Nonepileptic seizures treatment workshop summary

W. Curt LaFrance, Kenneth Alper, Debra Babcock, John J. Barry, Selim Benbadis, Rochelle Caplan, John Gates, Margaret Jacobs, Andres Kanner, Roy Martin, Lynn Rundhaugen, Randy Stewart (+1 others)
2006 Epilepsy & Behavior  
In May 2005, an international, interdisciplinary group of researchers gathered in Bethesda, MD, USA, for a workshop to discuss the development of treatments for patients with nonepileptic seizures (NES). Specific subgroup topics that were covered included: pediatric NES; presenting the diagnosis of NES, outcome measures for NES trials; classification of NES subtypes; and pharmacological treatment approaches and psychotherapies. The intent was to develop specific research strategies that can be
more » ... xpanded to involve a large segment of the epilepsy and psychiatric treatment communities. Various projects have resulted from the workshop, including the initial development of a prospective randomized clinical trial for NES. neuropsychological characteristics of patients with NES. However, the lack of biological models, clear diagnostic classifications, and rigorously validated interventions continues to have a negative impact on treatment development. Thus, there is a great need for interdisciplinary collaboration to address the issue of approach to treatment. Conceptually, as the disciplines of neurology and psychiatry are being reunified, a joint perspective of mind/brain interactions is regaining prominence. The "Decade of the Brain" brought great therapeutic advances for many neuropsychiatric disorders. However, NES still occupy the gap between neurology and psychiatry, and treatment remains poorly studied. Despite our knowledge, we have not progressed much beyond anecdotal reports of treatments for NES, and no blinded, randomized, controlled trials of treatment for the disorder have been completed. The purpose of the NES Treatment Workshop was to stimulate future research in this understudied area. The workshop, which took place in Bethesda on May 1-3, 2005, was sponsored by the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Mental Health (NIMH), and the American Epilepsy Society (AES). Participants included a multidisciplinary group of neurologists, psychiatrists, neuropsychiatrists, psychologists, neuropsychologists, statisticians, nurses, and other health researchers familiar with NES, whose focus was to propose a research agenda for NES treatment trials. This effort built on the two NES conferences organized by Dr. John Gates and the NINDS in the 1990s, held in Fort Lauderdale and Bethesda. Results of these workshops yielded information on diagnosis, neurological and psychiatric comorbidities, and psychological functioning in patients with NES, which was subsequently published in a book now in its second edition [1] . The goal of the current workshop was to lay the groundwork for optimizing NES treatment strategies and clinical trial designs. Goals of the workshop included: characterization of diagnostic and treatment models of NES; assessment of the potential efficacy of therapies in individual patients by examining past treatment reports and pilot trials for NES; establishment of a collaborative network that enables investigators to design and implement controlled treatment trials for NES. As a means of focusing discussion, the meeting began with a brief presentation by the organizers as to workshop objectives:
doi:10.1016/j.yebeh.2006.02.004 pmid:16540377 pmcid:PMC5065724 fatcat:7fdo6pajtrf7tmda7jyxs6sa2u