Multidisciplinary Care May Help to Reduce Disparities Associated With Race in Youth With Psychogenic Nonepileptic Seizures

• Published in: Pediatric neurology 2024-02, Vol.151, p.29-33
• Main Authors: Burch, Maggie Mary, Rossiter, Samantha, McGinty-Kolbe, Katie, Fredwall, Megan, Tschirner, Christy, Enciso, Laurie, Iskander, Jeannette, Trott, Kristen, Jackson, Kenneth, Albert, Dara V F
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Child; Conversion Disorder; Electroencephalography; Epilepsy - diagnosis; Humans; Psychogenic Nonepileptic Seizures; Retrospective Studies; Seizures - diagnosis
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2023.11.007

Psychogenic nonepileptic seizures (PNES) are a common type of functional neurological disorder in which patients experience seizurelike episodes. Health disparities based on race and socioeconomics, documented in children with epilepsy and adults with PNES, have not been reported in children and adolescents with PNES. We hypothesize that disparities exist in this population, which impact overall care and therefore influence outcomes. We retrospectively analyzed youth referred to our multidisciplinary clinic from 2018 to 2020. All patient charts were screened by social work before the visit to identify potential barriers to care, and a nurse conducted follow-up calls. Patients' race was identified from the electronic health record and compared with several variables. Outcomes were collected via phone follow-up. Descriptive statistics were produced, and comparisons between white patients and patients of other races were completed using Fisher exact tests and multivariable logistic regressions. During the study period, 237 patients were eligible for the analysis. Sixty-eight patients (29%) identified as a race other than white. Only 60%, 56%, and 40% of the cohort were reached for follow-up at one, three, and 12 months, respectively. In general, outcomes were similar between racial groups; however, we found that patients of nonwhite race were more likely to receive support from social work due to barriers identified in screening (P = 0.045). Health disparities based on race may exist in youth with PNES. A multidisciplinary clinic including social work may help mitigate barriers leading to more equitable care and similar outcomes for white and nonwhite youth with PNES.