Clinical-Psychological Treatment of Epileptic Seizures: A Controlled Study

1991 ◽  
pp. 81-96 ◽  
Author(s):  
Niels Birbaumer ◽  
Thomas Elbert ◽  
Brigitte Rockstroh ◽  
Irene Daum ◽  
Peter Wolf ◽  
...  
Keyword(s):  
Psychological Treatment ◽  
Epileptic Seizures ◽  
Controlled Study

scholarly journals Developmental Background and Outcome in Patients with Nonepileptic Versus Epileptic Seizures: A Controlled Study

Epilepsia ◽  
1998 ◽  
Vol 39 (5) ◽  
pp. 463-469 ◽  
Author(s):  
Magdalena Berkhoff ◽  
Regula S. Briellmann ◽  
Bogdan P. Radanov ◽  
Filippo Donati ◽  
Christian W. Hess
Keyword(s):  
Epileptic Seizures ◽  
Controlled Study

Psychological treatments for functional non-epileptic attacks: a systematic review

2009 ◽  
Vol 21 (4) ◽  
pp. 158-168 ◽  
Author(s):  
Danielle Gaynor ◽  
Hannah Cock ◽  
Niruj Agrawal
Keyword(s):  
Systematic Review ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Epileptic Seizures ◽  
Future Research ◽  
Psychological Treatments ◽  
Psychogenic Seizures ◽  
Epileptic Attack ◽  
Behavioural Therapies ◽  
Randomised Controlled

Objective:There is a lack of clarity about the most useful intervention for functional non-epileptic attacks (FNEA). Outcomes for this condition remain often poor, with considerable personal, social and economic impact. In order to guide clinical practice and future research in this area, we have performed a systematic review of the published literature on the psychological treatment of FNEA.Methods:A comprehensive literature search was carried out using key words: non-epileptic seizures; psychogenic seizures; psychogenic non-epileptic seizures; pseudoseizures; funny turns; non-epileptic attack; hysterical seizures; and pseudoepileptic. Studies specifically looking at psychological treatment of FNEA were identified. Studies of patients also having comorbid organic seizure disorders were excluded.Results:17 studies that met the inclusion criteria were identified. A broad variety of psychological interventions for FNEA has been investigated. Only one randomised controlled trial has been completed to date. Existing evidence appears to suggest that various psychological treatments, including presenting the diagnosis, psychoeducation, behavioural therapies and mixed modality treatments, may be effective.Conclusion:While a range of psychological treatments may be beneficial for this patient group, we do not have clear evidence to suggest which treatment is most efficacious. Specific elements of presenting the diagnosis and psychoeducation may be required in addition to traditional cognitive behavioural therapeutic approaches. Large, methodologically robust studies are urgently required to establish the most effective form of treatment.

scholarly journals Accident risk in patients with epilepsy

2008 ◽  
Vol 66 (2a) ◽  
pp. 175-178 ◽  
Author(s):  
Karla Teixeira Souza ◽  
Marilisa M. Guerreiro ◽  
Carlos A.M. Guerreiro
Keyword(s):  
Epileptic Seizures ◽  
Outpatient Clinics ◽  
Controlled Study ◽  
Accident Risk ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Patients With Epilepsy ◽  
Prospective Longitudinal ◽  
Structured Questionnaire

OBJECTIVE: To compare the risk of accidents in patients with uncontrolled seizures, in seizure-free patients, and in patients with chronic headache. METHOD: This was a prospective longitudinal case-controlled study with interviews. A semi-structured questionnaire was used in the epilepsy and headache outpatient clinics of the Hospital das Clínicas of UNICAMP. RESULTS: Group I was composed of 48 patients with uncontrolled seizures, group II was composed of 24 seizure-free patients and group III was composed of 32 patients with headache. Thirty-nine patients (81%) in group I, 13 (54%) in group II, and 19 (59%) in group III reported accidents in the last two years. In the first group, 649 accidents (89%) were related to epileptic seizures and the average number of accidents not related to seizures was 1.7. The average number of accidents in groups II and III were both 2.4. CONCLUSION: Epileptic seizure was the most important factor determining the occurrence of accidents in people with epilepsy.

scholarly journals Impact of integrated district level mental health care on clinical and functioning outcomes of people with depression and alcohol use disorder in Nepal: a non-randomised controlled study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
M. J. D. Jordans ◽  
E. C. Garman ◽  
N. P. Luitel ◽  
B. A. Kohrt ◽  
C. Lund ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Health Workers ◽  
Psychological Treatment ◽  
Controlled Study ◽  
Primary Care Mental Health ◽  
Treatment Groups

Abstract Background Integration of mental health services into primary healthcare is proliferating in low-resource countries. We aimed to evaluate the impact of different compositions of primary care mental health services for depression and alcohol use disorder (AUD), when compared to usual primary care services. Methods We conducted a non-randomized controlled study in rural Nepal. We compared treatment outcomes among patients screening positive and receiving: (a) primary care mental health services without a psychological treatment component (TG); (b) the same services including a psychological treatment (TG + P); and (c) primary care treatment as usual (TAU). Primary outcomes included change in depression and AUD symptoms, as well as disability. Disability was measured using the 12-item WHO Disability Assessment Schedule. Symptom severity was assessed using the 9-item Patient Health Questionnaire for depression, the 10-item Alcohol Use Disorders Identification Test for AUD. We used negative binomial regression models for the analysis. Results For depression, when combining both treatment groups (TG, n = 77 and TG + P, n = 60) compared to TAU (n = 72), there were no significant improvements. When only comparing the psychological treatment group (TG + P) with TAU, there were significant improvements for symptoms and disability (aβ = − 2.64; 95%CI − 4.55 to − 0.74, p = 0.007; aβ = − 12.20; 95%CI − 19.79 to − 4.62; p = 0.002, respectively). For AUD, when combining both treatment groups (TG, n = 92 and TG + P, n = 80) compared to TAU (n = 57), there were significant improvements in AUD symptoms and disability (aβ = − 15.13; 95%CI − 18.63 to − 11.63, p < 0.001; aβ = − 9.26; 95%CI − 16.41 to − 2.12, p = 0.011; respectively). For AUD, there were no differences between TG and TG + P. Patients’ perceptions of health workers’ skills in common psychological factors were associated with improvement in depression patient outcomes (β = − 0.36; 95%CI − 0.55 to − 0.18; p < 0.001) but not for AUD patients. Conclusion Primary care mental health services for depression may only be effective when psychological treatments are included. Health workers’ competencies as perceived by patients may be an important indicator for treatment effect. AUD treatment in primary care appears to be beneficial even without additional psychological services.

scholarly journals Magnesium as an Effective Adjunct Therapy for Drug Resistant Seizures

2012 ◽  
Vol 39 (3) ◽  
pp. 323-327 ◽  
Author(s):  
Peter A. Abdelmalik ◽  
Nina Politzer ◽  
Peter L. Carlen
Keyword(s):  
Intractable Epilepsy ◽  
Retrospective Chart Review ◽  
Epileptic Seizures ◽  
Controlled Study ◽  
Seizure Freedom ◽  
Drug Resistant ◽  
Cns Depressant ◽  
Drug Resistant Epilepsy ◽  
Double Blinded

Objective:To explore the use of magnesium (Mg), an endogenous ion and enzymatic co-factor used in a variety of medical applications, for the treatment of epileptic seizures resistant to traditional medical therapy.Background:For almost a century, Mg has been used as prophylaxis and treatment of seizures associated with eclampsia. Mg is a CNS depressant, with numerous functions intracellularly and extracellularly. However, because of the availability of well studied anticonvulsant drugs, Mg has not been tested widely in the treatment of epileptic seizures.Methods:A retrospective chart review of 22 cases of drug resistant epilepsy, where a trial of empiric oral Mg supplementation (mainly in the form of Mg-oxide) was conducted.Results:Oral Mg supplementation was associated with a significant decrease in the number of seizure days per month, from 15.3 ± 13.2 (mean ± SD) to 10.2 ± 12.6 at first follow up (3-6 months, p=0.021), and to 7.8 ± 10.0 seizure days/month at second follow up (6-12 months, p=0.004). Thirty-six percent had a response rate of 75% or greater at second follow-up. Two patients reported seizure freedom. Most patients were well maintained on MgO 420mg twice a day, or in 2 cases, Mg Lactate, without significant adverse effects, the most frequent being diarrhea (4/22).Discussion:These results suggest that oral Mg supplementation may prove to be a worthwhile adjunctive medication in treating drug intractable epilepsy.Conclusions:A prospective, double-blinded, placebo controlled study is warranted to evaluate the potential of Mg for the treatment of drug-resistant seizures.

scholarly journals Psychological treatment of patients with psychogenic non-epileptic seizures: An outcome study

Seizure ◽  
2008 ◽  
Vol 17 (7) ◽  
pp. 595-603 ◽  
Author(s):  
Jarl Kuyk ◽  
Mieke C. Siffels ◽  
Patricia Bakvis ◽  
Wilhelmina A.M. Swinkels
Keyword(s):  
Psychological Treatment ◽  
Epileptic Seizures ◽  
Outcome Study

Psychogenic non-epileptic seizures: aetiology, diagnosis and management

2014 ◽  
Vol 20 (1) ◽  
pp. 13-22 ◽  
Author(s):  
Maria Oto ◽  
Markus Reuber
Keyword(s):  
Psychological Treatment ◽  
Epileptic Seizures ◽  
Initial Step ◽  
Diagnosis And Management ◽  
Model Combining ◽  
Underlying Causes ◽  
Iatrogenic Harm ◽  
Patient’S History

SummaryPsychogenic non-epileptic seizures (PNES) have a significant impact on most patients in terms of distress, disability, loss of income and iatrogenic harm. Three-quarters of patients with PNES are initially misdiagnosed and treated for epilepsy. Misdiagnosis exposes patients to multiple iatrogenic harms and prevents them from accessing psychological treatment. In most cases, the patient's history (and witness accounts) should alert clinicians to the likely diagnosis of PNES. Since this diagnosis may be resisted by patients and may involve ‘un-diagnosing’ epilepsy, video-electroencephalogram recording of typical seizures is often helpful. The underlying causes of PNES are diverse: a model combining predisposing, precipitating and perpetuating factors is a useful way of conceptualising their aetiology. The initial step of treatment should be to limit iatrogenic harm. There is some evidence for the effectiveness of psychotherapy.

Combination of Hormonal and Psychological Treatment for Female Sexual Unresponsiveness: a Comparative Study

1978 ◽  
Vol 133 (4) ◽  
pp. 339-346 ◽  
Author(s):  
Anthony Carney ◽  
John Bancroft ◽  
Andrew Mathews
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Comparative Study ◽  
Factorial Design ◽  
Psychological Treatment ◽  
Controlled Study ◽  
Testosterone Therapy ◽  
End Of Treatment

SummaryThirty-two couples with the presenting problem of female sexual unresponsiveness were treated in a controlled study using a balanced factorial design. Treatment involved a combination of drug therapy and counselling. Half the subjects received testosterone and half diazepam, half received weekly and half monthly counselling. They were assessed before treatment, at the end of treatment and at six months follow-up.Those receiving testosterone did significantly better on a number of behavioural and attitudinal measures than the diazepam group. There were no notable differences in outcome between the two counselling regimes. There were no undesirable side-effects with the testosterone.Further work is needed to establish the indications for testosterone therapy for unresponsive women.

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