Abstracts

Rationale: Psychogenic nonepileptic seizures (PNES) are the major causes of nonepileptic paroxysmal events (NPEs). However, there are many other reasons of NPEs in the pediatric population. And moreover, actual epileptic seizures are occasionally mistaken for PNES. The aim of our study was to review the final diagnosis and clinical outcomes, of the pediatric patients who was diagnosed with NPEs Methods: We retrospectively reviewed the hospital chart of 48 patients who diagnosed with NPEs from January, 2005 to December, 2011. Results: The mean age of patients at diagnosis was 11.13±5.04 years and the male to female ratio was 1.8:1. Video electroencephalography was performed in 33 patients. The results were normal in 93.9%(31 of 33),and epilepsy in 2 patients. Provocation test was performed in 15 patients, 10 patients had seizures in response to suggestion and intravenous saline injection. The final diagnosis were as follows: PNES(n=25, 52.1%), epilepsy(n=4, 8.3%), psychosis(n=3, 6.2%), chorea(n=2, 4.2%), tic(n=2, 4.2%), and others (migraine, parasomina, side effect of drugs, autonomic symptoms, infantile masturbation, shudder attack, and jitterness). Before the final diagnosis, 27 patients had taken antiepileptic drugs. Twenty-three patients diagnosed with NPEs(23 of 44, 52.2%) were exposed to unnecessary antiepileptic drugs. High percentage of patients(n=20, 41.7%) were lost at follow-up after accurate diagnosis, and 60% of these patients were PNES. After a mean period of 14 months of follow-up in 28 cases, 21 cases(75%) were symptom free. Conclusions: In our pediatric patients, there are various causes of NPEs. Video electroencephalography was helpful to differentiate these mimics from epilepsy. Although the overall prognosis of NPEs in the follow-up groups was good however, there were many lost patient after diagnosis.