The clinical characteristics of childhood-onset and late-onset functional seizures: How do they differ?

Area of Science:

• Neurology
• Epilepsy Research
• Clinical Neuroscience

Background:

• Functional seizures (FS) are a neurological disorder with varying onset ages.
• Investigating differences between childhood-onset and late-onset FS is crucial for understanding disease heterogeneity.
• Previous research has not fully elucidated the distinct characteristics of these two FS subtypes.

Purpose of the Study:

• To compare the clinical characteristics and predisposing factors of childhood-onset functional seizures (FS) versus late-onset FS.
• To identify potential age-associated differences in the presentation and progression of FS.
• To provide evidence supporting FS as a heterogeneous condition.

Main Methods:

• A retrospective study comparing patients with FS onset at age 14 or younger versus age 50 or older.
• Data collected from epilepsy monitoring units at centers in Iran and the USA.
• Inclusion of 140 patients: 80 with childhood-onset FS and 60 with late-onset FS.

Main Results:

• Late-onset FS patients had significantly higher rates of medical comorbidities (OR=13.9) and head injury history (OR=5.97).
• The duration of illness was considerably longer in childhood-onset FS (6 years) compared to late-onset FS (2 years).
• Similarities and differences in clinical features and risk factors were identified between the two groups.

Conclusions:

• Functional seizures represent a heterogeneous condition with distinct features based on age of onset.
• Late-onset FS is associated with a higher burden of comorbidities and a history of head trauma.
• Childhood-onset FS is prone to prolonged periods of being undiagnosed and untreated, underscoring the need for timely diagnosis.