Jacqueline French, MD: Barriers to Identifying Nonmotor Seizures


The director of Translational Research and Clinical Trials Epilepsy at NYU Grossman School of Medicine discussed the need to improve education about nonmotor seizures.

“I always talk about the ‘television seizure.’ You never see anybody on TV having a seizure which is not falling to the ground, shaking their arms and legs, frothing at the mouth—and I think if you asked a person on the street, ‘what is a seizure,’ that’s what they would tell you.”

A recent study published in Epilepsia as part of the Human Epilepsy Project by a group of authors including Jacqueline French, MD, professor of neurology, and director, Translational Research and Clinical Trials in Epilepsy, NYU Grossman School of Medicine, suggests that the early identification of nonmotor seizures may help prevent injury and serious morbidity.

In the study, more patients with new-onset focal disease presented with initial nonmotor seizures than motor seizures (55% vs. 45%, respectively; P = .04), and the majority of injuries reported by patients prior to diagnosis for those who presented initially with nonmotor seizures occurred in those who ultimately developed motor seizures (92 of 167 patients; 55.1%). Those who never developed motor seizures were less likely to be injured (8 of 79; 10.1%) by a significant margin (P <.001).

Part of the challenge in identifying these patients is one of education about seizures, French told NeurologyLive. Most people, she noted, don’t understand the multiple ways a seizure can present—often without convulsions. She pointed to the successful F.A.S.T. (Face drooping, Arm weakness, Slurred speech, Time to call 9-1-1) campaign that has aided in stroke as a good example of how to push for better understanding. She offered up epilepsy’s own version: S.S.S.S.S—short, sudden, strange, similar spells.

Pellinen J, Tafuro E, Yang A, et al. Focal nonmotor versus motor seizures: The impact on diagnostic delay in focal epilepsy. Epilepsia. Published online October 20, 2020. doi: 10.1111/epi.16707
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