Eye movement desensitization and reprocessing in the psychological treatment of trauma‐based psychogenic non‐epileptic seizures

Abstract

Little is known about the types of mental health treatment that are most effective for psychogenic non-epileptic seizure (PNES) patients who have high rates of comorbid post-traumatic stress disorder (PTSD) and dissociation. Eye movement desensitization and reprocessing (EMDR) has proved to be effective in the treatment of PTSD, anxiety states, dissociative symptoms and somatoform disorders. This study, which utilized a non-controlled qualitative multiple revelatory case design, integrates EMDR into the psychological treatment of PNES patients with confirmed trauma experiences. With EMDR targeting trauma and dissociative symptoms in three patients, PNES were extinguished in two. Those patients have remained seizure-free for 12-18 months.

EMDR in the Treatment of Medically Unexplained Symptoms: A Systematic Review

“…In the remaining 16 articles the results of 110 patients were described. The same patient was described twice in the studies of Grant (2000) and Grant and Threlfo (2002), and also in the studies of Schneider et al (2007Schneider et al ( , 2008; another patient described by Silver, Rogers, and Russell (2008) did not have a somatoform complaint; and 5 of 8 patients described by Kelley and Benbadis (2007) did not receive EMDR treatment. This left 102 unique patients who received EMDR for a somatic symptom.…”

“…Follow-up data were collected for all but one large study (Mazolla et al, van Rood and de Roos 2009), a case series (Wilensky, 2006), and one case study (Grant, 2000). The period of follow-up measurements ranged from less than 1 month (Ray & Page, 2002;Russell, 2008a), 1 to 6 months (Chemali & Meadows, 2004;Grant & Threlfo, 2002;Russell, 2008a;Silver et al, 2008), 6 to 36 months (Brown et al, 1997;de Roos et al, in press;Gupta & Gupta, 2002;Kelley & Benbadis, 2007;McGoldrick et al, 2008;Royle, 2008;Schneider et al, 2008), to up to 10 years (McGoldrick et al, 2008) after treatment (Table 2).…”

“…The 16 studies (Table 2) consisted of one RCT (Ray & Page, 2002), two uncontrolled clinical studies (de Roos et al, in press;Mazolla et al, 2009), seven case series (Brown, McGoldrick, & Buchanan, 1997;Grant & Threlfo, 2002;Gupta & Gupta, 2002;Kelley & Benbadis, 2007;McGoldrick, Begum, & Brown, 2008;Schneider et al, 2008;Wilensky, 2006), and six single cases (Chemali & Meadows, 2004;Grant, 2000;Royle, 2008;Russell, 2008aRussell, , 2008bSilver et al, 2008).…”

“…After discussion, a further 6 studies were excluded (Friedberg, 2004;Hassard, 1995;Hekmat, Groth, Rogers, 1994;Kelley, Benbadis, & Adams, 2005;Marcus, 2008;Protinsky, Sparks, & Flemke, 2001). In the remaining 16 articles the results of 110 patients were described.…”

Closing the Major Gap in PNES Research

“…Hypnosis (45) and eye movement desensitization and reprocessing (EMDR) (46) have been studied in either single case studies or small group studies for PNES. Group therapy has shown some improvement in psychological well-being, while family therapy may be helpful when there is significant family dysfunction (9).…”