Abstracts

We observed anecdotally that patients admitted for video/EEG (vEEG) monitoring who we diagnosed with non-epileptic seizures (NES) seemed to have a larger body habitus than similar patients with epilepsy. Non-epileptic seizures are often considered physical manifestations of psychological distress. There is some limited evidence that weight problems are more common in people with psychiatric illness, and we postulated that there might be a higher prevalence of overweight and obesity in patients with NES. The goal of this study was to test our hypothesis that there was a measurable difference in body mass index (BMI) in patients with non-epileptic seizures compared to their epileptic counterparts.
Study subjects and controls were chosen from the list of all patients admitted to our inpatient video/EEG (vEEG) monitoring unit between January 2000 and March 2003. The diagnosis of NES was made only when the vEEG-recorded events were identified by the patient and/or family as typical, and those events were not accompanied by any EEG abnormalities. All patients over age 18 who we diagnosed with NES were included in the study. We selected age- and gender-matched controls whose diagnosis of epilepsy was confirmed by vEEG. Patients who had both non-epileptic and epileptic seizures were excluded. The height and weight of each patient was collected from the patient[rsquo]s intake history and physical, or from the hospital pharmacy computer system. These data were entered into an Excel spreadsheet and the BMI was calculated. Data were analyzed using the SPSS for Windows statistics program.
The mean BMI of NES patients was 29.9 (SD 9.1), and the mean BMI of patients with epilepsy was 26.4 (SD 8.7). There was no statistically significant difference between the two groups (p = 0.10, t-test). Categorical data analysis also showed no statistically significant difference between the groups: 22 of 36 (61%) NES patients were overweight or obese (defined as a BMI equal to or greater than 25), compared to 15 of 35 (43%) epileptic patients (p = 0.16, Fisher[rsquo]s exact test).
We found no significant difference in body mass index between patients with non-epileptic seizures and their age- and gender-matched epileptic counterparts. These results emphasize the importance of avoiding bias and stereotyping when we evaluate and treat patients with unexplained or refractory seizures. One factor we did not control for was the use of anti-epileptic drugs, which could potentially have affected the results. Of interest, the percentage of overweight and obese NES patients in our study (61%) is almost identical to that of the general adult American population [ndash] 64% as measured by the National Center for Health Statistics NHANES survey of 1999-2000.