations and clinical characteristics were evaluated. There were 12 males (2 records were incomplete) and 33 females (One record was missing). Results: : Records of ten males (9 males < 50 years) and 32 females (27 females <50 years) were included in the study. Seven males and 19 females were younger than 35 years of age at seizure onset; three males and 9 females were between 35-50 years at seizure onset; and 4 females were older than 50 years of age at seizure onset. Seizures occurred daily and weekly in 60% of males and in 50% of females. All males and females presented with clinical seizures that lasted less than 5 minutes; seizures with a duration between 5-10 minutes occurred in 2 men and 19 women; seizures with a duration of 11-20 min occurred in 7 men and 7 women; and seizures lasting longer than 20 minutes occurred only in 6 females. All men (100%) and 75% of women had their clinical events in the first 24 hours after being admitted to the EMU. Twenty-five percent of the women continued to have recurrent spells for more than 2 days. Bilateral motor manifestations occurred in 70% of men and 75% of women. Pelvic thrusting occurred in 10% of men and 17% of the women. Conclusions: The clinical manifestations of PNES are similar across gender with the exception of the longer duration of clinical seizures in female as compared to male patients. Furthermore, we observed recurrent spells throughout the admission period in female patients, while no such recurrence were observed in the male patients after the first 24 hrs.