Identity of Emotional Triggers in Epilepsy

Feldman, Robert G.; Paul, Norman

doi:10.1097/00005053-197605000-00005

Cited by 83 publications

(35 citation statements)

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“…However, there is also a connection between stress and seizures independent of these two factors (Haut et al, 2007). This is further shown in a study demonstrating that audio and video recordings designed to elicit empathetically stressful responses were sufficient to induce spontaneous seizures in patients with epilepsy (Feldman and Paul, 1976). Moreover, patients with refractory epilepsy tend to report triggering factors, such as stress, more often than patients whose seizures are well controlled with medication.…”

Section: Hormonal Variationsmentioning

confidence: 92%

Epilepsy: Ever-changing states of cortical excitability

et al. 2012

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Section: Hormonal Variationsmentioning

confidence: 92%

Epilepsy: Ever-changing states of cortical excitability

et al. 2012

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“…Furthermore, patients with refractory epilepsy tend to report triggering factors, such as stress, more often than patients whose seizures are well controlled with medication, underscoring the potential therapeutic benefits of a better understanding of the relationship between stress and epilepsy (Sperling et al, 2008). Finally, in a study that did not rely on patient reporting, audio and video recordings designed to elicit empathetically stressful responses were sufficient to induce spontaneous seizures in patients with epilepsy (Feldman and Paul, 1976). Taken together, these findings suggest that the physiologic stress response is sufficient to provoke seizures in patients with epilepsy.…”

mentioning

confidence: 99%

Stress and Epilepsy: Multiple Models, Multiple Outcomes

Sawyer

Escayg

2010

Journal of Clinical Neurophysiology

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Human studies show a link between stress and epilepsy, with stress causing an increase in seizure frequency and severity in patients with epilepsy. Many different animal model systems have been used to better understand this connection and the possible mechanisms involved. This review highlights the results of such studies relating stress and seizure susceptibility, with a focus on the hypothalamic-pituitary-adrenal axis and its relationship to seizure generation. The effects of hypothalamic-pituitary-adrenal axis mediators, acute stress, chronic stress, and early life stress on the seizure phenotype are summarized. Results suggest that stress has both anticonvulsive and proconvulsive properties, depending on the animal strain and the stress/seizure induction paradigm used. Attempts to interpret the stress-epilepsy literature must take these variables into account. The growing availability of genetically modified mice that carry either human epilepsy mutations or mutations in stress pathway genes now provide the opportunity to examine the relationship between stress and epilepsy more directly.

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“…Stressful verbal stimuli presented to healthy controls can produce electroencephalography (EEG) changes that are subtle (narrowing of the bandwidth and regional changes in frequency), but sufficiently large for a blinded reviewer to correctly identify 92% of stress stimuli on EEG alone 12. Similarly in people with various epilepsies, stressful interviews induced changes (exaggerated spiking, paroxysmal activity or epileptiform complexes) in the majority13 and there are case series of stress-inducing audio/video recordings inducing seizures in patients with temporal lobe epilepsy in particular 14. There are a few larger or longer-term truly prospective studies, some of which show an increased risk of seizures with stress15 and some where the effect of stress could not be distinguished from the effects of confounders such as sleep deprivation, alcohol and missed medication 16…”

Section: Is There Clinical Evidence That Stress Causes Seizures/epilementioning

confidence: 99%

Stress and epilepsy: fact or fiction, and what can we do about it?

2016

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People with epilepsy report stress as the most common trigger for their seizures and some believe it caused their epilepsy in the first place. The link between stress and epilepsy has been studied in extensively in preclinical, epidemiological and clinical studies with at times confusing results, and clinical studies in particular fraught with confounders. However there is little doubt that stress if bad for health in general, and there is now a substantial body of pre-clinical evidence suggesting that chronic stress can worsen seizures in established epilepsy, in selected cases may even be a causal factor epilepsy. Taken together it is surely time for healthcare professionals working with people with epilepsy to pay more attention to stress in clinical practice, in which context some practical advice and guidance for screening and management are provided

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Identity of Emotional Triggers in Epilepsy

Cited by 83 publications

References 0 publications

Epilepsy: Ever-changing states of cortical excitability

Epilepsy: Ever-changing states of cortical excitability

Stress and Epilepsy: Multiple Models, Multiple Outcomes

Stress and epilepsy: fact or fiction, and what can we do about it?

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