Survey offers first-ever look at treatment practices for nonepilepti...( PROVIDENCE R.I. A new nationwide cl...),Health

PROVIDENCE, R.I. A new nationwide clinician survey provides the first comprehensive look at what is community care or treatment as usual for nonepileptic seizures (NES), laying the groundwork for clinical trials aimed at identifying effective treatments for this neuropsychiatric disorder.

There is currently no standard treatment for NES, a disorder that resembles an epileptic seizure but is not caused by abnormal activity in the brain. Findings of the survey are published in the April issue of Epilepsy & Behavior.

Typically, neurologists are the first to encounter, diagnose and provide initial treatment for patients with NES, sometimes referring them for psychiatric treatment. But too often, patients with this disorder are lost between the practice divide of neurology and psychiatry, says lead author W. Curt LaFrance, Jr., M.D., M.P.H., director of neuropsychiatry and behavioral neurology at Rhode Island Hospital.

By helping to define treatment as usual, our survey better equips researchers to design much-needed clinical trials to evaluate treatments for noneplipetic seizures, which we hope will someday bridge this divide and improve the quality of life of patients suffering from this disorder, adds LaFrance, whos also an assistant professor of psychiatry and neurology (research) at The Warren Alpert Medical School of Brown University.

Defined as involuntary episodes of sensation, movement, or behavior that may mimic epileptic seizures, NES are classified into two major groups: physiologic and psychogenic. Physiologic NES are triggered by a number of conditions, such as cardiac arrhythmia, sudden drops in blood pressure, sleep disorders, and hypoglycemia. A psychogenic NES appears to be caused by emotional trauma or excessive stress. According to estimates, of the three million people diagnosed with epilepsy in the U.S., between five and 20 percent of patients with seizures actually may have either NES alone or a combinat
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