New research by clinical psychologists from the UK and US has revealed psychogenic seizures which could be mistaken for epilepsy are linked to feelings of anxiety.
The team of researchers devised a new set of tests to determine whether there was a link between how people interpret and respond to anxiety, and incidents of psychogenic nonepileptic seizures (PNESs) -- seizures that can be brought on by threatening situations, sensations, emotions, thoughts, or memories.
Experts from the University of Lincoln, University of Nottingham, and University of Sheffield in the UK, with Arizona State University in the USA, used a series of questionnaires and computer tests to determine if a patient regularly avoids situations which might bring on anxiety.
The tests correctly predicted whether a patient had epilepsy or PNESs in 83% of study participants. Such seizures appear on the surface to be similar to epileptic fits, which are caused by abnormal brain activity.
Lead researcher Dr Lian Dimaro completed the study as part of her doctorate in Clinical Psychology on the Trent Doctorate in Clinical Psychology programme, which is jointly run by the University of Lincoln and University of Nottingham.
"PNES can be a very disabling condition, and it is important that we understand the triggers so that we provide the correct care and treatment," said Dr Dimaro, who is now a Clinical Psychologist based at Nottinghamshire Healthcare NHS Trust.
"This study was one of the first to bring modern psychological tools of investigation to this problem. The findings support the idea that increasing a person's tolerance of unpleasant emotions and reducing avoidant behaviour may help with treatment, suggesting that patients could benefit from a range of therapies including acceptance and commitment therapy to help reduce the frequency of seizures, although more research is needed in this area."
Participants completed questionnaires to determine the level to which they suffered from anxiety, their awareness of their experiences, and if they would avoid situations which would make them feel anxious.
They then completed a computer task which required rapid responses to true or false statements. This test was designed to gather data on immediate, or implicit, beliefs about anxiety. Participants also answered questions about common physical complaints that may have no medical explanation, also called somatic symptoms. These can include things like gastrointestinal problems, tiredness and back pain.
The results showed that those with PNES reported significantly more somatic symptoms than others in the study, as well as avoidance of situations which might make them anxious. The group with PNES also scored significantly higher on a measure of how aware they were of their anxiety compared with the control group.
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Some seizures mistaken for epilepsy may be linked to feelings of anxiety