A neurobehavioral approach for treatment of complex partial epilepsy: efficacy

Abstract

This is a retrospective study of the efficacy of a short-term comprehensive multidisciplinary neurobehavioral treatment approach for complex partial epilepsy. Eleven patients were treated intensively for five consecutive days followed by 6 months of weekly telephone contact and an additional 6 months of monitoring of seizure logs and journals. Data was analysed at least 24 months after initiation of treatment. Pre-treatment seizure frequency ranged from 1 to 15 per month. Post-treatment seizure frequency was zero per month for the nine patients who experienced less than four seizures per month prior to treatment and less than two per month for the other two patients. Additional benefits of the treatment program were improved levels of professional achievement in the arts and computer sciences and reduction of medication dosages.

Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: A staged approach

“…For example, seizures occurring in the presence of environmental or emotional stressors are not strong indicators of PNES or rule out epilepsy (Haut et al., ). In addition, seizures stopped by behavioral techniques are not strongly confirmatory of PNES (Reiter & Andrews, ). Obviously, a history and witnesses' description suggestive of PNES and an abnormal interictal EEG could be consistent with a diagnosis of possible PNES; however, in the absence of a clinician observing the ictus on video or in person, and with the question of interictal epileptiform discharges (IEDs), an alternative diagnosis of epilepsy would have to be considered very carefully.…”

Psychological treatments for adults and children with epilepsy: Evidence‐based recommendations by the International League Against Epilepsy Psychology Task Force

“…The aim of nonpharmacological seizure management techniques is to increase life quality as well as decrease seizure frequency and/or duration. Seizure management techniques could pragmatically be divided into 3 different approaches: (1) interventions to influence the consequences of seizures, for example, mindfulness training on awareness and nonjudgmental acceptance of seizure‐related physical symptoms; (2) interventions to affect the onset of seizures, for example, discrimination of seizure triggers through a functional analysis of individual seizure development and lifestyle recommendations for stress coping; and (3) techniques to abort ongoing seizures, for example, aura interruption techniques, that is, countermeasures to stop seizures from developing …”

“…interventions to influence the consequences of seizures, for example, mindfulness training on awareness and nonjudgmental acceptance of seizure-related physical symptoms; (2) interventions to affect the onset of seizures, for example, discrimination of seizure triggers through a functional analysis of individual seizure development and lifestyle recommendations for stress coping; and (3) techniques to abort ongoing seizures, for example, aura interruption techniques, that is, countermeasures to stop seizures from developing [109][110][111][112]. T A B L E 5 AAN LOE of studies investigating interventions aiming at improving medication adherence…”

The third major pillar of epilepsy treatment—using psychological approaches papers presented at the 23rdinternational epilepsy congress (prague) 1999

“…This led to presentations in the field at the 23 rd International Epilepsy Congress in Prague, most of which are printed here. Two of the presentations have already been published in Seizure 6,7 .…”

“…Other lecturers concentrated on clinical investigations of single components of psychological approaches which have already been established in some centres, such as the significant dependency of major types of emotionrelated seizure precipitation on the lateralization of the epileptic focus (Donna Andrews) 6 , the positive impact of learning seizure control by means of two types of biofeedback (respiration and slow cortical potentials) on depression and control orientation, which may develop as an additional factor in maintaining seizure control (Carmen Uhlmann), and the potential role of specifically trained dogs for early aura detection, with the remarkable 'side-effect' of seizure reduction (Stephen Brown). Indication-specific, clinical studies were reported on various neurobehavioural treatment concepts for juvenile myoclonic epilepsy (Zarko Martinovic) and complex partial epilepsy (Joel Reiter) 7 , each with comparable results in that psychological approaches are effective and hence should be offered to all patients with these diagnoses.…”