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Epilepsy


Neurobiofeedback(sm) Training for Epilepsy

The technique of Neurobiofeedback(sm) training was first used therapeutically for epilepsy, and the scientific literature is extensive for this condition, dating back to the early 1970's. Neurobiofeedback(sm) has been shown to be helpful for many forms of epilepsy, including petit mal, grand mal, and complex partial seizures. A variety of training protocols have been used successfully. However, this technique did not become widely accepted until some time after being shown effective. This is atributed to the fact that initially the training took a very long time, was not widely available, and was considerably expensive.

Today, with rapidly increasing computer technology and refinement in methodology, training is much more economical. (This has lead to an overall advancement in the field in general). In many cases, the client may respond dramatically in just a few sessions. In other cases, the training remains long-term, requiring 60 or more training sessions. Neurobiofeedback(sm) may also need to be accompanied with additional lifestyle changes to avoid those conditions which effect a lowering of seizure threshold. Also, active interventions may be learned which can serve to promote some control over seizure activity. Finally, determination of dietary susceptibilities may be important, such as a number of substances which may alter the seizure threshold adversely.

Neurobiofeedback(sm) should be considered as one element of a comprehensive program of epilepsy management, which includes pharmacological intervention, dietary sensitivity analysis, and consideration of lifestyle issues, which are found to impinge on seizure susceptibility. Epilepsy is highly susceptible to many behavioral variables, which the client may exercise a significant level of control over.

In many cases, medication is sufficient to achieve seizure control. However, behavioral side effects are still likely to be observed. In some cases, anticonvulsant medications may be accompanied by significant side effects on the client's mood, sleep, mental alertness, and cognitive ability. The behavioral consequences appear to be associated with what is most likely "sub-clinical seizure activity," namely cortical disturbances which are qualitatively similar to seizure phenomena, but not quantitatively sufficient to result in a well-defined seizure. These phenomena are what neurologists looks for in a clinical electroencephalograms (EEG's).

Neurobiofeedback(sm) is likely to achieve regulation of such behavioral disturbances even before an improvement in seizure incidence is observed. Neurobiofeedback(sm) training may also be used to reduce the medication dose required to achieve seizure control, and hence reduce the side effects attributable to such medication. Persons under medication should remain under the active supervision of their prescribing practitioner as they undergo the training. Following the advice of the prescribing practitioner is particularly important because of the potential need to adjust the medication as the training progresses.

In many cases of epilepsy in young children, the cause may be a difficult birth, even though the seizures don't manifest until later stages of cortical maturity. In these cases, there may be other deficits in the child's functioning which are also attributable to the traumatic birth (mood disorders, sleep disorders, learning disabilities, attention deficits, etc.), which may also respond to the Neurobiofeedback(sm) training.

Note: The word Neurobiofeedback(sm) was coined by us and is used to describe the marriage between both traditional biofeedback (EMG) and neurofeedback (EEG). You are likely to see many variations in the description of these techniques, but generally speaking, neurofeedback is what is being referred to in most areas of this site and the literature cited below.


TECHNICAL PAPERS & ABSTRACTS

  • Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning. Sterman MB.Clin Electroencephalogr. 2000 Jan;31(1):45-55. Review.

  • The state of EEG biofeedback therapy (EEG operant conditioning) in 2000: an editor's opinion. Duffy FH. Clin Electroencephalogr. 2000 Jan;31(1):V-VII.

  • Remediation of Nocturnal Seizures by EEG Biofeedback
    Jonathan Walker, M.D. presentation at the 1995 Annual Conference of the Society for the Study of Neuronal Regulation.

  • Neurotherapy and Drug Therapy in Combination for Adult ADHD, Personality Disorder, and Seizure
    Lisa M. Hansen, B.S., David L. Trudeau, M.D., and Dixie L. Grace, Ph.D Journal of Neurotherapy, 2(1), 1996

  • EEG biofeedback and relaxation training in the control of epileptic seizures.
    Tozzo CA, Elfner LF, May JG Jr  Int J Psychophysiol 6 (3): 185-194 (Aug 1988)

  • Neuropsychological assessment of subjects with uncontrolled epilepsy: effects of EEG feedback training.
    Lantz DL, Sterman MB  Epilepsia 29 (2): 163-171 (Mar 1988)

  • The Response of a case of petit mal epilepsy to EEG sensorimotor rhythm biofeedback training.
    Tansey MA  Int J Psychophysiol 3 (2): 81-84 (Nov 1985)

  • A double-blind investigation of the relationship between seizure activity and the sleep EEG following EEG biofeedback training.
    Whitsett SF, Lubar JF, Holder GS, Pamplin WE, Shabsin HS  Biofeedback & Self-Regulation 7 (2): 193-209 (Jun 1982)

  • EEG operant conditioning in intractable epileptics.
    Lubar JF, Shabsin HS, Natelson SE, Holder GS, Whitsett SF, Pamplin WE, Krulikowski DI  Arch Neurol 38 (11): 700-704 (Nov 1981)

  • Quantitative analysis of training, sleep EEG and clinical response to EEG operant conditioning in epileptics.
    Sterman MB, Shouse MN  Electroencephalogr Clin Neurophysiol 49 (5-6): 558-576 (Sep 1980)

  • Sensorimotor rhythm feedback training and epilepsy: some methodological and conceptual issues.
    Quy RJ, Hutt SJ, Forrest S  Biol Psychol 9 (2): 129-149 (Sep 1979)

  • EEG feedback training of epileptic patients: clinical and electroencephalographic analysis.
    Kuhlman WN  Electroencephalogr Clin Neurophysiol 45 (6): 699-710 (Dec 1978)

  • Effects of central cortical EEG feedback training on incidence of poorly controlled seizures.
    Sterman MB, Macdonald LR  Epilepsia 19 (3): 207-222 (Jun 1978)

  • Operant conditioning of the EEG in two patients with epilepsy: methodologic and clinical considerations.
    Finley WW  Pavlov J Biol Sci 12 (2): 93-111 (Apr 1977)

  • Behavioral management of epileptic seizures following EEG biofeedback training of the sensorimotor rhythm.
    Lubar JF, Bahler WW  Biofeedback & Self-Regulation 1 (1): 77-104 (Mar 1976)

  • Effects of sham feedback following successful SMR training in an epileptic: follow-up study.
    Finley WW  Biofeedback & Self-Regulation 1 (2): 227-235 (Jun 1976)

  • Reduction of epileptic seizures through EEG biofeedback training.
    Seifert AR, Lubar JF  Biol Psychol 3 (3): 157-184 (Nov 1975)

  • Reduction of seizures and normalization of the EEG in a severe epileptic following sensorimotor biofeedback training: preliminary study.
    Finley WW, Smith HA, Etherton MD  Biol Psychol 2 (3): 189-203 (1975)

  • Andrews, D.J., & Schonfeld, W.H. (1992). Predictive factors for controlling seizures using a behavioural approach. Seizure, 1, 111-116.

  • Ellertson, B., & Klove, H. (1976). Clinical application of biofeedback training in epilepsy. Scandinavian Journal of Behavior Therapy, 5, 133-144.

  • Wyler, A.R., Lockard, J.S., & Ward, A.A. (1976). Conditioned EEG desynchronization and seizure occurrence in patients. Electroencephalography and Clinical Neurophysiology, 41, 501-512.


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