Stressful Life Events and with Seizure Frequency in Patients Epilepsy

Abstract

We tested whether unpleasant life events increased seizure occurrence in persons with epilepsy. Forty-six subjects maintained daily diaries for 10-36 weeks in which they recorded seizures and life events. Mean age of subjects was 39 years; 78% were female; 83% had complex partial seizures (CPS). On the average, subjects reported 3.3 seizures a week. Analyses first were conducted within each subject and then in the sample overall. For each person, we tested whether seizure frequency increased within 24 h of the occurrence of unpleasant events, using Poisson regression analyses that adjusted for daily antiepileptic medication, sleep duration and quality, alcohol intake, menstrual status, and pleasant events. Rarity of events precluded analyses in 9 subjects. Events increased seizure frequency in 5 subjects (14%) (p < 0.05). Events decreased seizure frequency in 2 subjects (p < 0.05). When individual risk ratios were aggregated across subjects, unpleasant events were significantly associated with seizure increase only in men (RR = 1.67, 95% Confidence interval 1.09, 2.54). However, this finding must be interpreted with caution because of the limited number of men in the sample. In other aggregate analyses, events and seizures were not associated in subjects grouped by seizure type, age of seizure onset, current age, ethnicity, educational level, or marital status. Identification of factors that distinguish patients with and without event-triggered seizures requires further study.

Clinical Research Physical Exercise in Outpatients with Epilepsy

“…However, the epilepsies constitute a heterogeneous group of disorders, probably with different underlying pathophysiologic mechanisms (43). Opposite effects on seizure susceptibility of an intervention across subjects may therefore not be unexpected (44).…”

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

“…Persons exposed to sub-acute or chronic stressful conditions such as active army duty or the loss of a child appear more likely to develop epilepsy than those in less stressful scenarios [11,12]. Stress has also been demonstrated to be a trigger factor, or precipitant, as well as an exacerbating factor for seizure occurrence in persons with epilepsy [7,[13][14][15][16][17][18][19][20][21][22]. Trigger factors increase the probability of seizure over a relatively short time period, usually hours to a couple of days, while exacerbating factors increase the probability of seizures over longer periods of time, often days to weeks.…”

Influence of an Evacuation in February 1995 in The Netherlands on the Seizure Frequency in Patients with Epilepsy: A Controlled Study

“…In studies by Temkin and Davis (7) and Neugebauer et al (8), patients prospectively recorded epileptic seizures and life events during a 10-to 36-week period. Both studies provide empiric evidence that stressful events are strongly associated with greater seizure occurrence;…”