The behavioral treatment of epilepsy generation and inhibition of seizures

Abstract

These studies provide abundant evidence of the close interrelation between seizure activity and behavior. They reaffirm the point that epileptic seizures do not occur in a behavioral vacuum and strengthen the theoretical framework for behavioral treatment of epilepsy patients. As our understanding of the epileptic focus and its connections to surrounding cerebral systems increases, the concept that seizure control is significantly influenced by altering behavior of the patient becomes more comprehensible. Epileptic seizures should not be thought of as arising randomly. They occur in focal seizures when the pools of neurons surrounding the epilepsy focus are sufficiently excited for seizure activity to spread. Generalized seizures occur when the level of cortical excitability, or corticoreticular excitation, has reached a point at which thalamic recruiting volleys generalize and start to spread. In the partial epilepsies, a detailed clinical history should be taken as to the nature and characteristics of the aura and the form that seizure generalization or spread may take. Charting events surrounding the time of the seizure as described below are the engine which drives the creation of a countermeasure and its application to stopping seizures. They are the heart of a behavioral program and skill in interpreting the data will be repaid by the finding of the appropriate countermeasures for seizure reduction. This information will define those aspects of the patient's psychic life or behavior that will both trigger and inhibit seizure activity. Discussing this information with the patient will help him or her to understand that their seizures are not necessarily random events, but are intimately related to feelings, actions, and thoughts. A complete treatment of epilepsy involves not just medication, but includes teaching the patient about their brain and its functioning, and how they can use their feelings, thinking, and behavior in the control of their epilepsy.