Abstracts

Rationale: Psychogenic non-epileptic seizures (PNES) have largely an emotional substrate. Family dysfunction is known to contribute to that. There is limited data whether poor knowledge about epilepsy adds to their pathophysiology. Using a cohort of patients with epileptic seizures (ES) and their caregivers as control group, we aimed to investigate differences in epilepsy knowledge in families living with PNES.

Methods: PNES and ES patients and caregivers completed surveys about demographic, clinical and psychosocial characteristics. Knowledge about seizures was evaluated with the Epilepsy Knowledge Profile-General (EKP-G). Comparison of EKP-G scores and its correlates was performed between the two groups of patients and caregivers.

Results: 43 PNES patients and 165 ES patients were recruited. Compared to ES patients, PNES patients had shorter disease duration, higher seizure frequency, normal electroencephalographic and imaging studies, they utilized acute hospital care more frequently and they were previously maintained on fewer antiseizure medications (ASMs). PNES patients also reported more frequently a history of abuse and other comorbidities, they exhibited greater degree of depression, anxiety and stigma, and poorer quality of life. There was no statistically significant difference in epilepsy knowledge scores between PNES and ES patients. In PNES patients, EKP-G scores were higher in insured and employed patients of higher socioeconomic status and were associated with better compliance with ASMs. In ES patients, EKP-G scores were higher in insured and married, Caucasian patients and they were associated with poorer quality of life and greater degree of depression.

28 PNES caregivers and 99 ES caregivers were recruited. Aside for higher stigma levels in PNES caregivers, there were no significant demographic, caregiving, or psychosocial differences between the two caregiver cohorts, including their epilepsy knowledge scores. In PNES caregivers, EKP-G scores were higher when patients were insured and when both patients and caregivers had a better educational attainment. They were inversely correlated with caregiving time. In ES caregivers, EKP-G scores were higher when patients were insured and suffered from focal unaware seizures.

There was a statistically significant moderate correlation between patient and caregiver EKP-G scores both in the PNES and ES cohorts.

Conclusions: There is no difference between epilepsy knowledge scores in patients with PNES compared to patients with ES, nor in caregivers of patients with PNES compared to ES, corroborating the prevailing subconscious psychiatric rather than conscious cognitive framework for the pathogenesis of PNES. Patient and caregiver epilepsy knowledge is tightly linked in both cohorts and is associated with certain sociodemographic, disease and psychosocial characteristics that could act as future intervention targets.

Funding: Please list any funding that was received in support of this abstract.: N/A.