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Treatments for non-epileptic attack disorder.

G A Baker1, J L Brooks, L Goodfellow

  • 1Walton Centre for Neurology and Neurosurgery, Department of Neuropsychology, Lower Lane, Fazakerley, Liverpool, Merseyside, UK, L9 7LJ. Jayne.Brooks@thewaltoncentre.nhs.uk

The Cochrane Database of Systematic Reviews
|January 27, 2007
PubMed
Summary

This review found no reliable evidence that hypnosis or paradoxical therapy effectively treat psychogenic non-epileptic seizures (NES). More high-quality randomized studies are needed to establish effective treatments for NES.

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Area of Science:

  • Neurology
  • Psychiatry

Background:

  • Psychogenic non-epileptic seizures (NES) mimic epilepsy but lack physiological correlates.
  • Treatments for NES include psychological and pharmacological interventions, with variable success.
  • This Cochrane review aimed to establish the evidence base for NES treatments.

Purpose of the Study:

  • To assess if NES treatments reduce seizure frequency or improve quality of life.
  • To determine if any treatment is significantly more effective than others.

Main Methods:

  • Searched multiple databases (Cochrane, CENTRAL, MEDLINE, PsycINFO) up to July 2005.
  • Included randomized or quasi-randomized studies of psychological or non-psychological interventions for adult NES.
  • Excluded studies on childhood NES.

Main Results:

  • Three small, methodologically poor studies met inclusion criteria.
  • Two studies assessed hypnosis, one assessed paradoxical therapy.
  • No reliable evidence of improved seizure frequency or quality of life was found.

Conclusions:

  • Methodological limitations and small study numbers preclude reliable evidence for current NES treatments.
  • Hypnosis and paradoxical injunction therapy lack proven efficacy for NES.
  • High-quality randomized controlled trials are necessary to evaluate NES treatments.