Stress and Seizures (1)

One of the best recent research articles on a form of stress illness (1) has a huge flaw.  The study was done over ten years at the Comprehensive Epilepsy Program at Royal Melbourne Hospital in Australia.  They evaluate people who have seizures that are difficult for their regular doctors to manage.  Among many other tests, patients have simultaneous video monitoring and EEG (brain wave) for five full days around the clock.  This test identified 221 adult patients who outwardly appeared to be having seizures but the EEG showed they were not true epilepsy.  These are called psychogenic (meaning “caused by a psychological process”) non-epileptic seizures (PNES).  In the few patients I have seen who had these they were a form of stress illness.  The patients are not deliberately pretending or faking, they are reacting to overwhelming life stresses.

Consistent with my (limited) experience, the Melbourne researchers found evidence for underlying stresses in that 73% of these patients had one or more psychiatric diagnoses.  Most common were Depression (48%), Anxiety (15%) and Substance Abuse (12%) and 30% were taking some form of psychiatric medication.

The huge flaw in their work?  The psychiatric interview didn’t include questions about childhood stress.  More in the next post.

1. Jones SG et al.  Clinical Characteristics and Outcome in Patients with Psychogenic Nonepileptic Seizures.  Psychosomatic Medicine 72:487 – 497. June 2010.

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