The pediatric non-epileptic seizure.

Abstract

In order to observe the pattern of behaviour, the underlying stressors and possible association with psychosocial factors in Pediatric Non-Epileptic Seizure (NES); 22 children with unusual feature of poor control of their symptoms were studied. Detailed historical account, examination including psychiatric evaluation, EEG and CT Scan in all and video recording with provocative procedures were done wherever feasible. Ten males (45.5%) and 12 females (55.5%) were in the age range from 5 through 18 years. Ten children (45.5%) had uncontrolled symptoms while 12 (55.5%) had unusual symptoms. History and eye witness account was accurate in 15 (68.1%). Separate video recording could be done in 6 (27.3%) while induction with provocative procedures was possible in 7 (31.8%) older children. Pointers to NES were: stress induced events 13 (59.4%), persistence of symptom despite adequate treatment 10 (45%), lack of physical injury 20 (90.0%), symptoms when some one was around 12 (54.5%), lack of postictal phenomenon 12 (54.5%), lack of incontinence 22 (100%), positive gains 6 (27.0%) and gradual onset and offset 12 (54.5%). Nine children (40.0%) had coexisting epilepsy and NES. The present study addresses the need of awareness, provocative procedure, video recording of the event and individualised management of NES in our circumstances where video EEG facility is not available.