Abstracts

Rationale: Female patients with a history of epileptic seizures (ES) and non-epileptic seizures (NES) often report a history of abuse or trauma, including rape. Similar experiences are less well studied in female patients who are considered non-diagnostic (Non-Dx) after a comprehensive neurological evaluation. Methods: Seventy-three consecutive female patients admitted to the Barrow Neurological Institute (BNI) epilepsy monitoring unit (EMU) for event classification were administered a standardized medical/psychological interview as part of their comprehensive neurological evaluation. Patients were asked to report a history of sexual, physical, and emotional abuse and rape. A sub-sample of these patients completed the Minnesota Multiphasic Personality Inventory-2nd edition (MMPI-2). Patients underwent in-patient monitoring and a final diagnosis was rendered in 1 of 5 categories: ES, NES, mixed epileptic and non-epileptic (ES-NES), Non-Dx defined as no events occurring after a prolonged period of monitoring with no interictal background abnormalities, and other physiological events (Other). Results: Age of onset of events was found to be predictive of diagnosis of ES versus NES (p=0.0007). Age of onset in the NES and Non-Dx groups was not significantly different (p=0.88). A significant between group difference on history of abuse and rape was not found between the ES, NES and Non-Dx groups. Fifty-five percent of the ES sample reported a history of abuse. The incidence of abuse and rape in the NES and Non-Dx groups was 77 and 73%, respectively. Clinical elevations were not detected on the MMPI-2 for the ES group. In contrast, psychological profiles for both the NES and Non-Dx groups revealed elevations on the Hypochondriasis, Depression, Hysteria and Schizophrenia scales. Conclusions: The inclusion of a Non-Dx category is a unique aspect presented in this study. A significant between group difference between the NES and Non-Dx groups was not found in age of onset of events, percentage of abuse and rape, or in elevations on the MMPI-2. These results contrasted significantly between the NES and Non-Dx and the ES group. Results suggest that patients in the Non-Dx group are more likely to represent NES patients. Results have significant implications for the post-monitoring management of Non-Dx patients.