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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a group of female in-patients clinically diagnosed as having non-epileptic attack disorder there was an increased incidence of a proven previous history of sexual abuse in childhood, when compared with a group of women with epilepsy and a group of women with other psychiatric disorders admitted to the same ward. This was particularly true of women with the 'swoon' and 'abreactive' type of non-epileptic attack disorder (see Part I). The incidence of a history of previous abuse was similar to the two control groups for other types of non-epileptic attack disorder. The swoon was seen as a cut-off phenomenon: the abreactive attack as a kind of acting out the memory of the abuse, part of a post-traumatic stress disorder. Both may respond to counselling for the abuse although it is too early to be certain, and there is a risk of further episodes of the non-epileptic attack disorder during periods of stress. Some patients with epilepsy, however, also had a history of previous sexual abuse: in some the stress of the abuse may have precipitated the epileptic seizures.
Seizure 1992 Mar
PMID:Diagnosis, management and prognosis of a group of 128 patients with non-epileptic attack disorder. Part II. Previous childhood sexual abuse in the aetiology of these disorders. 134 16

A patient is described who began to have paroxysmal convulsive behaviour, followed by a post-ictal aggression, which was initially diagnosed and treated as epilepsy. The behaviour began after the patient was raped. She had many of the symptoms of post-traumatic stress disorder. It is suggested that the paroxysmal behaviour was an 'acting out' of intrusive and vivid memories of the rape, so called 'flashbacks'. Because the rape had occurred comparatively recently and the events that occurred during the rape were known, it was easy, in this particular patient, to understand the relationship between the previous trauma and the paroxysmal behaviour. The case throws some light on the relationship between similar paroxysmal behaviour in the victims of child sexual abuse and the trauma they had suffered and explains why they behave in the way that they do.
Seizure 1992 Mar
PMID:Seizure behaviour in a patient with post-traumatic stress disorder following rape. Notes on the aetiology of 'pseudoseizures'. 134 18

One hundred and seven consecutive patients attending the outpatient epilepsy clinic at a teaching general hospital were assessed by clinical interview for a history of sexual abuse. Questionnaires dealing with overall psychiatric symptomatology i.e., (SCL-90), (TSC-40) and depression (ZSRDS) were also used. The majority of subjects were single (60%), living at home (76.6%) and had an average age of 29 years. The mean duration of epilepsy was 18.8 years and the seizures were controlled with medication in 65.2% of patients. Ten (9.3%) of the subjects had been sexually abused. This frequency of sexual abuse is lower than in the general population and among psychiatric patients. The specific form of sexual abuse consisted of sexual intercourse (n = 4), fondling (n = 4) and oral sex (n = 2). The sexually abused subjects had significantly higher scores on the anxiety subscale of the SCL-90 and depression score on the ZSRDS than non-abused subjects.
Seizure 1992 Dec
PMID:Sexual abuse and psychiatric symptoms in an epileptic population. 134 75

Previous sexual abuse is now thought to be a common cause of non-epileptic seizures (pseudoseizures). However, since sexual abuse is common, a previous history of sexual abuse may also occur in people with actual epilepsy. We present six patients in all of whom sexual abuse may, by acting as a stressor in the already predisposed, have precipitated epilepsy and in some of whom the abuse may have affected the actual experiences of the epilepsy itself: all but one of the patients had partial seizures.
Seizure 1992 Dec
PMID:Epileptic seizures induced by sexual abuse. Pathogenic and pathoplastic factors. 134 76

About 20% of patients with intractable epilepsy do not have epileptic seizures. The exact diagnosis is in fact difficult because most of the time, the seizures are not directly visualized. In case of uncertainty, prolonged EEG/Video monitoring and clinical observation are necessary to avoid escalated drug therapy and behavioural problems. We describe two such cases. The diagnosis of non epileptic attacks was told to the patients, the antiepileptic drugs were progressively withdrawn and an intensive psychotherapy was started. The seizures decreased in number and severity. In both cases, sexual abuse in childhood was discovered.
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PMID:[Non-epileptic crisis: which therapeutic strategy to follow?]. 783 5

Conversion disorders are characterized by change or loss of physical functions which indicates a neurological disorder (e.g. paralysis, sensory disturbances, or epilepsy like seizures). Clinical/neurological examination does not confirm any organic basis for the symptoms. Conversion disorders are more frequent in girls than in boys. They are rarely seen below the age of seven. A correspondence is often found between the personality of the child, (a conscientious attitude) and family relations. The families seem quite normal, but often have high expectations of their children, are sensitive to social stigmatization and have an underlying anxiety for health problems. A model is often found for the child's symptoms. Symptoms may be precipitated by an infection or a physical trauma. Sexual abuse is sometimes discovered. Multiprofessional assessment and treatment by a neuropediatrician, physiotherapist, child psychiatrist/psychologist and educational therapist may reduce "doctor shopping" and contribute to a favourable outcome.
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PMID:[Conversion disorders in children and adolescents. A multidisciplinary approach]. 807 24

The results of an audit of all patients with non-epileptic attack disorder admitted over a 1-year period to a neuropsychiatry tertiary referral centre are presented. The high incidence of: sexual abuse, previous psychiatric history and previous brain injury is noted. Reference is made to the reaction of patients and relatives to disclosure of the diagnosis and the management difficulties which this group of patients pose. The different underlying psychopathological processes are discussed and it is suggested that the diagnosis of NEAD, purely by the exclusion of epilepsy, might carry the risk of treating these patients as a homogenous group. An eclectic approach by an experienced, multi-disciplinary team is probably the most appropriate way of successfully managing the condition.
Seizure 1994 Jun
PMID:Non-epileptic attack disorder: a clinical audit. 808 39

The clinical characteristics, psychosocial background, neuropsychological testing, clinical and social outcome were analysed in 93 adults with psychogenic seizures (PS). Thirteen (14%) were males and 80 (86%) were females. Mean age was 31.7 years (range 16 to 55 years). Lack of responsiveness associated with motor activity was the most common finding. Neuropsychological testing done in 46 cases revealed hysteroid traits and coping mechanisms and depression to be the most prevalent underlying problems. History of sexual abuse was evident in 10 (10.7%) cases. Social impact analysis revealed that of 62 patients who were working at the onset of PS, 34 were not working at the time of the diagnosis of PS. In 25 cases, PS were the reason for not working. After a mean follow-up of 60.7 months done in 63 patients, 16 (25.4%) patients were seizure-free. There were no obvious significant predictors of poor prognosis.
Seizure 1993 Dec
PMID:Psychogenic seizures in adults: a longitudinal analysis. 816 96

Twenty-seven outpatients with video-EEG-documented pseudoseizures were interviewed by a psychiatrist to determine the historical course of seizures and diagnose the current presence of these DSM-III-R diagnoses: affective disorders (85%), dissociative disorders (85%), and posttraumatic stress disorder (33%). Their mean (26.7) and median (26.9) Dissociative Experiences Scale scores were elevated. Eighty-eight percent of subjects had sustained significant trauma, including sexual abuse/rape (77%) and physical abuse (70%). Four psychodynamic pathways to pseudoseizures were noted. Most commonly, pseudoseizures originated from dissociated personalities or ego states, were expressions of dissociated memories of child abuse, and were triggered by recent stresses or traumas.
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PMID:Etiology and clinical course of pseudoseizures. Relationship to trauma, depression, and dissociation. 835 8

Nonepileptic seizures (NES) must be distinguished from epilepsy to avoid the adverse effects of unnecessary antiepileptic drugs and to initiate appropriate psychiatric treatment. A higher frequency of prior sexual abuse has been suspected in NES, although no prospective controlled study has compared patients with NES and epilepsy. A series of patients with conversion disorder presenting as epilepsy and 140 patients with complex partial epilepsy (CPE) without evidence of conversion were selected from a series of consecutive admissions to a comprehensive epilepsy center. The groups did not differ with respect to age, years of education, race, or marital status, but the percentage of women was greater in the conversion NES group (73.2%) than in the CPE control group (50.7%; p < 0.002). The frequency of a history of sexual or physical abuse was greater in the NES group (32.4%) than in the CPE controls (8.6%; p < 0.000). Severity of sexual but not physical abuse was significantly greater in the NES group relative to controls (p < 0.05). There was a trend for a closer relationship of the perpetrator of sexual abuse to the victim among the NES patients compared with CPE controls (p < 0.1). These results support the impression that childhood abuse is more common among patients with conversion NES than with epilepsy, and suggests that in some cases childhood abuse may be a contributory pathogenetic factor.
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PMID:Nonepileptic seizures and childhood sexual and physical abuse. 841 51


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