Stress sensitivity of childhood epilepsy is related to experienced negative life events

Abstract

SUMMARYPurpose: To evaluate the effect of stress on seizure frequency in childhood epilepsy, and to assess possible differences between children in whom seizures are precipitated by stress and those in whom they are not. Methods: Parents or caregivers of children with active epilepsy (aged 2-16 years) were sent questionnaires on developmental and epilepsy characteristics, life-time stress exposure, and the effect of stressful periods and moments of acute stress on seizure frequency in their child. Further information was extracted from patient files. Key Findings: Parents or caregivers of 153 children with a median age of 8.8 years responded to the questionnaires. Thirty-nine percent reported an increase in seizure frequency during periods of stress, with a median increase of 2.5 times the frequency compared to nonstressful periods.Thirty-seven percent reported that seizures were precipitated by acute stress, with stress being a precipitating factor in 33% (median value) of the seizures. Overall, 51% of the patients reported stress sensitivity of seizures. A higher number of negative life events experienced in total life was related to an increase in seizure frequency in stressful periods (odds ratio [OR] 1.3, p = 0.01) as well as to the precipitation of seizures by acute stress (OR 1.3, p = 0.02). Significance: Stress sensitivity is reported in half of the children with epilepsy. Results of this study suggest a relation between experienced negative life events and stress sensitivity of childhood epilepsy. One possible explanation could be that experiencing negative life events may cause a larger response to daily stressors, thereby increasing the likelihood to induce epileptic activity.

The relation between cortisol and functional connectivity in people with and without stress‐sensitive epilepsy

“…32 An association between early life stress and stress sensitivity of seizures has been shown previously. 33 Most studies comparing people with epilepsy in the interictal state with healthy controls reported higher functional connectivity in epilepsy. 19,20,34,35 An increase in theta band functional connectivity was associated with seizure frequency in tumor-related epilepsy.…”

Seizure occurrence and the circadian rhythm of cortisol: a systematic review

“…The seizure precipitant most often reported is stress [1][2][3][4][5][6][7]. The relation between stress and seizures is expected to be mediated by stress hormones like corticotrophinreleasing hormone (CRH), adrenocorticotropic hormone (ACTH), and cortisol, affecting neuronal excitability and seizure threshold [8,9].…”

Seizure precipitants in Dravet syndrome: What events and activities are specifically provocative compared with other epilepsies?

“…To detect Dravet-specific reported seizure precipitants, we compared these in the cohort with Dravet syndrome with precipitants reported in two cohorts recently studied: a cohort with childhood epilepsy from the same University Medical Centre and a communitybased cohort with epilepsy from the same geographical region [13,14].…”

“…Of the 345 patients fulfilling the selection criteria, 153 (44%) had responded. The purpose of this questionnaire-based study was to address the relationship between stress, among other seizure precipitants, and epilepsy [13].…”

“…Cohort with childhood epilepsy [13] Community-based cohort with epilepsy [14] General questions Are there any circumstances/precipitants that often provoke seizures in the present or in the past? mail approach to 1894 patients, 575 (30%) responded, and, in 248 of them, a definite epilepsy diagnosis was confirmed by evaluation of medical data and questionnaires [15].…”