Electroconvulsive treatment for nonepileptic seizure disorders

• Published in: Epilepsy & behavior 2009-07, Vol.15 (3), p.382-387
• Main Authors: Blumer, Dietrich, Rice, Steven, Adamolekun, Bola
• Format: Article
• Language: English
• Subjects: Adult; Electroconvulsive Therapy - methods; Electroconvulsive treatment; Epilepsy; Epilepsy - diagnosis; Epilepsy - therapy; Female; Humans; Male; Middle Aged; Neurology; Nonepileptic seizures; Paroxysmal disorders; Seizure disorder; Startle
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2009.05.004

Abstract Because of its striking prevalence among females, the paroxysmal disorder presenting with nonepileptic seizures was termed hysteria in premodern times. In our time, the disorder has remained widely misunderstood and mistreated. The diagnostic early history of painful traumatic events as the source of the nonepileptic seizures is hidden by the shame of the victim and remains ignored. Early effective psychotherapeutic intervention is rarely carried out. Antiepileptic treatment is commonly initiated, and tends to worsen the seizure condition, which commonly becomes chronic. Key evidence from our treatment of patients with both epileptic and nonepileptic seizures had shown that low doses of antiepileptic drugs were required, because the patients markedly improved as some epileptic seizures were allowed to occur. This prompted our use of electroconvulsive treatment for a select series of 18 patients with the most severe chronic nonepileptic seizure condition. This treatment proved remarkably effective for 11 of the 15 patients who tolerated the treatment. Together with their seizures, the patients had had bodily pains, depressive moods, and often anxiety. Their disorder can be clearly distinguished from ordinary depression, and the remarkable effect of electroconvulsive treatment in its treatment seems to be in accordance with premodern views of a polarity between the two paroxysmal disorders epilepsy and hysteria. Further studies of our topic are called for.