CHICAGO—About half of staring spells referred to a new-onset seizure (NOS) clinic turn out to be epileptic seizures, according to a retrospective chart review presented at the 47th Annual Meeting of the Child Neurology Society.
Children with nonepileptic staring were younger and more likely to have developmental delay, compared with children with epileptic staring, said Seunghyo Kim, MD, Visiting Associate Professor of Pediatrics at Emory University School of Medicine in Atlanta, and his colleagues. In addition, children with nonepileptic staring were more likely to have been referred by a primary care physician than by an emergency department.
A Common Reason for Referral
Staring spells are common in children and a frequent reason for referral to NOS clinics, the investigators said. Staring spells may be generalized absence seizures, focal seizures, or nonepileptic events. Few studies, however, have examined patients who newly present to a neurology clinic with the chief complaint of staring spells.
To evaluate the clinical and demographic features of children who present with staring spells to a regional NOS clinic, the researchers reviewed charts from 2,818 patients who visited a children’s hospital between September 22, 2015, and March 19, 2018. The investigators identified 189 patients with staring spells.
They excluded 48 cases where staring was accompanied by or followed by generalized tonic-clonic seizures or other motor seizures. In addition, they excluded 16 cases of established epilepsy and four cases of provoked seizures, including febrile seizures.
The final study population included 121 cases. About 48% of these patients with staring spells were African American, and 38% were white. Patients’ mean age at first visit to the NOS clinic was 6, and mean age at staring spell onset was 5.2.
Fifty-nine patients (49%) had epileptic staring episodes, and 62 patients (51%) had nonepileptic events.
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