Nonepileptic Seizures in Children

Abstract

SUMMARYPurpose: To determine if the clinical characteristics of nonepileptic seizures (NES) are different in children younger than 13 years age as compared to adolescents. Methods: Retrospective review of medical records and video-EEGs (VEEG) of all patients with NES confirmed on VEEG monitoring was performed. Results: Sixty-eight (3.5%) of 1,967 patients monitored with VEEG had a clinical diagnosis of NES. Fifty-nine of 68 patients had their habitual event recorded. Mean age at the time of the VEEG diagnosis was 13 years 4 months. Twenty-two patients were less than 13 years (group A) and 37 were 13 years and older (group B). The male to female ratio was equal in group A, with female predominance seen in group B. NES commonly manifested as subtle motor activity in group A (p < 0.01) and prominent motor activity in group B (p < 0.001). Difficulties at school, family discord, and interpersonal conflicts, were frequent stressors in both groups. Sexual abuse was the least frequent. Depression was more common in group B; cognitive dysfunction (p < 0.001) and epilepsy (p < 0.01) were more common in group A. Conclusions: Differences in clinical semiology and predisposing factors may help identify young children and adolescents who might be at risk for the development of NES. KEY WORDS: Pseudoseizures-Epilepsy-Video-EEG.Nonepileptic seizures (NES) are nonepileptic events that may resemble epileptic seizures, but are not associated with abnormal cortical electrical discharges. They should be suspected whenever the attacks are frequent despite appropriate medical management, have atypical clinical features and are exacerbated by stress and when EEGs are repeatedly normal. A variety of terms have been used in the literature to describe these events, including pseudoseizures, psychogenic seizures, hysterical epilepsy, pseudoepileptic seizures, and nonphysiologic or functional seizures. We prefer to use the term NES, because it is more neutral. NES have been described extensively in the literature mainly in adults and less frequently in chil-

Social participation in young people with nonepileptic seizures (NES): A qualitative study of managing legitimacy in everyday life

“…Seven of these twenty-nine also had learning difficulties. These findings are in agreement with other studies [19,20]. The prognosis in children is significantly better than in adults.…”

Psychogenic nonepileptic seizures and movement disorders

“…29 For both disorders, there is a predominance of women (74%-90% among PNES 30 and 61%-87% among PMD), 31 but in patients with PNES, such sex distinction seems to become evident only after the age of 13 years. 32 These disorders can develop at any age, [29][30][31][32] though a higher occurrence is consistently reported between age 20 and 45 for both PNES and PMD. 2,31 Moreover, no demographic and clinical differences with regards to ethnicity have been found between Spanish and North American populations 33 and when comparing patients from Latin America with other published series from North America and Turkey, 34 supporting the transcultural aspect of these disorders.…”

Psykogene ikke-epileptiske anfall hos barn

“…I materialer bestående av barn henvist til video-EEG for en diagnostisk utredning av forskjellige typer anfall, har man funnet tilstanden hos 3,5 -20 % (12,16,17). Blant barn henvist til pediatriske epilepsisentra for intraktabel epilepsi er det funnet en forekomst av barn med slike anfall på 10 -23 % (8,18).…”