Introduction

Psychogenic nonepileptic seizures(PNES) constitute a considerable proportion of referral for epilepsy to any specialized centre.

Methods

Clinical spectrum of children aged 6-16 years presenting with PNES (confirmed by short-term video EEG with suggestion) between May 2017 and April 2018 in a North Indian tertiary care center and their clinical response to Cognitive Behavioral therapy (CBT) on follow up were analyzed. Stressors, associated co morbidities, Verbal IQ (Intelligence Quotient) and behavioral abnormalities were assessed using HTP(House tree person) test, sentence completion test, DSM V (Diagnostic and statistical manual of mental disorders) criteria, MISIC (Malin’s intelligence scale for Indian children) and CBCL (Child behavior checklist) respectively.

Results

Out of 117 children enrolled, 58% were boys. Age group presentation wasbimodal (more children between 6-8 years and 10-12 years).31% participants were already on antiepileptic drugs. Commonest semiology was dialeptic (49 %), followed by nonepileptic aura (26 %) and motor (17%). Commonest stressors were school related issues (43%),followed by family stressors (34%). Secondary stressors were found in 47% of children. The most common psychiatric co-morbidities were adjustment disorder (32%) and oppositional defiant disorder (23%). Predominant behavioral co-morbidities associated were somatic complaints (67%), attention problems (38%) and anxious/depressed (21%). 12%, 31% and 3% children had below average IQ, borderlineand mild intellectual disability respectively. On CBT, 63% and 88% children were event free within 1 month and 6 months of follow up respectively.

Conclusions

Dialeptic PNES is commonest in children, with most children responding favorably to CBT.