Behavioral intervention as an add-on therapy in epilepsy: Designing a clinical trial

Polak, Emily; Privitera, Michael; Lipton, Richard B.; Haut, Sheryl R.

doi:10.1016/j.yebeh.2012.09.012

Cited by 27 publications

(15 citation statements)

References 38 publications

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“…These findings were in congruence with the study of Polak et al (2012) [17] which used the deep breathing and progressive muscle relaxation (PMR) as a stress management approach. In all, 67 patients who completed the study; the median seizure frequency was reduced by 29% at (p = .006).…”

Section: Discussionsupporting

confidence: 88%

“…Additionally, Elsas et al [29] demonstrated that reduction or even elimination of emotional-triggered seizures was achieved through the use of an epilepsy-specific behavioral approach comprising counseling and relaxation. A similar report of the effectiveness of behavioral therapy in epilepsy as an additional modality to pharmacotherapy has been shown by Polak et al (2012) [17] who discussed the challenges of research in this respect.…”

Section: Discussionsupporting

confidence: 61%

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Effect of designing a nursing educational protocol on frequency of epileptic attacks

Mohammed

Mohammed²,

Hassan³

2018

JNEP

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Background and objective: Educating the epileptic patient represents a critical part of quality care and is considered a therapeutic outcome for those patients. This study aimed to determine epileptic patients' knowledge regarding the disease and frequency of seizure attacks prior to the implementation of the educational protocol and to evaluate the effect of an educational protocol on epileptic patient's knowledge and frequency of seizure attacks.Methods: Design: A quasi-experimental (pre-posttest) design was submit to meet the aim of the study. Patients: Sixty convenient male and female adult seizure patients were their age ranged between 18-64 years. Setting: This study was carried out in Neurological department and neurology out-patient clinic at Minia University Hospital. Tools of data collection: Four tools were utilized; Pre/posttest questionnaire sheet, Perceived Stress Scale, Epworth Sleepiness Scale, and patient teaching booklet.Results: About 86.7% of the study sample has an unsatisfactory level of knowledge about seizures and 13.3% have satisfactory knowledge about seizures before the implementation of the protocol. While in posttest II it was noticed that 90.0% have satisfactory knowledge about seizures. There was a high positive significant correlation between perceived stress scale and frequency of attacks among the study subjects.Conclusions: An improvement in seizure patients’ knowledge after the implementation of the educational protocol. An improvement in patient’s knowledge positively reflected on minimization and control frequency of seizure attacks. Recommendation: An educational and training protocol should be planned in a continuous manner and offered on regular basis to seizure patients.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 61%

Effect of designing a nursing educational protocol on frequency of epileptic attacks

Mohammed

Mohammed²,

Hassan³

2018

JNEP

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“…Additionally, Elsas et al [23] demonstrated that an epilepsy-specific behavioral approach comprising counseling and relaxation was successful in reducing or even eliminating emotional-triggered seizures. A similar report of the effectiveness of behavioral therapy in epilepsy as an adjunct to pharmacotherapy has been shown by Polak et al [24] who has also discussed the challenges of research in this area.…”

Section: Discussionsupporting

confidence: 60%

Effect of progressive relaxation technique in reducing epileptic seizures among adolescents

Sorour

Mohamed

2014

JNEP

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Epilepsy is a serious and a common neurological condition of which the medical, psychological and social implications are far-reaching and there is still a paucity of research in the psychology and social issues in epilepsy. The aim of this study was to examine the effect of progressive relaxation technique in reducing epileptic seizures among adolescents. The study was carried out on a convenience sample of 28 secondary school students attending the school health insurance center Beni-Suef city using a quasi-experimental design with pre-post assessment. Data collection tools included an interview questionnaire for the personal and disease characteristics; stress level was assessed using Cohen's (1994) 10-question tool. After a pretest, the researchers trained the participants in applying a stress management exercise, and asked them to practice it at home and to document the frequency and duration of daily practice using a diary for eight weeks. The post-intervention stress level was assessed using the same tool. The results revealed statistically significant changes in all ten items of the stress scale, with a median post-pre total difference of -0.3 (p < .001). The number of seizures decreased from a median of 3/week to one seizure in the last four weeks of follow-up (p < .001). A statistically significant weak negative correlation was found between the frequency of seizures and the number of progressive relaxation techniques practiced. The study findings indicate the effectiveness of a simple technique in improving the life of adolescents having epilepsy. However, the small sample size could not show the correlation between the practice of this relaxation technique and the frequency of the seizures. A randomized controlled clinical trial is recommended to confirm the findings.

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“…Patients with TRE can frequently predict subsequent seizure occurrence immediately after an acute stress experience (Haut, Hall, Masur, & Lipton, 2007;Nakken et al, 2005;Privitera et al, 2014). Behavioral stress management techniques, including progressive relaxation, biofeedback, and cognitive-behavioral therapy, have been proposed as adjunct to anti-seizure drugs (ASDs) in TRE (Polak, Privitera, Lipton, & Haut, 2012;Ramaratnam, Baker, & Goldstein, 2003). Clinical trials examining stress management interventions showed that these techniques may outperform comparable nonstress targeted interventions in reducing seizure frequency (Lundgren, Dahl, Yardi, & Melin, 2008;Nagai, Goldstein, Fenwick, & Trimble, 2004;Puskarich et al, 1992;Tang, Poon, & Kwan, 2015).…”

Section: Introductionmentioning

confidence: 99%

Neural response to stress and perceived stress differ in patients with left temporal lobe epilepsy

Goodman

Allendorfer

Heyse

et al. 2019

Human Brain Mapping

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Patients with epilepsy are often able to predict seizure occurrence subsequent to an acute stress experience. However, neuroimaging investigations into the neural basis of this relationship or the potential influence of perceived life stress are limited. The current study assessed the relationship between perceived stress and the neurobehavioral response to stress in patients with left temporal lobe epilepsy (LTLE) and healthy controls (HCs) using heart rate, salivary cortisol level, and functional magnetic resonance imaging and compared these effects between HCs and LTLE. Matched on perceived stress levels, groups of 36 patients with LTLE and 36 HCs completed the Montreal Imaging Stress Task, with control and stress math task conditions. Among LTLEs, 27 reported that prior (acute) stress affected their seizures (LTLES+), while nine did not (LTLES−). The results revealed that increased perceived stress was associated with seizure frequency in LTLE. Further, cortisol secretion was greater in LTLE, but did not vary with perceived stress as observed in HCs. A linear mixed‐effects analysis revealed that as perceived stress increased, activation in the hippocampal complex (parahippocampal gyrus and hippocampus) decreased during stressful math in the LTLES+, increased in HCs, but did not vary in the LTLES−. Task‐based functional connectivity analyses revealed LTLE differences in hippocampal functional connectivity with sensory cortex specific to stressor modalities. We argue that the current study demonstrates an inhibitory hippocampal mechanism underlying differences in resilience to stress between HCs and LTLE, as well as LTLE patients who report stress as a precipitant of seizures.

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Behavioral intervention as an add-on therapy in epilepsy: Designing a clinical trial

Cited by 27 publications

References 38 publications

Effect of designing a nursing educational protocol on frequency of epileptic attacks

Effect of designing a nursing educational protocol on frequency of epileptic attacks

Effect of progressive relaxation technique in reducing epileptic seizures among adolescents

Neural response to stress and perceived stress differ in patients with left temporal lobe epilepsy

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