Abstracts

To explore circumstances around the emergence of a first seizure in adult onset epilepsy; i.e.what trends, if any, exist in the quality and quantity of life events occurring in the 12 months preceding the onset of an initial epileptic seizure. Research suggests that how individuals adjust to significant life events may explain the time of onset of a disease or chronic disorder. (Holmes, T.H., Rahe, R. The Social Readjustment Rating Scale, J Psychosom Res. 1967. 11:213-218). Although stress is recognized as a major precipitant for seizures in patients with a known seizure disorder, few studies, in any, have explored the cluster of life events associated with the onset of a first seizure in adult onset epilepsy. We also explored patients[apos] beliefs about the causes of their epilepsy, their knowledge of seizure triggers and their sense of control., A qualitative study using a phenomenological approach. Patients were selected prospectively from the M.N.H. epilepsy clinic and monitoring unit. Interviews were audio-taped using a semi-structured interview guide and a life experiences survey. Interviews continued until data saturation was achieved and themes identified., All patients reported significant life events experienced in the 12 months prior to the onset of their first seizure. Different themes were noted between men and women and among women of different age groups. All male responders reported primarily work related stressors prior to their first seizure. When significant others were present during the interviews, family stresses were also identified. Young women in their 20[apos]s identified a perception of diminished self efficacy in completing developmental tasks. Middle aged women described major losses and disruption in family relationships. None of the respondents reported irrational beliefs about the cause of their epilepsy. 93% of respondents were able to identify their seizure triggers and planned strategies to control them. The majority of patients also expressed the belief that stress increased the frequency of their attacks., A positive relationship between significant life events and timing of a first seizure in adult onset epilepsy was demonstrated in this limited sample. A larger sample is needed to further evaluate this finding. The majority of the patients interviewed believe that stress and seizures are related. This adds to what has been reported in other studies (Antebi, D., Bird, J. The Facilitation and Evocation of Seizures. Br J Psych. 1993.162: 759-64). The patients had the perception of high self control, were able to identify a relationship between their seizures and likely triggers, and discuss strategies to control such triggers. This study highlights the need to specifically inquire about stressors which may be present and may play a role in the triggering of adult onset epilepsy., (Supported by Savoy Foundation.)