SAN DIEGO—Scripted communication of a diagnosis, a psychiatry consultation, and weekly follow-up phone calls are effective strategies for decreasing events and improving the quality of life in patients with psychogenic nonepileptic seizures, according to research presented at the 66th Annual Meeting of the American Epilepsy Society.
Although psychogenic nonepileptic seizures are a common indication for admission for video EEG monitoring, there is no standard and effective approach to communicate a diagnosis and provide treatment, noted Geeta Ganesh, MD, and colleagues.
“Our aim was to evaluate whether scripted communication of the diagnosis of psychogenic nonepileptic seizures, inpatient psychiatry consultation, and follow-up phone calls decreased psychogenic nonepileptic seizures and improved quality of life,” said Dr. Ganesh, from the Department of Neurology at Emory University in Atlanta.
Three Approaches Tested
The researchers based their findings on analysis of patients who were admitted to Emory University Hospital’s long-term video monitoring unit for diagnostic evaluation between June 2011 and May 2012. Before diagnosis, all participants had reported their event frequency and had completed the Quality of Life in Epilepsy-10 (QOLIE) survey and the Beck Depression Inventory-II.
After video EEG monitoring confirmed a diagnosis of psychogenic nonepileptic seizures, all patients were randomized to one of three groups. One group of 12 patients (average age, 45; 10 women) received standard care. A second group of 10 patients (average age, 38; seven women) had a scripted diagnosis and a psychiatry consultation. A third group of 15 patients (average age, 34; 13 women) received a scripted diagnosis, a psychiatry consultation, and weekly follow-up phone calls. The researchers reassessed event frequency, QOLIE-10 scores, and Beck depression scores eight weeks after the patients were discharged.
Weekly Follow-Up Phone Calls May Be Effective
Dr. Ganesh and colleagues found that all three treatment groups had a decrease in event frequencies, QOLIE-10 scores, and Beck depression scores. “Groups receiving scripted delivery of the diagnosis, psychiatry consultations, or weekly phone calls had statistically significant improvements in event frequency and QOLIE-10 scores,” stated the researchers. “Only the group receiving weekly phone calls had a statistically significant improvement in Beck depression scores.
“Future studies with larger subject enrollment and longer follow-up are needed to explore whether these results are reproducible and long-lasting,” Dr. Ganesh’s group concluded.”
—Colby Stong
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Editor
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