[P1-67] Paroxysmal Nonepileptic Events in Children with Epilepsy
[Introduction] The aim of this study was to reveal characteristics of paroxysmal nonepileptic events (PNEs) suspected as epileptic seizures by their family in children with epilepsy. [Methodology] Between October 2006 and January 2016, 892 habitual paroxysmal events in children with epilepsy were recorded by video-EEG (vEEG) at Nagoya University Hospital. Among them, 89 events (71 children) were confirmed to be PNEs by vEEG. We divided these PNEs into 2 groups according to doctor’s suspicion before vEEG: PNEs suspected as epileptic seizures and PNEs suspected as PNEs. We classified PNEs in the former group by suspected seizure types. [Results] The median age of the 71 children at vEEG recordings was 3.3 years. Concurrent epilepsies were focal epilepsies (n=33), infantile spasms (n=17), and others (n=21). The most common types of PNEs were voluntary movements (n=12) and sleep myoclonus (n=12), followed by awake myoclonus (n=9), paroxysmal ocular deviations (PODs, n=8), and tonic posturing (n=8). Voluntary movements and myoclonus were often misdiagnosed as epileptic spasms. PODs and tonic posturing were often misdiagnosed as focal seizures with motor components. Seven of 8 patients with PODs had concurrent epileptic seizures of epileptic spasms. Diffuse cerebral lesion or reduced visual acuity was seen in 7 patients with PODs. [Conclusions] We demonstrated the characteristics of PNEs suspected as epileptic seizures in children with epilepsy and spotlighted the existence of POD in differential diagnosis of paroxysmal events. These results will support clinicians to precisely diagnose paroxysmal events in children with epilepsy.