STRESSFUL LIFE EVENTS AND SEIZURE FREQUENCY IN PATIENTS WITH EPILEPSY

We tested whether unpleasant life events increased seizure occurrence in persons with epilepsy. Forty-six subjects maintained daily diaries for 10-36 weeks in which they recorded seizures and life events. Mean age of subjects was 39 years; 78% were female; 83% had complex partial seizures (CPS). On the average, subjects reported 3.3 seizures a week . Analyses first were conducted within each subject and then in the sa mple overall. For each person, we tested whether seizure frequency inc reased within 24 h of the occurrence of unpleasant events, using Poiss on regression analyses that adjusted for daily antiepileptic medicatio n, sleep duration and quality, alcohol intake, menstrual status, and p leasant events. Rarity of events precluded analyses in 9 subjects. Eve nts increased seizure frequency in 5 subjects (14%) (p < 0.05). Events decreased seizure frequency in 2 subjects (p < 0.05). When individual risk ratios were aggregated across subjects, unpleasant events were s ignificantly associated with seizure increase only in men (RR = 1.67, 95% Confidence interval 1.09, 2.54). However, this finding must be int erpreted with caution because of the limited number of men in the samp le. In other aggregate analyses, events and seizures were not associat ed in subjects grouped by seizure type, age of seizure onset, current age, ethnicity, educational level, or marital status. Identification o f factors that distinguish patients with and without event-triggered s eizures requires further study.