Page 89 - JCBP-3-3

Journal of Clinical and
Basic Psychosomatics Impact of seizures on life

Table 4. Impact on social interaction in DS patients
Theme Subtheme Sub‑subtheme Quote
Impact on social Support (2) P: They encouraged me to keep doing things. There was a
interaction in DS time when I wanted to give up, I didn’t want to... it was the
last semester, as I had many seizures at school, I didn’t want to
continue and... However, teachers, friends told me “do it, it’s only
one semester to go.”
Isolation (4) P: And the truth is that at the beginning I shut myself up a bit
because I was ashamed to be seen with those things, errr…
I: With the seizures.
P: Of course... yes, I isolated myself...
Interpersonal conflict Mistreatment Health professionals (2) P: And on top of that she yelled at me, (the neurologist) told
me “you have epilepsy! Don’t you understand? (...) You have
epilepsy!” and I froze... there I realized that I couldn’t move,
because I wanted to “eat her up” and I couldn’t.
Others (3) P: I’ve always had a bad time. Last year it was worse because I
didn’t go (to school) and everyone was waiting to see if I got
expelled because it was unfair to others... They said... “why isn’t
she coming?”... I don’t know. don’t piss me off (...) because they
thought it wasn’t fair for them that I wasn’t going (...) they didn’t
share the homework, the director had to speak with them.
Disbelief (2) P: No, before…My mum asked me, “do you really faint?”
Reaction of others to seizures (2) P: And he told me “you’re scary,” and that’s ugly. The fear. I mean,
I don’t like it... that’s one of the reasons why I also isolate myself,
I scare others.
Note: I: interviewer. P: Patient. The numbers in brackets indicate the frequency with which each subtheme appears.
Abbreviation: DS: Dissociative seizure.

In our sample, both patients with DRE and DS both groups, although previous studies have also found
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recognized emotions as possible seizure triggers. The that people with DS and ES have differences in emotional
study of emotions as seizure triggers has been carried out processing. 39
separately for both types of conditions. Rawlings et al. Another possible explanation for this phenomenon can be
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found that tiredness and anxiety were common triggers for found in the fact that all the patients included were women.
DS. This phenomenon was also described in studies with It has already been described that there are differences in the
people with ES. For example, stressful events have been expression and recognition of emotions between both sexes.
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reported to trigger seizures and it has even been reported Thus, including only women in the sample may explain the
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that the onset of epilepsy in some cases can occur after perception of emotions through gender-related factors, in
stressful events. In fact, recent studies have evaluated addition to those related to the disease.
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biological indicators linking stress to epilepsy, finding
changes in EEG (exaggerated spiking, paroxysmal activity, Finally, this finding may be related to the fact that the
or epileptiform complexes), increased cortisol levels, or perception of emotions is not universal and it is mediated
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an inhibitory hippocampal mechanism In the case of DS, by culture. Previous local studies 21,23 highlighted cultural
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hyperreactivity in the amygdala and increased connectivity differences in Argentina, where there is greater diffusion of
with motor and autonomic regions have been found, which psychotherapy and one of the highest rates of psychologists
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could arise from early adversity or chronic stress. 37 in the world. This may contribute to greater openness in
sharing emotional experiences, which could explain the
Thus, although the emotions experienced as a
consequence of the seizures differ slightly between both high emotional expression found in the participants.
groups, the perception of emotion as a triggering factor of Social interaction was significantly affected by the
a seizure was observed in both. Although in our sample disease, with both DS and DRE patients reporting
both groups acknowledged their emotions, the recognition experiences of discrimination, ridicule, and exclusion.
of emotions in both groups of patients is still controversial Perceived discrimination and lack of understanding
in the existing literature. A recent review showed that there from others have already been reported in DS and DRE
are no significant differences in alexithymia levels between patients in previous studies. 19,20 Even so, in our sample,

Volume 3 Issue 3 (2025) 83 doi: 10.36922/jcbp.8112