Abstracts

Non-epileptic seizures (NES) refer to seizure-like events not associated with epilepsy. There is currently no standard of care for the treatment of NES. Presentation of the diagnosis in an informative and non-judgmental manner may in itself reduce or even resolve NES while inadequate/unclear diagnostic presentation can lead to avoidance of necessary follow-up treatment. Traditionally, psychopharmacology in the form of psychotropic medication, and/or psychotherapy have been used with NES patients. The need for proper support and treatment contained in such approaches is not in doubt. However, outcome measures are lacking, as a reduction in NES may be associated with symptom substitution. The current study aimed to derive a specific treatment modality for NES in which illness-related symptoms were assessed and monitored following treatment completion.
Following diagnosis of NES based upon seizures captured during video EEG monitoring, patients were interviewed by the staff[apos]s clinical psychologist. Psychiatric interview was conducted and patients were referred for an outpatient psychotherapy treatment. Prior to the initial session, patients completed standardized questionnaires to assess quality of life (Quality of Life in Epilepsy-31; QOLIE-31), coping skills (Coping Inventory for Stressful Situations; CISS), traumatic symptoms (Davidson Trauma Scale; DTS), and dissociative tendencies (Curious Experiences Survey; CES). A time-limited psychotherapy group was initiated using a psychoeducational approach. Group leaders provided instructional handouts at the onset of each of the first 9 sessions describing NES, anger expression and management, NES comobordities, trauma and abuse, and stress coping mechanisms, among others. A final group session was provided for review and was followed by completion of questionnaires administered pretreatment.
Results of standardized questionnaires revealed a significant decline in post-traumatic symptoms on the DTS [t(3) = 3.922, p = .029]. Nonsignificant trends were observed indicating decreased dissociative symptomatology on the CES and increased coping skills and quality of life on the CISS and QOLIE-31, respectively.
Group therapy utilizing a psychoeducational approach is warranted for individuals with NES. Individuals report significant declines in post-traumatic symptoms. Reduction in dissociative symptomatology occurred along with improved quality of life and coping strategies. Psychoeducation served not only to provide information on NES diagnosis but helped elucidate the mechanism by which NES may develop, thus empowering individuals and contributing to seizure control or remission. Group therapy aided not only in providing support, but proved to be a powerful means of identification.