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Epilepsy Question

Doug Knowles knowled at ccsmtp.ccf.org
Wed Nov 17 16:21:24 EST 1993

In article <1993Nov13.011847.1357 at sol.UVic.CA> cnielsen at engr.uvic.ca writes:
>A Question about Epilepsy
>How and to what extent does stress effect the strength/frequency of epileptic
>seizures, and especially temporal lobe (psychomotor) epilepsy?
>I heard from one neurologist that the only reason that stress effects
>epilepsy is that they do not sleep as well when they are under stress.
>It seems to me that one could have had a good night's sleep and a stressful
>event will exhaust them.  Often, epileptic seizures will occur when the victim
>is tired, so wouldn't stress bring on or intensify seizures?

Quoting from various authors in _The_Treatment_of_Epilepsy:_
Principles_and_Practice, Elaine Wyllie, editor, 1993, 
published by Lea & Febiger:

"Sleep deprivation and the recording of nonrapid eye movement
sleep (NREM) may increase the sensitivity of the EEG to demonstrate
interictal epileptiform alterations, especially in patients with
partial epilepsy" pg. 250

"Emotional stress may precipitate temporal lobe seizures, and
multiple psychiatric disorders may coexist with this epileptic
syndrome."  pg. 516

"In one early study, emotional stress was found to precipitate
EEG abnormalities in 75% of patients with complex partial
seizures.  Neurobehavioral therapy, based on learning theory,
conditioning, psychodynamic or biofeedback techniques, occasionally 
may be useful as an adjunct to antiepileptic drugs.  Such 
approaches attempt to control and modify emotional and environmental
conditions that modulate the occurrence of seizures.  Although
these approaches do not produce complete control in temporal lobe
epilepsy, a number of studies have reported some success, 
particularly with other seizure types." pg. 520

"Some single seizures in absolutely normal individuals are the
result of specific physiologic stress, most commonly sleep
deprivation...Popular speculation suggests that major emotional
stress without other factors can cause seizures [in normal 
individuals-wdk] but all evidence seems to be to the contrary."
pg. 588

So, yes.  Sleep deprivation is a strong activator of seizures.
Emotional stress is probably also proconvulsive.

W. Douglas Knowles, Ph.D.          E-mail: knowled at ccsmtp.ccf.org
Dept. Neurosciences                          voice: (216)444-3870
Cleveland Clinic Foundation                  FAX:   (216)444-7927
9500 Euclid Avenue, Cleveland, OH 44195 USA                      

"Data is not information is not knowledge is not wisdom."

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