Reducing the Frequency of Seizures Xenia OH

Epilepsy (also known as seizure disorder) is a neurological condition with symptoms which vary from a momentary lapse of attention to convulsions. Damage to brain cells can disrupt the normally smooth-running pattern of electrical activity in the brain by causing an electrical overload. This can create a seizure, which causes a sudden change in the individual's consciousness and/or change in motor activity. Epilepsy was one of the first brain disorders to be described. It was mentioned in ancient Babylon more than 3,000 years ago. The word epilepsy is derived from the Greek word for "attack." It was once thought that people who had epilepsy were being visited by demons or gods. However in 400 B.C., the early physician Hippocrates suggested that epilepsy was a disorder of the brain. A seizure disorder includes any condition in which there are repeated episodes of seizures of any type. Epilepsy (idiopathic seizure disorder) is a term used when the seizure disorder has no identifiable cause such as brain disease. Psychogenic non-epileptic seizures (PNES) are events superficially resembling an epileptic seizure but without the characteristic electrical discharges associated with epilepsy. It is estimated that 20% of seizure patients seen at specialist epilepsy clinics have PNES.

Cognitive behavioral therapy (CBT) is a psychological method of treatment for generalized anxiety disorder (GAD), which involves a therapist working with the patient to understand how thoughts and feelings influence behavior. The goal of the therapy is to change negative thought patterns that lead to the patient's anxiety, replacing them with positive, more realistic ones. Elements of the therapy include exposure strategies to allow the patient to gradually confront their anxieties and feel more comfortable in anxiety-provoking situations, as well as to practice the skills they have learned. CBT can be used alone or in conjunction with medication. CBT usually helps one third of the patients substantially, while another third does not respond at all to treatment.

Researchers at Rhode Island Hospital found that psychogenic non-epileptic seizures (PNES) could be reduced with cognitive behavioral therapy. The study included 21 patients who after being diagnosed with PNES had at least one typical PNES that was captured on video EEG. The researchers outlined a clinical model for the management of PNES, where a key component was to identify precursors, precipitants and perpetuating factors of the seizures. The cognitive behavior therapy (CBT) consisted of identifying and modifying cognitive distortions and environmental triggers for PNES in the hopes that it would reduce seizures. The results of the 12 week trial found that CBT was effective in terms of reducing the frequency of PNES. It was noted that 16 of the 21 patients reported a 50 percent reduction in seizure frequency, and 11 of the 17 who completed the CBT reported no seizures per week by their final CBT session. The researchers also evaluated the participant's quality of life scores, as well as assessments of depression, anxiety, somatic symptoms and psychosocial functioning, all of which showed statistically significant improvement from baseline to the final session. Based on the results of this study, it appears that CBT is beneficial in helping patients suffering with non-epileptic seizures by reducing the frequency of seizures and significantly improving their quality of life.¹

¹ Lafrance WC Jr, Miller IW, Ryan CE, et al. Cognitive behavioral therapy for psychogenic nonepileptic seizures. Epilepsy Behav. Apr2009;14(4):591-6.