Abstracts

This study compares patients with verified epileptic seizures (ES) and non epileptic seizure like events (NESLE), based on information obtained in clinical interviews, to determine which historical variables most reliably distinguish between these groups. All patients who were admitted for video EEG monitoring at Allegheny General Hospital between December 1998 and December 2004 and had a report, from at least 24 hours of video EEG monitoring, that suggested either an epileptic seizure or a non epileptic event were included. All patients admitted for monitoring were seen for a clinical interview by the first author. Data were coded based on that clinical interview including whether or not patients reported 1) pending litigation, 2) pending application for disability, 3) marital discord, 4) an unstable work history, 5) history of working in healthcare, 6) significant abuse or psychosocial stress during childhood, 7) history of sexual abuse, 8) current family conflict, 9) history of antisocial behavior, 10) history of delinquincy in childhood, 11) family history of seizures, 12) family history of mental health problems, CFS, or fibromyalgia, 13) family history of alcohol abuse, 14) incontinence during events, 15) history of self injury during an event, 16) events during sleep, 17) psychotropic medication at time of evaluation, 18) that events are related to stress, 19) history of psychiatric hospitalization, 20) history of panic disorder, 21) history of other anxiety disorder, 22) history of depression, and 23) history of other psychiatric diagnosis. Data were subjected to chi square analysis to determine whether there were significant between group differences. Of the 153 reports of monitoring available for review, 65 recorded seizures and 56 recorded NESLE. In the other cases patients did not have events or events were not clearly classified. There were significant between group differences in patient report of 1) marital discord, 2) significant abuse or psychosocial stress during childhood, 3) history of sexual abuse, 4) family history of mental health problems, CFS, or fibromyalgia, 5) family history of alcohol abuse, 6) psychotropic medication at time of evaluation, 7) history of psychiatric hospitalization, 8) history of panic disorder, 9) history of other anxiety disorder, 10) history of depression, and 11) history of other psychiatric diagnosis. Many variables previously suggested to distinguish between patients with ES and NEE were not found to be significantly different in our two patient groups. The variables that did differ in the two groups suggest patients with NESLE are more likely to report histories of significant stress and abuse during childhood, current isues with relationships, and psychiatric diagnoses and treatment.