Predictors of seizure reduction after self-regulation of slow cortical potentials as a treatment of drug-resistant epilepsy

Variables were identified that predict seizure reduction following self-regulation of slow cortical potentials (SCPs) as part of a behavioral self-management program. A sequence analysis across 52 weeks determined 14 patients to have greater than 50% seizure reduction, 8 patients with less than 50% reduction, and 12 patients without improvement. Three variables accounted for 70% of treatment success: (1) cortical excitability at the beginning of training, (2) epileptic focus, and (3) personality variables. Reduction of complex partial and secondary generalized seizures covaried with SCP control attained in the last training session. EEG spectral parameters and cognitive function appeared unrelated to treatment outcome. Successful patients may be those without large negative SCP amplitudes at the beginning of training, without a left temporal epileptic focus, and who score low on life satisfaction and are highly reactive to stress. Patients with complex partial and secondarily generalized seizures may be more likely to experience seizure reduction if they demonstrate good SCP control at the end of their training.