Development of De novo Functional Seizures after Epilepsy Surgery (S35.010)

Abstract

<h3>Objective:</h3> The purpose of this evaluation was to identify the frequency and risk factors of de novo FS in patient after epilepsy surgery. <h3>Background:</h3> Functional seizures (FS) (also known as psychogenic non-epileptic seizures (PNES) or dissociative seizures) are seizures that mimic an epileptic seizure but have no associated epileptogenic EEG changes and are thought to have a psychological basis. Epilepsy surgery can be an effective means of treatment for patients with drug refractory seizures, but it is important to understand the complications that can arise from surgery. <h3>Design/Methods:</h3> The surgical data based showed 1116 patients who underwent epilepsy surgery from 1998 to 2022. The clinic notes were reviewed and identified 37 patients who developed de novo FS post-surgery. They were characterised by their age, sex, age of surgery, duration of epilepsy before surgery, pre-operative psychiatric co-morbidities, type/site of surgery, and post-operative complications <h3>Results:</h3> 37 patients were identified (30F, 7M). The mean age at the time of surgery was 36.2 (17–52 years). 31 patients had documented post-operative de novo FS. 16 patients had a documented pre-operative psychiatric diagnosis. 10 patients developed immediate post-operative complications and de novo FS an average of 9.8 months after surgery. 4 patients with no past psychiatric issues developed psychosis following immediate post-operative complications. Patient with no immediate post-operative complications with or without pre-operative psychiatric diagnosis developed de novo FS on average of 29.4 months after epilepsy surgery <h3>Conclusions:</h3> 1) The rate of development of de novo FS after epilepsy surgery is low (2.77%). 2) The patients who have de novo FS after surgery have high rates of pre-operative psychiatric diagnoses (43.2 %), are predominantly female (81.1%) , and have immediate post-op complications (27%). 3) Immediate post-operative complications can result in new functional seizures developing less a year after surgery <b>Disclosure:</b> Dr. Manoj has nothing to disclose. Dr. Yogarajah has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for MEWA. Dr. Yogarajah has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Forensic Access. Dr. Yogarajah has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Eopinex. The institution of Dr. Yogarajah has received research support from MRC. Dr. Yogarajah has received publishing royalties from a publication relating to health care. Dr. Huda has nothing to disclose. Ms. De Tisi has nothing to disclose. John Duncan has nothing to disclose.