In adults with non-epileptic or dissociative seizures, what is the most effective treatment (psychological or medical, with particular focus on trauma focused treatment such as EMDR) in improving patient outcomes, such as a reduction in the frequency of seizures and improved quality of life?
The authors of a systematic review (SR) reported that there is
currently no sound evidence on which to base treatment decisions
for people with non-epileptic attacks. Two randomised controlled
trials (RCTs) presented some evidence to suggest that behavioural
treatment may reduce the number of seizures, however, the trials
had small sample sizes - and no definite clinical implications can
be made from this evidence. The authors of one pilot RCT stated
that they could neither substantiate nor refute the utility of a
serotonin selective reuptake inhibitor treatment in patients with
psychogenic non-epileptic seizures.
The need for further large, multi-centre, randomised controlled
trials that evaluate a number of treatments was commonly reported
in the included studies. The author of one RCT also suggested that
future studies may benefit by stratifying groups on the presence of
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