The facilitation and evocation of seizures. A questionnaire study of awareness and control

The finding that seizures can be precipitated in some epileptic patients by stimuli which originate from outside the central nervous system is not new. The influence of psychological changes on seizure frequency has, however, been much more difficult to determine. Patients who become aware of such associations may gain some control over their seizures. One hundred randomly selected out-patients with epilepsy were asked about their awareness of such associations and whether, as a consequence, they believed they had any control of their seizures. Ninety-two reported associations between seizures and facilitators or precipitants. The group who had made associations between independent states or stimuli and their seizures were more likely to have poorly controlled seizures and to be taking more anticonvulsants. Many had used this knowledge to control their seizures.