Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
Epilepsy Behav. 2023 Aug;145:109336. doi: 10.1016/j.yebeh.2023.109336. Epub 2023 Jun 27.
We investigated childhood-onset functional seizures (FS) and late-onset FS and hypothesized that there are differences in their characteristics.
In this retrospective study, we investigated all patients with confirmed FS with an age at onset of 14 years or younger and those with an age at onset of 50 years or older, who were admitted to the epilepsy monitoring units at one center in Iran (Shiraz Comprehensive Epilepsy Center, from 2008 until 2022) and one center in the USA (Vanderbilt University Medical Center, from 2011 until 2022).
One-hundred and forty patients were included. They included 80 patients with childhood-onset FS and 60 with late-onset FS. Those with late-onset FS were more likely to have medical comorbidities compared with the patients with childhood-onset FS (OR = 13.9). Those with late-onset FS more likely had a history of head injury compared with the patients with childhood-onset FS (OR = 5.97). Duration of illness was significantly longer in patients with childhood-onset FS compared with the patients with late-onset FS (6 years vs. 2 years).
Our study identified several similarities and differences in the clinical characteristics and predisposing factors of patients with childhood-onset and late-onset FS. In addition, we found that childhood-onset FS is more likely to remain undiagnosed and thus untreated for many years. These findings provide additional evidence that FS is a heterogenous condition and we propose that a proportion of the differences between patients may be accounted for by age-associated factors.
我们研究了儿童期起病的功能性癫痫发作（FS）和晚发性 FS，并假设它们在特征上存在差异。
在这项回顾性研究中，我们调查了所有在伊朗的一个中心（设拉子综合癫痫中心，从 2008 年到 2022 年）和美国的一个中心（范德比尔特大学医学中心，从 2011 年到 2022 年）的癫痫监测病房入院的确诊为 FS 且发病年龄在 14 岁或以下的患者，以及发病年龄在 50 岁或以上的患者。
共纳入 140 例患者。其中 80 例为儿童期起病 FS，60 例为晚发性 FS。与儿童期起病 FS 患者相比，晚发性 FS 患者更有可能合并有医学合并症（OR=13.9）。与儿童期起病 FS 患者相比，晚发性 FS 患者更有可能有头部外伤史（OR=5.97）。与晚发性 FS 患者相比，儿童期起病 FS 患者的疾病病程明显更长（6 年 vs. 2 年）。
我们的研究发现儿童期起病和晚发性 FS 患者在临床特征和易患因素方面存在一些相似和不同之处。此外，我们发现儿童期起病 FS 更有可能多年未被诊断和治疗。这些发现提供了进一步的证据表明 FS 是一种异质性疾病，我们提出患者之间的部分差异可能归因于与年龄相关的因素。
