Abstracts

Rationale: Because of high rates of trauma (44-100%) and abuse (23-77%) among PNEA patients, it has been suggested that PNEA are a clinical expression of a PTSD subtype. Although little is known about psychological treatments that are most effective with PNEA, EMDR has proved to be an effective treatment for trauma and is now showing promise in the treatment of PNEA patients with trauma and abuse histories. This presentation details outcomes of 74 patients with PNEA, the majority of whom have such histories, who have been referred for mental health treatment. Methods: This study integrates EMDR into the mental health treatment of PNEA patients referred after video EEG monitoring confirmed the presence of psychogenic attacks and diagnostic interviews revealed virtually ubiquitous trauma and abuse histories/experiences. Data were analyzed for patients referred over a 6-year period from a hospital-based clinic serving Floridians and persons from the southeastern US. Results: The study protocol was comprised of 2-3 initial sessions for diagnosis and rapport building followed by weekly EMDR ranging from 3 to 15 sessions. Of 74 patients referred, 31 were from distant locales and were matched with mental health practitioners in their home locations. 43 patients were interviewed; 20 were seen for consultation only - they refused treatment, preferring to pursue disability benefits. 21 of 23 remaining had trauma and abuse histories. 14 of those realized complete remission of PNEA with EMDR; 8 discontinued treatment because of relocation, transportation difficulties, and the like. Followup reveals no return to seizure status. Conclusions: EMDR appears to be an efficacious intervention in the psychological treatment of PNEA patients with trauma histories. A two year highly innovative single center randomized controlled tial comparing EMDR with another innovative promising approach, Neurofeedback Therapy (NFT) is planned for the fall of 2010 for 60 patients.