Contribution of Cognitive Behavioral Therapy on Epilepsy Treatment, Case Report

Abstract

Introduction: Andrews / Reiter method based cognitive behavioral therapy (CBT) has been applied to a 33-year-old female patient who was followed up for 28 years with the diagnosis of drug resistant epilepsy. Depression, anxiety, quality of life and seizure frequency were followed. Case Report: The patient has been followed up with idiopathic photosensitive occipital lobe epilepsy and has been used many antiepileptics for years could not be achieved seizure control completely. Interviews were designed for the patient based on the method developed by Andrews / Reiter for patients with epilepsy. After the first interview, a total of 13 sessions were held once every two weeks. The Quality of Life in Epilepsy Inventory (QOLIE-31), Beck Depression Scale (BDI), Beck Anxiety Scale (BAI), Medication Adherence Report Scale (MARS), and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) were administered.The scales were administered at baseline, at the fifth interview, and after the end of therapy, totally 3 times. The patient had aura sensation 9 times throughout the entire process. Two of these had seizures with focal symptoms after the aura. There was no epileptic transformation after the other 7 aura sensations. When the patient's visual aura started, she started to do breathing exercises. In this way, she said, she was able to stop the aura's progress. During follow-up, the patient's quality of life, depression and anxiety scores improved. Drug incompatibility was very rare and the patient started to use her antiepileptics completely regularly after the 5th session. Discussion: Psychiatric treatments in epilepsy may contribute to quality of life and emotional well-being. The acquired behavior may be changing the underlying epileptic neural networks. In our patient, the addition of cognitive behavioral therapy to the antiepileptic treatment caused improvement in quality of life, anxiety and depression. Moreover, there was a decrease in the frequency of seizures in our patient. CBT is advantageous in epilepsy due to the lack of side effects and drug interactions and its low cost. In addition, in patients with drug-resistant epilepsy and in patients with difficulties in medical treatment CBT can be improved compliance of drugs, quality of life, anxiety and depression, as a result seizure frequency can be reduced and epilepsy can be coped better.