ICNC Abstracts, ICNC 2018

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A Prospective Study of Non-Epileptic Events in Children with Intractable Epilepsy
Shermila Pia, Andrew Mallick, Elliot Warren, Nick Kane

Last modified: 2018-09-15

Abstract


Introduction: Non-epileptic events (NEE) are defined as paroxysmal disturbances of normalfunction which superficially resemble epileptic seizure, but are devoid of EEG findings.Compared to the adult population, studies on children with NEE are limited. While NEE do notrepresent the same medical risks as epilepsy, they can be just as debilitating to patients and theirfamilies.Methods: Prospective study of 264 pediatric patients with intractable epilepsy ages 5 months to17 years enrolled in the Children’s Epilepsy Surgery Service program at Bristol Royal Children’sHospital from 2009 to 2018.Inclusion Criteria: Children with epilepsy diagnosed clinically and with routine EEGwho failed 2 or more anti-epileptic drugs at sufficient doses for over 6 months.Exclusion Criteria: Paroxysmal events that can mimic seizure: syncope, parasomnia,cardiac arrhythmia, or migraineNon-Epileptic Events were diagnosed based on lack of EEG change during videoed eventsconfirmed over 3-5 days by caregivers to be typical attacks. Current vEEG guidelines for thediagnosis of PNES were used.Results: We prospectively identified Non-Epileptic Events (NEE) in 129 patients (49%) of ourobserved population. We report co-occurrence of epilepsy and NEE in 111 patients (42%) whichis higher than the reported occurrence of PNES in other recent reports of pediatric populations.There was no significant difference in surgical outcomes between patients with concurrent NEE-Epilepsy compared with Epilepsy alone.Conclusions: Non-Epileptic Events are commonly found with concurrent epilepsy in pediatricpatients with medically intractable epilepsy. Identification of both non-epileptic and epilepticseizures is key for optimal treatment of these patients but does not preclude good surgicaloutcomes.

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