Abstracts

Patients with epilepsy frequently identify stress as a precipitating factor in seizure occurrence. September 11, 2001 was considered to be a significantly stressful event for most individuals within the New York Metropolitan area. To date, there is inconclusive data evaluating how different types of stress, described as significant life events or daily stressors, play a role in seizure frequency.
We retrospectively evaluated 31 individuals, both surgical and nonsurgical (14 males, 17 females) from the Multi-Center Study of Outcomes of Epilepsy Surgery, (Columbia University site), who had seizures during the investigative time period. The study population was age 22-66 with refractory epilepsy who had seizures and/or auras three months prior to 9/11 and 3 months post 9/11. The Outcome Study protocol required patients to record seizures and isolated auras as separate events thereby enabling us to evaluate them separately. Three patients were excluded due to a combination of epileptic and nonepileptic seizures.
Three months prior to 9/11, the nonsurgical group experienced a mean seizure frequency of 16.1. In the same group, three months post 9/11, there was a mean seizure frequency of 19.7 (p=0.184). The mean seizure frequency for the surgical group was 2.4 three months prior to 9/11 and the mean seizure frequency was 3.4 post 9/11 (p= 0.279). Auras in the pre 9/11 period, for the nonsurgical group was a mean of 5.3. Auras had a mean increase of 9.4 post 9/11 (p=0.216). In the surgical group, there was mean aura frequency of 3.2 pre 9/11 and a mean aura frequency of 1.8 post 9/11 respectively (p=0.192).
There was no statistically significant difference in seizure and/or aura frequency during the investigative time period for the study population. There was a trend, however, toward an increase in seizures during the post 9/11 period. It is worthwhile to note that 2 patients, (1 surgical, 1 nonsurgical) had seizures on 9/12. Additionally, during the routine study interviews, many patients reported stress as seizure provoking. Stress is very individualized and it is not clear that the modest change in seizure frequency was related to the events of 9/11. The results indicate that further study is warranted to investigate the effects of this common phenomenon on seizures and epilepsy.