Abstract Details

Title Association of interictal EEG findings in those with concomitant epileptic seizures and PNES

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-006

Objective To assess whether epileptics with EEG abnormalities in the right hemisphere have a higher rate of concomitant PNES.

Background

PNES is classified as a functional neurological disorder (FND), however, more recently, various studies have attempted to elucidate structural, anatomical, or molecular alterations that might implicate certain regions of the brain in the development of functional disorders, like PNES.

Design/Methods

We performed a retrospective chart review of patients ages 18-69 who were admitted to the Epilepsy Monitoring Unit at Parkland Hospital between the years 2016-2018. Information was abstracted from EEG reports of patients diagnosed with epileptic seizures (ES) and concomitant Psychogenic Non-epileptic seizures (PNES) and ES. The relationship between R-sided EEG abnormalities and a concomitant diagnosis of PNES was explored using odds ratios.

Results There were 140 patients with ES alone, and 47 patients with PNES+ES. The odds ratios for R-sided ictal, epileptiform interictal, and non-epileptiform interictal abnormalities on EEG were 1.044 [95% confidence interval(CI) (0.26, 4.15)], 2.652 [95% CI (0.97, 7.24)], and 4.769 [95% CI of (1.71, 13.27)], respectively.

Conclusions In patients with concomitant ES+PNES, there is a greater likelihood of finding R-sided ictal and interictal findings on EEG. Our findings support an association between R-sided interictal abnormalities and concomitant PNES in people having epilepsy, consistent with previous research suggesting R-sided neuroanatomical structures having a role in the development of PNES. Specifically, abnormal cortical function in neuroanatomical regions involved in emotion and delusion may be hypothesized to a mediate a relationship between PNES and the right hemisphere of the brain.

Authors/Disclosures
Gabriela Alejo, MD (Jackson Memorial Hospital) PRESENTER	Dr. Alejo has nothing to disclose.
	No disclosure on file
Brendan J. Kelley, MD, FAAN (University of Texas Southwestern)	Dr. Kelley has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Kelley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Labcorp. Dr. Kelley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Esai.

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