Abstracts

RATIONALE: To evaluate the effect of a behavioral modification program completed by a mental-relaxation technique on patients with refractory epileptic seizures. METHODS: Preconditions for attendance were at least 10 seizures in the previous year and constant medication during the study. 20 patients were treated. The study comprised a 6-week baseline, a one year intervention and a one year follow up. The psychotherapeutic treatment-program started with single-sessions, continued with group-sessions in a weekly alternating schedule with single sessions and ended with group sessions. Our instruments of work-up included three different semi-structured questionnaires and a special developed seizure log. Outcome measures were seizure reduction during the program and after one year follow up and quality of life scales like: 1. self-knowledge about behavioral circumstances during the precipitating process of the seizure occurrence, 2. self-confidence in dealing with the illness and 3. reduction of fear about the seizures. RESULTS: First we found a 45% reduction of seizure frequency in our patient group. Three patients became completely seizure free. A second outcome was that the patients developed their ability to cope with the illness. This improved their daily quality of life. CONCLUSIONS: Our results show that psychotherapeutic treatment programs are helpful to gain a sufficient self-control concerning the seizure situation in many patients and might enable some patients even with refractory epileptic seizures to become completely seizure free. The branched process of therapeutic interventions is described and the psychodynamic effects of an active self-initiated coping with seizures will be discussed. Finally we would like to put forward the idea to complement the traditional pharmacological and surgical treatment methods of epilepsy by a method which makes use of the patients own resources of actively coping with illness.