This poster will discuss the importance of Continuous EEG monitoring and how it benefits patients in the diagnosis of Functional Seizures* vs. Epilepsy. "One might wonder why EEGs are ordered again on patients with a diagnosis of nonepileptic spells (NES). One in five patients with NES have co-existent epilepsy, which is not diagnosed for years in some cases," Arun Antony, M.D. (University of Pittsburgh Medical Center, Department of Neurology.) "Some authors report that NES can be associated with a physical brain disorder playing a role in their development: head injury may contribute to the pathogenesis of NES. New-onset psychogenic seizures after resective epilepsy surgery or other intra-cranial neurosurgery have been described." (From: Epilepsy in the elderly. Special clinical features and treatment strategies, Der Internist, 2014 Jul;55(7):782-8) Case Study: This is a 61-year-old male that was evaluated for seizures at our institution over the past few years. His past medical history is significant for epilepsy (trauma induced), traumatic brain injury (TBI), NES, and craniotomy for tumor removal. A routine EEG performed in October 2017 showed a mild generalized disturbance of cerebral dysfunction. A repeat EEG done in November of that year suggested left temporal dysfunction. He has also had subsequent EEGs that were interpreted as "essentially normal." In May of 2018, a 25-minute routine EEG captured an event with hand rigidity/shaking associated with decreased responsiveness that did not have an EEG correlate. As of 2021, the patient continues to have these events. His current treatment plan includes multiple antiepileptic drugs and a service dog that assists him. From this case, we learned that patients who have NES can have concomitant epilepsy and/or psychological disorders that need an equal amount of attention and care as any epileptic patient. In conclusion, managing dual diagnosis patients can be difficult for both the physicians and the technologist, but it is not a service that goes without notice. EEG, and more specifically, continuous EEG monitoring which we utilized for this patient, is an essential tool in the diagnosis and treatment of complicated patients, and we are happy to help aid in patients in these life-changing analyses. *The AES is now referring to Non-epileptic Seizures as Functional Seizures. "Functional Seizures commonly referred to as non-epileptic seizures (NES) is a descriptive term for a diverse group of disorders which refers to paroxysmal events that can be mistaken for epilepsy, but are not due to an epileptic disorder." (From: https://fndhope.org/fnd-guide/symptoms/seizures/)
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