Question:
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?
Answer:
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
personality disorders.
To view the full summary, click the Download Document
link to the right.
To view the Cochrane review which is included in this summary,
click Related Documents, below.