AUTHOR=Mariotti Sara , Valentin Damien , Ertan Deniz , Maillard Louis , Tarrada Alexis , Chrusciel Jan , Sanchez Stéphane , Schwan Raymund , Vignal Jean-Pierre , Tyvaert Louise , El-Hage Wissam , Hingray Coraline 

TITLE=Past Trauma Is Associated With a Higher Risk of Experiencing an Epileptic Seizure as Traumatic in Patients With Pharmacoresistant Focal Epilepsy

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.669411

DOI=10.3389/fneur.2021.669411

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> The present study aimed to evaluate the prevalence of traumatic experienced seizures (TES) and of postepileptic seizure PTSD (PS-PTSD) in patients with pharmacoresistant focal epilepsy and to explore the determining factors of TES.</p><p><bold>Methods:</bold> We conducted an observational study enrolling 107 adult refractory epilepsy patients. We used the DSM-5 criteria of traumatic events and PTSD to define TES and PS-PTSD. We assessed all traumatic life events unrelated to epilepsy, general and specific psychiatric comorbidities, and quality of life.</p><p><bold>Results:</bold> Nearly half (<italic>n</italic> = 48) of the 107 participants reported at least one TES (44.85%). Among these, one-third (<italic>n</italic> = 16) developed PS-PTSD. The TES group was more likely to experience traumatic events unrelated to epilepsy (<italic>p</italic> &lt; 0.001), to have generalized anxiety disorder (<italic>p</italic> = 0.019), and to have specific psychiatric comorbidities [e.g., interictal dysphoric disorder (<italic>p</italic> = 0.024) or anticipatory anxiety of seizures (<italic>p</italic> = 0.005)]. They reported a severe impact of epilepsy on their life (<italic>p</italic> = 0.01). The determining factors of TES according to the multifactorial model were the experience of trauma (<italic>p</italic> = 0.008), a history of at least one psychiatric disorder (<italic>p</italic> = 0.03), and a strong tendency toward dissociation (<italic>p</italic> = 0.03).</p><p><bold>Significance:</bold> Epileptic seizures may be a traumatic experience in some patients who suffer from pharmacoresistant epilepsy and may be the source of the development of PS-PTSD. Previous trauma unrelated to epilepsy and psychiatric history are determining factors of TES. These clinical entities should be explored systematically.</p>