Abstracts

Rationale: It is well known that art provides a medium to express oneself. Our pilot study (Epilepsy Behav. 2005 Mar;6(2):196-202) suggested that patients with psychogenic non-epileptic seizures (PNES) had significantly greater color usage when depicting their seizure experiences on a body outline compared to patients with epileptic seizures. The Body Outline Task looks at visual artwork completed by seizure patients that may potentially be a simple but useful tool to identify patients with a higher likelihood of having psychogenic seizures. The Body Outline Task had an increasing positive predictive value for PNES, with 80% positive prediction when 10 of the 12 available colors were used. Thus, the primary objectives for the present study are: 1) to confirm the relationship between the number of colors used and PNES diagnosis, 2) observe the positive predictive value at higher number of colors used, and 3) to validate our Body Outline Task as a unique clinical aid in the diagnosis of neurological versus psychogenic non-epileptic seizures.Methods: From March 2009 to June 2011, patients between 18 and 70 years of age undergoing continuous video-EEG monitoring at St. Charles Hospital (Port Jefferson, NY) were invited to participate. The subjects were given a standard box of 24 colored pencils, a sex appropriate body outline printed on a standard sheet of white paper, and written and verbal directions to express how your seizures make you feel . The subject s diagnosis was acquired after completion of the study. Logistic regression was used in prediction of the number of colors the patients used in their drawings to have PNES.Results: Currently, 45 subjects have completed this study: 10 of PNES, 20 of epilepsy, 1 pending diagnosis, and 14 that are excluded from the study. Epilepsy diagnoses include: partial onset seizures (5), complex partial seizures (10), generalized seizures (4), and mesial frontal lobe seizures (1). One subject presented with both PNES and complex partial seizures, and was included in both PNES and epilepsy groups during analysis. Subjects with non-psychogenic non-epileptic events or pending diagnosis were not included in our analysis. Preliminary results based on the current population (n = 30) indicates no statistical significance between the number of colors used and PNES diagnosis as compared to epilepsy group (P = 0.738; odds ratio = -0.0476). No statistical significance was achieved when comparing color use and PNES diagnosis against complex seizure with a temporal focus (P = 0.711; odds ratio = -0.0696).Conclusions: Preliminary results show no significant difference in color usage between the PNES and epilepsy groups or between PNES and complex partial seizures with a temporal focus. These findings differ from our pilot study, which suggested a significant relationship between color use and PNES. It is suspected that the difference in patient population between different epilepsy centers may explain the variation in results. With continued study, we hope to further understand the relationship between color usage and underlying event pathology.