Abstracts

RATIONALE: Non-epileptic seizures (NES) represent a considerable treatment challenge for neurology clinics. One area of difficulty is that there is no uniform psychological theory for the treatment of these seizures. While trauma has been recognised as important in NES this may be over-emphasised as a causal explanation. Cognitive behaviour therapy (CBT) is an established psychotherapy and has led to treatments for disorders such as social phobia, panic and depression. The fundamental tenet of CBT is that belief systems and cognitions are critical in determining moods and behaviour. METHODS: This study assessed belief systems in five patients with established non-epileptic seizures (four women, one man, mean age = 27) using a standard cognitive behaviour approach. RESULTS: This revealed a common set of beliefs in this pilot group. Their early life experiences had led them to believe that emotional expression was prohibited and in the event of increased stressors in their lives or a trauma they developed somatic symptoms in the form of non-epileptic seizures. The diagnosis of these behavioural events as epileptic led to further powerful belief systems, which acted as factors creating further somatisation. CONCLUSIONS: While based on a small number of patients, this theory provides a promising approach to the understanding of NES.