Cognitive Behavioural Therapy in Dissociative Seizures

The purpose of this study is to determine whether adults with disoociative (psychogenic non-epileptic) seizures receiving cognitive behavioural therapy (CBT) show a greater reduction in seizures and health service use and greater improvement in employment status and overall psychosocial functioning than patients who receive standard care.

Preliminary results from a pilot study demonstrated that cognitive behavioural therapy (CBT) is associated with a significant benefit for patients with dissociative seizures. The current study aims to extend these findings by conducting a randomised controlled trial comparing CBT with standard outpatient medical care. Standard outpatient care has been chosen as the comparison treatment as it most closely resembles what is currently offered to this group of patients by the National Health Service. The primary outcome measure will be seizure frequency. Secondary outcome measures will be work and social adjustment and health service use. Our hypothesis is that CBT will be superior to standard outpatient care for patients with dissociative seizures as determined by the above measures.

non epileptic seizures, cognitive behavioural therapy, dissociative disorders, Seizure disorders, randomised controlled trial

Inclusion Criteria: clinical diagnosis of dissociative seizures diagnosis confirmed by video EEG telemetry where practicable aged 16 - 70 Exclusion Criteria: co existent diagnosis (past or present) of epilepsy seizure frequency of less than 2 seizures per month current alcohol or drug abuse benzodiazepine use exceeding the equivalent of 10mg diazepam per day.

Goldstein LH, Deale AC, Mitchell-O'Malley SJ, Toone BK, Mellers JD. An evaluation of cognitive behavioral therapy as a treatment for dissociative seizures: a pilot study. Cogn Behav Neurol. 2004 Mar;17(1):41-9. doi: 10.1097/00146965-200403000-00005.