IBAS − Institute for Breathing and Sleep

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Breath Control in Seizures

Non-epileptic Seizures (NES) are fits that look like epileptic fits but are not due to epilepsy, and are instead thought to be a psychological response to life problems (they are 'psychogenic'). They are very common presentations to emergency rooms and GP practices, and in specialist epilepsy centres such as the Austin they may comprise up to 50% of all admitted patients - yet by comparison with epilepsy we know very little about them. This has implications for treatment, which remains very limited, and the prognosis is consequently often poor.
One thing that has been reliably observed is that patients with NES have had troubled lives, with very high rates of childhood trauma. The usual way psychiatrists understand NES is as a response to these traumas, and the usual treatment is to explore the traumas; patients are often uncomfortable with this process, however, making treatment difficult, and unacceptable to many. The treatment is also expensive, slow, hard to find, and of limited benefit, so alternatives are urgently needed.
We have found that many patients with NES show a rapid increase in their breathing before they have their fit, while others have found that patients with NES have very high rates of panic attacks. We think these things may be related: we think that some NES may be a special kind of panic attack, since the symptoms of panic attacks are brought about by patients breathing too quickly. This means we might be able to treat the NES by teaching patients to control their breathing, without the difficulty of exploring their painful memories. Breath Control Training is a technique taught by physiotherapists to patients with asthma; we will try teaching it to patients with NES to see if it helps control their fits.
The Comprehensive Epilepsy Program at Austin Health admits patients with seizures for diagnostic work-up. Roughly one patient per week will be diagnosed with NES. We would invite those patients to participate in this study, aiming to recruit 20 patients. We will assess their breathing and their fits, and offer them training in Breath Control by a physiotherapist. We will then follow them up to see if their fits get better. This will show us if the therapy works, and if it does we will then obtain funding for a larger trial.

Full Name

Breath Control as a Cause and a Treatment for Psychogenic Non-Epileptic Seizures

Primary Investigator

David Berlowitz

Stream

Respiratory > Respiratory - Other

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