Aura interruption: The Andrews/Reiter behavioral intervention may reduce seizures and improve quality of life - A pilot trial

Patients with epilepsy frequently experience depression and emotional stress and these may function as seizure triggers in epileptogenic frontotemporal cortex, which serves in emotional processing. Eight patients enrolled in a pilot trial of a 6-month epilepsy-specific behavioral approach comprising counseling and relaxation to recognize and eliminate emotional seizure triggers. Potential participants with psychogenic seizures were excluded by long-term EEG and/or the MMPI profile. One participant became seizure free, another had an approximately 90% reduction in seizures, and two additional participants achieved a greater than 50% reduction in seizure frequency (total responder rate = 50%), stable during 6 months of observation after the intervention. All completers showed marked and stable improvement of quality of life (Quality of Life in Epilepsy-89 inventory) and temporary improvement in the Profile of Mood States. An adequately powered randomized controlled trial is needed to confirm our findings, which suggest that behavioral approaches may hold promise for motivated patients with epilepsy.

► Stress may trigger seizures because frontotemporal cortex processes emotions. ► Eight patients learned techniques for self-control of emotional seizure triggers. ► Two participants had a 90% or greater seizure reduction; 2 had a greater than 50% reduction. ► Completers had marked and stable improvement in quality of life. ► Behavioral interventions may hold promise for motivated patients with epilepsy.