[Neurofeedback therapy influence on clinical status and some EEG parameters in children with primary generalized...

Pharmacological treatment of epilepsy in some patients is ineffective and alternative methods of treatment are need. These include neurofeedback (EEG biofeedback, NF). The aim of this study was to evaluate the clinical and neurophysiological effectiveness of NF in children with epilepsy with primary generalized seizures.

The study involved a group of 63 children with primary generalized seizures, aged 6-16 years, including 39 girls and 24 boys. As the efficacy of pharmacotherapy was not satisfactory for them, they have been referred to Neuromedica Institute in Krakow for NF treatment. The evaluation of preliminary clinical and neurophysiological parameters was performed. Individual NF therapy protocols were elaborated and trainings were conducted for 0.5-4 years. Individual therapy protocols were prepared by biofeedback specialist and trainings were conducted by biofeedback therapists. The same specialist also made a comparison of selected elements of the EEG in children before and after NF therapy.

The children enrolled into the study were diagnosed with epilepsy at the age of 6 months to the age of 16 years Tonic-clonic seizures and absence seizures were the most often seizure types in the examined group. Seizures occurred in 19 children every day. In 33/63 children clinical manifestation of seizures and EEG pattern when taken together allow the specific epilepsy syndrome diagnosis in 7 cases. In 27 children two or more antiepileptic drugs were used, and in 36 monotherapy was used. NF therapy had a significant impact on the clinical condition of the children, causing subsidence of seizures in most of them. In 23/63 children antiepileptic treatment was withdrawn and in 15 reduction of treatment was achieved. The impact of the NF therapy on the EEG parameters was beneficial, both in terms of the background activity and other parameters. Paroxysmal EEG pattern subsided in the vast majority of children (63 to 16) including a continuous paroxysmal activity from 12 to 4, interrupted from 51 to 12 and generalized from 63 to 21, with reduced susceptibility to photostimulation from 31 to 18 and hyperventilation from 39 to 17.

In half of children with primary generalized epilepsy with a characteristic EEG pattern specific epilepsy syndrome was diagnosed. In half of children subsidence of epileptic graphoelements in EEG was observed after NF therapy. In % of children paroxysmal bioelectric pattern subsided and sensitivity of EEG to hyperventilation and photostimulation decreased significantly. NF therapy had a positive impact on all the parameters of background bioelectrical activity. In 1/3 of children treated with NF pharmacotherapy of epilepsy was discontinued and in 1/4 reduced.