Page 85 - JCBP-3-3

Journal of Clinical and
Basic Psychosomatics Impact of seizures on life

a disorder characterized by a predisposition to generate Reuber conducted a systematic review of qualitative
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ES and is diagnosed if a person has presented: (a) at least studies exploring the experiences of DS patients, identifying
two unprovoked seizures occurring >24 h apart, (b) one five key themes: seizure events, diagnosis, treatment and
unprovoked seizure and probability of further seizures management, emotional experiences, and the impact on
similar to the general recurrence risk after two unprovoked daily life. Both reviews mainly include studies conducted
seizures, or (c) diagnosis of an epilepsy syndrome. It is in developed countries, with little research in low-income
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estimated that 6.38/1000 people have active epilepsy. countries. Some exceptions can be found in Keikelame and
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Nearly one-third of people with epilepsy have drug- Swartz’s report, where women with ES were interviewed in
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resistant epilepsy (DRE). This condition is defined as South Africa’s popular sectors. In Argentina, Sarudiansky et
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a failure to achieve seizure freedom after adequate trials al. have published studies both on people with ES 21,22 and DS. 23
of two tolerated and appropriately chosen and used
antiepileptic drug schedules. 5 Although multiple studies have explored the impact
of both types of seizures from a qualitative methodology,
Dissociative seizures (DSs) are considered one type of few articles compare the reports of people with ES and
functional neurological disorder (FND). FND encompasses DS. Rawlings et al. analyzed written accounts of people
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a wide range of symptoms that can resemble neurological with ES and DS and categorized the responses into five
conditions but without similarly identifiable biomarkers. themes: seizure onset, emotional tone, seizure symptoms,
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DSs are defined as episodes of altered subjective experience, treatment, and daily life. They compared the responses
involuntary movements, and reduced self-control; of both types of patients and observed differences in the
although they may resemble an ES, they are not caused by experiences of both groups.
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hyper-synchronous neuronal activity. Their prevalence is
estimated to be 2 – 33/10000, though 20 – 40% of patients Thus, studies comparing the impact of ES and DS on
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attending specialized centers present DS. 9 individuals’ lives are still in their early stages, primarily
focusing on individuals with ES rather than those with
Both conditions significantly impact the quality of life. drug-resistant epilepsy (DRE). However, it would be
Jones et al. have reviewed quantitative studies on the quality valuable to compare the experiences of people with DS and
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of life in people with DS and found that psychological factors DRE, as both groups consist of patients with seizures that
(such as depression, dissociation, anxiety, and avoidance) and do not respond to pharmacological treatment. Therefore,
socio-environmental factors (such as family functioning) were the aim of this study is to compare the life impact of DS and
more strongly associated with the quality of life than seizure- ES in individuals with DRE from underserved contexts in
related variables. Conversely, Taylor et al. have reviewed Argentina using a qualitative approach.
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quantitative studies on the quality of life in people with ES.
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The frequency and severity of seizures as well as the presence As previously discussed, this approach is expected
of psychiatric comorbidity (especially depression and anxiety) to enhance our understanding of the experiences of
were found to be associated with a reduction in quality of life. both patient groups from their own perspectives. Such
Likewise, in the past decade, studies quantitatively comparing information would help guide professionals and patients
the quality of life in both groups of patients were published, in developing strategies to improve quality of life, while
mostly reporting that people with DS have a poorer quality of considering the specificities of the local context.
life compared to those with ES. 12-15 2. Materials and methods
Although quantitative data provide valuable insights,
qualitative methods provide more detailed information 2.1. Materials
about the patient’s experience and allow a better A semi-structured interview based on the McGill Illness
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understanding of the complexity of these conditions. Narrative Interview in Spanish was used and adapted into
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In addition, qualitative methods enable participants to Argentinian Spanish by M.S., considering local language
express their emotions and thoughts in detail and choose variations. The adaptation was informed by cultural and
what they consider important to tell, beyond forcing them linguistic considerations specific to the Argentinian context,
to answer closed questions. 18 and it was reviewed and tested in prior studies with people
The impact on life of DS and ES has been investigated diagnosed with DS or DRE. 22,23 This interview was developed
through qualitative approaches. Kerr et al. conducted to elicit patients’ illness experiences.
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a systematic review of qualitative studies focusing on 2.2. Participants
individuals with ES, identifying 23 areas of impact,
including cognitive, emotional, and disclosure-related All participants were admitted to the video-
challenges, among others. Similarly, Rawlings and electroencephalogram (VEEG) unit, where a

Volume 3 Issue 3 (2025) 79 doi: 10.36922/jcbp.8112