A Post Discharge Support Program for Patients Experiencing Psychological Non-Epileptic Seizures: A Pilot Project

Abstract Rationale: There are no accepted standards of care for patients with psychological non-epileptic seizure (PNES) disorder. However the literature regarding PNES identified three common themes including acceptance of the diagnosis; consistent support and follow up; and development of appropriate outcome indicators. This pilot project was designed to address these themes rather than focus on a specific treatment modality. Methods: The pilot project was initiated at the University of Louisville Comprehensive Epilepsy Center (CEC) to evaluate the feasibility of a post-discharge support program for the PNES population. Outcomes identified for measurement included seizure frequency, health care utilization, anti-epileptic medication use and three quality of life indicators. Results: Ten patients were admitted to the program. The five intervention group patients reported declines in seizure frequency, health care utilization and anti-epileptic medication use. Survey return from both the intervention and control groups was minimal precluding statistical analyses. The patients in the intervention group were diverse with regard to psychosocial backgrounds, trauma history, and PNES triggers which allowed the team to view the pilot with regard to patient specific variables leading to the development of a PNES treatment readiness model. Conclusion: Though small in scale, this pilot project adds to the body of knowledge about care of the patient diagnosed with PNES by focusing on identified care themes rather than specific treatment modalities. The Modified RED program will be further developed and evaluated. In addition, the Shafer-Prather PNES treatment readiness model being developed by the team will be evaluated in future work