A neurobehavioral treatment for unilateral complex partial seizure disorders: A comparison of right- and left-hemisphere patients

Abstract

This study looked at the efficacy of a multi-disciplinary neurobehavioral approach for treating patients with complex partial seizure disorders. Patients with a seizure focus in either the left or right hemisphere were compared for overall effectiveness of this approach in achieving control of complex partial seizures. Patients in this study received short-term treatment based on a model of self-control developed by the Andrews/Reiter Epilepsy Research Program. This research selected all patients who met the lateralization criterion from among cases receiving short-term treatment between 1992 and 1996. Forty-four patients were identified, a group of 21 right-hemisphere subjects and a second group of 23 left-hemisphere subjects. These patients were treated in a short-term (5 consecutive days) treatment protocol and then released, with weekly phone contact for 6 months following treatment. They were then followed for an additional 19 months through the continued submission of their seizure logs and journals. Subjects in both groups kept seizure records throughout the study starting with a two-month baseline period. Other data collected allowed study of the interaction of emotional states with seizure occurrence. This project produced valuable and relevant information regarding neurobehavioral management interventions as an effective adjunctive or alternative treatment for obtaining seizure control in epilepsy patients. Overall, 79% of patients treated achieved seizure control. More than 64% identified a recognizable emotional state that triggered seizures. The emotional trigger was specific for either the right or left hemisphere.

How Can We Enhance the Sense of Self-Efficacy in Epilepsy Individual Responses from 2 Qualitative Case Reports

“…It became apparent that it was very difficult for him to change his approach toward conflict due to the deep-seated nature of internal and external obstacles. Carl's case illustrates the seizure-triggering potential of suppressed anger if the seizure focus is located in the left hemisphere, as has been demonstrated by Andrews et al [12]. The modified seizure phenomena exemplify the interconnectedness of self-awareness and embodied psychological development and the observation that the enhancement of self-awareness may at times require an external dialogue.…”

“…The literature suggests that the Andrews/Reiter (A/R) intervention is one of the most comprehensive psychological approaches to epilepsy [11]. Prospective uncontrolled and retrospective evaluations have demonstrated a decrease in seizure frequency and an increase in HRQoL in individuals who participated in the A/R intervention [12,13,14,15]. To the knowledge of the authors of this study, a qualitative study investigating the concrete behavioral, cognitive and psychological effects of epilepsy-specific psychological interventions in general and the A/R approach in particular has so far not been conducted, even though qualitative research seems pertinent to the investigation of the complex effects of psychotherapeutic interventions by exploring and representing patient perspectives.…”

Verhaltensmedizin in der Neurologie: State of the Art

“…Einer neueren Erhebung zufolge [Balamurugan et al, 2013] sind dies vor allem Unregelmäßigkeiten in der Medikamenteneinnahme (40,9%), emotionale Belastungen (31,3%), Schlafmangel (19,7%), Müdigkeit (15,3%), ausgelassene Mahlzeiten (9,1%), Fieber (6,4%) und Rauchen (6,4%); gelegentlich wird auch noch die Menstruation genannt. Das Erkennen derartiger Auslöser lässt sich schulen, und über den kontingenten Einsatz der bereits genannten Verhaltensalternativen kann ein beginnender Anfall blockiert werden [Andrews et al, 2000; Danach weisen schwer beeinträchtigte ALS-Patienten dann eine gute Lebensqualität auf, wenn das soziale Netzwerk intakt ist und als fürsorglich erlebt wird. Verwandte und Pflegekräfte neigen dazu, die Depression der Patienten zu über-und die Lebensqualität zu unterschätzen.…”

Trigger self-control and seizure arrest in the Andrews/Reiter behavioral approach to epilepsy: A retrospective analysis of seizure frequency

“…anger for left-hemispheric, and fear for right-hemispheric foci). 12 It is possible that the physiology that underlies the genesis of seizures in the case of emotional seizure triggers may function similarly to the model of reflex epilepsies.…”