Abstracts

Rationale: Little is understood about risk factors for pediatric non-epileptic seizures (NES), a disorder with significant morbidity. Retrospective studies report learning or attention problems in 67% of NES children despite average IQ in 80% of this sample. This multisite study examined if NES children have undiagnosed learning challenges and compared learning disorder (LD) diagnoses, cognition, language, and academic achievement in NES children and their siblings. It also assessed the number and type of other comorbid psychiatric diagnoses associated with a LD diagnosis in the NES and sibling groups. Methods: NES participants were of school age (8 18 years) with confirmed typical NES episodes on video EEG. In this preliminary analysis, 22 NES and 22 siblings underwent structured psychiatric interviews, and standardized cognitive, language, and achievement testing. Chi-square analyses were used to examine differences in learning and psychiatric diagnosis distribution. Mixed models were applied to groups on cognitive, linguistic, and achievement measures, using family as a random effect. Within groups, non-parametric analyses were conducted.Results: Of the NES participants, 15 were female and 7 were male and sibling controls included 11 females and 11 males. Structured psychiatric interviews identified a similar high rate of LD NOS in 13 (59.1%) NES and 10 (45.5%) siblings. Nevertheless, parents reported learning difficulties in only one NES and one sibling. Standardized cognitive, language, and achievement scores revealed mean scores in the average range. The NES group (95.5%) had significantly more subjects with a psychiatric diagnosis than the siblings (72.7%) (p = .04). A LD diagnosis was unrelated to the presence of other psychiatric diagnoses in the NES group. In siblings with LD, 44.4% had a disruptive behavior diagnosis, mainly attention deficit hyperactivity disorder, compared to 7.7% of sibs without LD (p=.04). Despite co-occurring conversion disorder in all NES patients with LD compared to 1 sib, LD was not significantly associated with this diagnosis. Conclusions: Although NES children have high rates of LD, it is under-reported by parents and not evident on standardized test scores. Recognition of learning difficulties in this population might result in earlier, accurate diagnosis of NES. Implications for future studies include assessing and appropriately managing LD in NES children and exploring the methods used to cope with LD in NES and their sibs.