Document Type


Date of Degree

Spring 2023

Primary Advisor

Henry Kaminski, MD


Demographic Factors; Seizure Management; Emergency Department



Psychogenic nonepileptic seizures (PNES) mimic epileptic seizures in their clinical manifestations, but are not associated with an abnormal electrical discharge on electroencephalogram. PNES attacks are often treated and managed as likely epileptic seizures, subjecting the patient to unnecessary anti-seizure medications (ASM). Both epileptic seizures and PNES are common reasons for visiting the emergency department (ED), especially for patients without access to ambulatory care. There is growing evidence highlighting disparities in seizure care in the ED related to race, ethnicity, and socioeconomic status (SES). PNES is a significant burden to the patient and society because of the annual costs spent on ED visits, inpatient monitoring, and outpatient visits, among others. Optimal control of PNES can be achieved through consistent outpatient management. However, this is difficult to achieve in uninsured patients and those whom the current healthcare system fails to educate on the likely diagnosis and access to outpatient clinics, which is a significant factor of disparity in care. A major consequence of poor seizure management is the frequent use of the ED for seizure care. My goal was to identify if there are certain racial, ethnic, or social characteristics of patients presenting to the ED with seizures, if these characteristics among PNES patients differ from those with epilepsy, and if any of these characteristics serve as determinants for repeat ED visits for seizure care.


©2023 by Radwa Aly. All rights reserved.

Open Access


Available for download on Wednesday, April 23, 2025

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