Objective: One third of patients with epilepsy do not benefit from antiepileptic medications. Psychological interventions are used as an alternative to reduce seizures. Previous reviews of psychological interventions were inconclusive; this review provides an updated analysis. Data Selection: A literature search was conducted using Medline and PsychInfo databases, including studies published through March 2015. Reference lists were checked for additional relevant studies. Search terms included biofeedback, educational, behavioral, cognitive, and relaxation. Studies with psychological treatment and an outcome variable of seizure frequency were included; non-epileptic seizures were excluded. Analysis includes 64 studies of psychological interventions. Data Synthesis: Nine studies utilized cognitive behavioral therapy, with seven reporting a decrease in seizures of up to 80−100%. Ten studies examining behavior modification indicated that more than 70% of individuals achieve seizure control. Psychoeducation was provided on seizures, epilepsy, and coping skills in two studies, with results indicating a 50% reduction in seizures. Twenty-seven studies used biofeedback to teach individuals to generate shift in slow cortical potentials or enhance rhythmic sensorimotor patterns. These studies reported significant decreases in frequency (50–80%) or index (frequency by strength). Studies of relaxation including muscle relaxation or yoga resulted in a 21−86% decrease in seizures. Conclusion: Many studies have methodological deficiencies including lack of blinding, control, randomization, and small samples. Due to these constraints, no reliable evidence supports use of psychological interventions. Research demonstrates the potential of psychological intervention in treating patients with epilepsy. Studies should include standardized interventions, larger homogenous samples, and randomized-controlled studies before the effect of psychological interventions can be determined.
Use of Psychological Interventions in The Reduction of Seizure Frequency: A Review
Arch Clin Neuropsychol (2015) 30 (6): 493.
25 August 2015
J Pliego, C Riccio; A-21
Use of Psychological Interventions in The Reduction of Seizure Frequency: A Review. Arch Clin Neuropsychol 2015; 30 (6): 493. doi: 10.1093/arclin/acv047.21
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