A group psychotherapy trail including an intellectual disability patient experiencing psychogenic nonepileptic seizures

Abstract

Psychogenic non-epileptic seizures (PNES) are paroxysmal episodes resembling epileptic seizures. They have no abnormal electrical excitement and are thought to be triggered by psychological factors. Monitoring of EEG using a video recording has made diagnosis of PNES easier for clinicians. Guidelines to treat PNES have yet to be established. Particularly there are few interventional studies for treatment of PNES with intellectual disability (ID), and difficulties in treating it are common. In this study, we investigated the effectiveness of a group psychotherapy using an original textbook based on cognitive-behavioral therapy (CBT) in consideration of patients with ID. The study was performed at the National Center Hospital of Neurology and Psychiatry in Japan, and five patients with PNES and ID participated. We evaluated PNES symptoms before and after the twice a week intervention sessions for 3 weeks. PNES symptoms disappeared or were restrained in all cases after three-weeks. The study suggested a positive impact using group psychotherapy based on CBT for patients with PNES and ID. We also learned that intervention in consideration of personal issues of each patient with PNES and ID is necessary. Additional studies are needed for standardization of treatment of PNES with ID.