Survey offers first-ever look at treatment practices for nonepileptic seizures

April 21, 2008

A new nationwide clinician survey provides the first comprehensive look at what is community care or ‘treatment as usual’ for nonepileptic seizures (NES), laying the groundwork for clinical trials aimed at identifying effective treatments for this neuropsychiatric disorder.

There is currently no standard treatment for NES, a disorder that resembles an epileptic seizure but is not caused by abnormal activity in the brain. Findings of the survey are published in the April issue of Epilepsy & Behavior.

“Typically, neurologists are the first to encounter, diagnose and provide initial treatment for patients with NES, sometimes referring them for psychiatric treatment. But too often, patients with this disorder are lost between the practice divide of neurology and psychiatry,” says lead author W. Curt LaFrance, Jr., M.D., M.P.H., director of neuropsychiatry and behavioral neurology at Rhode Island Hospital.

“By helping to define ‘treatment as usual,’ our survey better equips researchers to design much-needed clinical trials to evaluate treatments for noneplipetic seizures, which we hope will someday bridge this divide and improve the quality of life of patients suffering from this disorder,” adds LaFrance, who’s also an assistant professor of psychiatry and neurology (research) at The Warren Alpert Medical School of Brown University.

Defined as involuntary episodes of sensation, movement, or behavior that may mimic epileptic seizures, NES are classified into two major groups: physiologic and psychogenic. Physiologic NES are triggered by a number of conditions, such as cardiac arrhythmia, sudden drops in blood pressure, sleep disorders, and hypoglycemia. A psychogenic NES appears to be caused by emotional trauma or excessive stress. According to estimates, of the three million people diagnosed with epilepsy in the U.S., between five and 20 percent of patients with seizures actually may have either NES alone or a combination of epileptic and nonepileptic seizures. NES is by far the most frequent nonepileptic condition seen in epilepsy centers.

More than 300 respondents across the United States completed the survey, including epileptologists, neurologists, neuropsychiatrists, and nurses. Approximately 80 percent of respondents said they believe psychotherapy is one of the most effective treatments for NES, followed by education and psychopharmacology. Nearly half prescribed psychotropic medications if patients were diagnosed with additional disorders, such as depression, and three-quarters reported tapering the amount of antiepileptic drugs that they prescribed.

Almost all respondents reported discussing the diagnosis of NES with their patients. Nearly 70 percent of neurologists continued to follow the patient after NES diagnosis. Treatment referrals were most commonly made to psychiatrists and psychologists, with 16 percent recommending psychiatric inpatient admission. “The study findings also underscores the importance of neurologists and psychiatrists working together to care for these patients,” adds LaFrance.

Barriers to treatment adherence were also identified, including insurance limitations, lack of reimbursement and lack of practitioners experienced with NES treatment.

They survey was administered in response to a recent NES Treatment Workshop sponsored by the National Institute of Neurological Disorders and Stroke, National Institute of Mental Health and the American Epilepsy Society.

Source: Lifespan

Explore further: The Journal of Heart and Lung Transplantation: 50 years of heart transplantation progress

Related Stories

The Journal of Heart and Lung Transplantation: 50 years of heart transplantation progress

December 4, 2017
This month marks the 50th anniversary of the world's firrst human heart transplant performed at Groote Schuur Hospital in Cape Town by South African surgeon, Christiaan Barnard. He transplanted the heart of a 25-year-old ...

Study shows promising multiple sclerosis treatment targets immune cells to increase neuroprotection

December 6, 2011
Laquinimod is an orally available synthetic compound that has been successfully evaluated in phase II/III clinical studies for the treatment of relapsing-remitting multiple sclerosis (RRMS). The mechanism of action of laquinimod ...

Study finds non-English speaking head and neck cancer patients have significantly worse outcomes

October 4, 2011
Researchers from Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) have found that among advanced head and neck cancer (HNC) patients receiving radiation-based treatment (RT), being non-English speaking ...

Test links strains of common parasite to severe illness in US newborns

April 12, 2012
Scientists have identified which strains of the Toxoplasma gondii parasite, the cause of toxoplasmosis, are most strongly associated with premature births and severe birth defects in the United States. The researchers used ...

Researchers unveil molecular details of how bacteria propagate antibiotic resistance

July 26, 2012
strains of pathogenic bacteria that are impervious to the antibiotics that subdued their predecessor generations – has required physicians to seek new and more powerful drugs for their arsenals. Unfortunately, in time, ...

Lung inflammation contributes to metastasis

December 15, 2015
Pre-existing inflammation in the lungs may increase the risk that cancers beginning elsewhere will spread to that organ, according to new research from Weill Cornell Medicine.

Recommended for you

New cellular approach found to control progression of chronic kidney disease

December 15, 2017
Researchers have demonstrated for the first time that extracellular vesicles - tiny protein-filled structures - isolated from amniotic fluid stem cells (AFSCs) can be used to effectively slow the progression of kidney damage ...

Testing shows differences in efficacy of Zika vaccines after one year

December 15, 2017
(Medical Xpress)—A large team of researchers with members from Harvard Medical School, Walter Reed Army Institute of Research, Bioqual Inc. and MIT has found that the efficacy of the three types of Zika vaccines currently ...

How to regulate fecal microbiota transplants

December 15, 2017
(Medical Xpress)—A small team of researchers at the University of Maryland, some with affiliations to the Veterans Affairs Maryland Health Care System, has written and published a Policy Forum piece in the journal Science ...

Screening could catch a quarter of hip fractures before they happen

December 15, 2017
Community screening for osteoporosis could prevent more than a quarter of hip fractures in older women - according to new research led by the University of East Anglia (UEA).

Urine test developed to test for tuberculosis

December 14, 2017
(Medical Xpress)—An international team of researchers has developed a urine test that can be used to detect tuberculosis (TB) in human patients. In their paper published in Science Translational Medicine, the group describes ...

40 years after first Ebola outbreak, survivors show signs they can stave off new infection

December 14, 2017
Survivors of the first known Ebola outbreak, which occurred in the Democratic Republic of the Congo in 1976, may be key to development of vaccines and therapeutic drugs to treat future outbreaks, according to a new study ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.