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Abstract Details

Dissociative seizures across the adult lifespan: female sex, delay to diagnosis and disability
Epilepsy/Clinical Neurophysiology (EEG)
Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)
043
We aimed to evaluate age-associated changes in patients with dissociative seizures and the impact of seizures on their life.
The clinical characteristics of dissociative seizures may vary across the lifespan. Older-onset dissociative seizures is viewed as rare, and there may be characteristics distinct from younger-onset dissociative seizures including less female predominance, fewer psychiatric comorbidities, and more medical comorbidities. As female sex and psychiatric comorbidities are factors associated with identifying dissociative seizures, it is unknown how these differences influence the diagnostic evaluation of seizures.
Based on data from 365 adult patients with documented diagnosis of dissociative seizures ranging from 18 to 88 years old, we evaluated how the quantity and prevalence of specific ictal behaviors, historical factors, and comorbidities varied based on patient age.
Ten percent of patients with DS presented to video-EEG after age 60. There were three factors with prominent change over age: female predominance decreased at 35 and 62 years old, older patients had longer time from seizure onset to documented diagnosis; and the prevalence of work disability increased substantially until age 30 then plateaued with 80% of patients reporting inability to work. Patient-reported comorbidities increased nonspecifically with age. The descriptions of ictal behavior did not vary substantially with age.

Despite similar presentation, with greater age came a greater delay to diagnosis. After age 30, most patients’ seizures had a substantial impact on their ability to work. These findings emphasize that patients can develop dissociative seizures at any age, and therefore prompt referral for definitive diagnosis and treatment should not be delayed due to age.

            All patients consented for the use of their records in research, and the UCLA Institutional Review Board approved this study. This work is consistent with Declaration of Helsinki.
Authors/Disclosures
Wesley Kerr, MD, PhD (University of Pittsburgh)
PRESENTER 		Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for SK Life Science. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven Pharmaceuticals. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurelis. Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for QurAlis. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven Pharmaceuticals. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsia. The institution of Dr. Kerr has received research support from NINDS. The institution of Dr. Kerr has received research support from American Epilepsy Society. The institution of Dr. Kerr has received research support from Â鶹´«Ã½Ó³»­. The institution of Dr. Kerr has received research support from SK Life Science. The institution of Dr. Kerr has received research support from Biohaven Pharmaceuticals. Dr. Kerr has received publishing royalties from a publication relating to health care.
Siddhika Sreenivasan No disclosure on file
Corinne Allas No disclosure on file
No disclosure on file
Amir Karimi No disclosure on file
No disclosure on file
No disclosure on file
Jena Grauer No disclosure on file
No disclosure on file
Jerome Engel, Jr., MD, PhD, FÂ鶹´«Ã½Ó³»­ (Reed Neurological Research Ctr) Dr. Engel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerebel. Dr. Engel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Engel has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink. Dr. Engel has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Steven Barris. Dr. Engel has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Cutler Law Firm. Dr. Engel has received publishing royalties from a publication relating to health care. Dr. Engel has received publishing royalties from a publication relating to health care. Dr. Engel has received publishing royalties from a publication relating to health care. Dr. Engel has received publishing royalties from a publication relating to health care.
No disclosure on file
John M. Stern, MD, FÂ鶹´«Ã½Ó³»­ Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB Pharma. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for SK Life Science. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurelis. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceribell. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz Pharma. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for LivaNova. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for LivaNova. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Stern has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Jazz. Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for SK Life Sciences. Dr. Stern has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology. Dr. Stern has stock in DEARhealth. Dr. Stern has stock in Ceribell. Dr. Stern has received publishing royalties from a publication relating to health care. Dr. Stern has received publishing royalties from a publication relating to health care. Dr. Stern has received publishing royalties from a publication relating to health care. Dr. Stern has received publishing royalties from a publication relating to health care.