Abstract Details

Title Nonepileptic Events in Children and Adolescents in New Onset Seizure Clinic

Topic Child Neurology and Developmental Neurology

Presentation(s) P14 - Poster Session 14 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-014

Objective The aim of this study was to evaluate the demographics and clinical spectrum of nonepileptic events (NEEs) in pediatric patients presenting to the regional New Onset Seizure clinic (NOSc).

Background NEEs are commonly referred to child neurology clinics for seizure evaluation and vary in presentation. There is limited characterization of NEEs in pediatric ages. Recent studies are based on electroencephalography monitoring units (EMU) which often exclude typical NEEs.

Design/Methods Retrospective chart review was performed on patients evaluated in the NOSc at Children’s Healthcare of Atlanta from 9/22/2015 to 3/22/2018. NEEs were diagnosed based on history, video electroencephalography (EEG) monitoring, or patient-provided video of event.

Results Of 2,818 pediatric patients evaluated in NOSc, 154 patients (5%) were ultimately diagnosed with NEEs. Most common type of NEE was staring (N=36, 23%), syncope (N = 35, 22%), and psychogenic nonepileptic spells (PNES; N = 20, 13%). Epileptiform discharges were observed in EEG's of 5 patients (3.2%). Patients were divided into three age groups. 1) Infant, Toddler, and Preschool group (1 month–5 years) included 76 patients. Most common diagnoses were staring spell (N=26, 34%), breath-holding spell (N=11, 15%), and Sandifer syndrome (N=11, 15%). 2) School-Age group (5–12 years) consisted of 47 patients. Most frequent diagnoses were syncope (N=14, 30%), staring spell (N=9, 20%), and PNES (N=7, 15%). 3) Adolescent Group (12–18 years) consisted of 31 patients. Most common diagnoses were syncope (N=12, 42%), PNES (N=12, 39%), and tremor (N=2, 6.5%).

Conclusions The clinical spectrum of NEEs varies with age. Staring spells are most common in children less than 5 years and convulsive syncope in those older than 5 years. In contrast to EMU-based studies, PNES is common in children over 5 years and increases with age. However, PNES is not the most common NEE in any age group. These results may help in clinical practice.

Authors/Disclosures
PRESENTER	No disclosure on file
Jenny Lin, MD (Center for Advanced Pediatrics)	Dr. Lin has nothing to disclose.
	No disclosure on file
Ton J. DeGrauw, MD	No disclosure on file
Sookyong Koh, MD, PhD (Ann & Robert H. Lurie Children's Hospital of Chicago)	No disclosure on file

�鶹��ýӳ��

�鶹��ýӳ��

Abstract Details