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| |  Cognitive Behavioural Therapy May Reduce Incidence of Non-Epileptic Seizures: Presented at AES By John Otrompke BOSTON -- December 8, 2009 -- Increased cognitive counselling reduces the incidence of epileptic-like seizures that do not have a biological origin, according to a study presented here at the American Epilepsy Society (AES) 63rd Annual Meeting. “The people in our study look as if they have epilepsy, but there is no organic cause,” explained Laura Goldstein, PhD, King’s College, London, United Kingdom, on December 6. “They have a lot of things that look like a grand mal seizure -- some fainting or some swooning and movement over parts of their body -- but they don’t have the EEG [electroencephalography] changes you’d associate with epilepsy.” “A high percentage of these patients have suffered abuse at some point in their life. There’s a risk of psychiatric causes for these seizures, or some type of neurological damages,” she added. In the study, 66 people with dissociative seizures were randomised to receive standard medical care with or without cognitive behavioural therapy. After 6 months, those who had received cognitive therapy were 3 times more likely to have been seizure-free for the preceding 3 months than those who had received only standard medical therapy alone. Precisely what constitutes standard medical care for such patients varies according to setting, according to Dr. Goldstein. “We’re a psychiatric unit, so we would have the patient reviewed by a neurologist; have the patient taken off of anti-epilepsy drugs, and give [them] support, including a general discussion of the psychiatric basis of the seizures, and education.” The people who received behavioural therapy saw a therapist for 1 hour a week for 12 sessions. “The cognitive behavioural therapy group may have done better because they saw people more frequently,” said Dr. Goldstein. “There was a small drop in seizures in the standard care group as well, and both groups saw an equivalent reduction in prescriptions written, as well as in emergency room visits,” she added. “However, the reduction in visits to the emergency room by ambulance was more pronounced than the drop in emergency room visits.” Patients in the study ranged in age between 18 and 70 years. The median age in the cognitive therapy group was 37.4, compared with 35.9 in the standard medical care group. [Presentation title: A Randomised Controlled Trial of CBT and Standard Medical Care In Patients With Dissociative (Non-Epileptic) Seizures. Abstract 2.135]
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