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Epilepsy Type Signs Linked To Stress

EEG shows abnormal activity in some types of s...

A study, published online in the journal Seizure, reveals that over 33% of patients believed to have intractable seizures were actually presenting stress-triggered symptoms.

A team of Johns Hopkins physicians and psychologists found that more than one-third of patients admitted to The Johns Hopkins Hospital's inpatient epilepsy monitoring unit had symptoms caused by stress, rather than a true seizure disorder.

According to the researchers, these patients, which included mothers in child-custody battles and returning war veterans, as well as over-extended professionals alike, have psychogenic non-epileptic seizures (PNES).

Signs of the condition include:
  • Convulsions
  • uncontrollable movements
  • far-off stares
The researchers note that signs of PNES appear to be stress-related behaviors that mimic and are misdiagnosed as epilepsy, but are not due to abnormal electrical discharges in the brain that characterize the neurological disorder.

Antiseizure medications fail to stop these patients' symptoms, indicating that there is nothing physically wrong with the their brains' electrical activity, say the researchers. In addition, the incidence of PNES is increasing, at least by what they have observed in recent months.

Previously, PNES like behaviors were referred to as "hysteria", whereas now they are usually considered to be part of a "conversion" disorder, in which the patient unconsciously converts emotional dysfunction into physical symptoms.

They highlight that in some cases, patients have become blind or paralyzed as a result of emotional trauma. According to the researchers, physicians have tried not to publicize or bring attention to PNES, as individuals at risk for pseudo-seizures are usually highly suggestible.

In the past few months, media reports from Western New York have described more than 12 female high school students who experienced uncontrollable tics and other movements, which experts now consider to be manifestations of a "contagious" psychiatric, rather than neurological disorder.

According to neurologists and neuropsychologists at the Johns Hopkins University School of Medicine, individuals with PNES do not necessarily experience more frequent or severe stressful events than healthy individuals or those with epilepsy, although PNES patients appear to be unable to effectively deal with those stresses and as a result, feel more distressed by them.

Jason Brandt, Ph.D., senior researcher of the study, professor of psychiatry and behavioral sciences and neurology at the Johns Hopkins University School of Medicine, explained:

"These patients behave as if they have an organic brain disease, but they don't. And it turns out that their life stresses weren't all that high, but they're very sensitive to stress and they don't deal with it well."
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