Anticipatory anxiety of seizures in epilepsy: A common, complex, and underrecognized phenomenon?

Author:

Kanner Andres M.1ORCID,Carrazana Enrique23ORCID,Munger Clary Heidi M.4ORCID,Rabinowicz Adrian L.2ORCID,Faught Edward5ORCID

Affiliation:

1. Comprehensive Epilepsy Center University of Miami Miller School of Medicine Miami Florida USA

2. Neurelis, Inc. San Diego California USA

3. John A. Burns School of Medicine University of Hawaii Honolulu Hawaii USA

4. Department of Neurology Wake Forest University School of Medicine Winston‐Salem North Carolina USA

5. Emory Epilepsy Program Emory University School of Medicine Atlanta Georgia USA

Abstract

AbstractThe diagnosis of epilepsy is associated with loss of predictability, which invariably results in the fear of when and if future seizures will occur. For a subset of patients with epilepsy (PWE), there may be a pathological persistent fear of seizure occurrence, resulting in limitations to daily activities through avoidant behaviors. Paradoxically, the research of anticipatory anxiety of seizures (AAS; also referred to as seizure phobia) has been practically nonexistent and, not surprisingly, this condition remains underrecognized by clinicians. The available data are derived from three small case series of patients followed in tertiary epilepsy centers. In this study, we review the available data on the reported clinical manifestations of AAS in PWE, and of the potential role of variables associated with it, such as personal and family psychosocial and psychiatric history and epilepsy‐related variables. In addition, we review the need for the creation of screening tools to identify patients at risk of AAS and discuss potential treatment strategies, which could be considered as part of the comprehensive management for PWE.

Funder

Neurelis

Publisher

Wiley

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