In our approach, we encourage drug mono-therapy at the lowest therapeutic level, because we recognize the importance for the patient to be able to function at his or her highest level of cognitive ability. This facilitates the patients' recognition of subtle cues within themselves and their environment that trigger seizures5, 6.
The study reported in this paper is intended to determine how successful the approach used at Andrews/Reiter is in controlling seizures and what factors may be helpful in predicting that success.
METHOD
Behavioral treatment approach used at Andrews/Reiter
Beginning in 1980, the Andrews/Reiter (A/R) method started to investigate and identify the psychological and behavioral aspects of seizure potential using a behavior model. Our goals in treatment were to reduce seizure frequency and improve quality of life. The approach to treatment was to identify the pre-seizure warning (aura), identify the triggers (people, situation, emotional or physical state), teach a diaphragmatic breathing technique that would be used when the patient was aware of the aura occurring or that stress was building-up, use electroencephalogram (EEG) biofeedback toward the goal of achieving therapeutic alpha activity (8-12 cps at 50 uV), and reduce medication in cases where it interfered with intellectual and cognitive functioning.
The benefits of operant conditioning using EEG biofeedback are well theorized1, 7-13, 20. Further, we began each training session with a diaphragmatic breath, in a Pavlovian attempt to develop a connection between the breath and the production of alpha activity.
