A Survey of Mothers' Impressions of Seizure Precipitants in Children with Epilepsy

Abstract

In a survey of 446 children with epilepsy attending a regional EEG unit, mothers of nearly 90% of the children reported factors that appeared to act as precipitants of their children's seizures. The relationship between these factors and the seizures ranged from consistent triggers to an occasional association. There were no differences in incidence according to sex, site of focus, or type of epilepsy. Associations between environmental events or internal states are so commonly perceived by mothers that routine inquiry would appear warranted. If the event can be corroborated as a seizure precipitant, application of psychological methods of seizure control may be appropriate; if the event cannot be corroborated, needless anxiety about particular situations for a child may be avoided.

Emergent Equivalence Relations Between Interoceptive (Drug) and Exteroceptive (Visual) Stimuli

“…Examples of stimulus control over types of behavior that have interoceptive components have been suggested in research on substance abuse (e.g., conditioned drug taking, conditioned withdrawal, conditioned tolerance, drug reinstatement; Bickel & Kelly, 1988;O'Brien, 1975;O'Brien, Childress, McLellan, Ehrman, & Ternes, 1988;O'Brien, Testa, O'Brien, Brady, & Wells, 1977;Siegel, 1978Siegel, , 1988, anxiety disorders (e.g., generalized anxiety, situational anxiety, panic attacks, worrying; Barlow et al, 1985;Borkovek, Wilkinson, Folensbee, & Lerman, 1983;Margraf et al, 1987), eating disorders (e.g., dietary restraint; Ruderman, 1986), and epilepsy (Verduyn, Stores, & Missen, 1988). Despite these reports, the development, complexity, and pervasiveness of these controlling-stimulus relations are not well understood (Street et al, 1989).…”

A study of the relationship between participation in common leisure activities and seizure occurrence

“…Furthermore, it may have been appropriate to focus on a chronic population as persons with frequent seizures have been shown to be most likely to report precipitating factors (2,3). Firstly, the study group did not contain children and its features were more akin to a chronic rather than general epilepsy population.…”

“…There is currently no empirical evidence to suggest that children and adults differ in their general susceptibility to seizure precipitants. Furthermore, it may have been appropriate to focus on a chronic population as persons with frequent seizures have been shown to be most likely to report precipitating factors (2,3). Nonetheless, the fact that many of our participants suffered from partial epilepsy should be borne in mind when considering the implications of our ®ndings for patients with some other forms of epilepsy.…”

“…In a survey of potential seizure precipitants, 29 of 100 adult patients attending a tertiary referral centre indicated that``concentration to a task'' increased the frequency of their seizures (2). In another study, the mothers of 237 children with frequent seizures attending a regional EEG unit reported that being`a lert and concentrating'' had some association with seizures in 60% of cases (3). Studies which rely on selfreport are dif®cult to interpret.…”

Practitioner Review: Recognition of Pseudoseizures in Children and Adolescents

“…Conversely, strongly motivated patients may render themselves incontinent or bite their tongue, or otherwise injure themselves, in order to be convincing. $ The presence of an emotional trigger to the attack has little discriminatory value in view of the frequency with which careful enquiry reveals emotional factors acting as precipitants of seizures (Verduyn, Stores, & Missen, 1988). $ Extremes of emotional response by the patient to the attacks are difficult to assess accurately.…”