INS NYC 2024 Program

Symposium	Symposia 12 Program Schedule 02/16/2024 01:45 pm - 03:15 pm Room: West Side Ballroom - Salon 3 Symposia 12: Beyond Assessment: Integrating Rehabilitation Models into the Neuropsychology of Epilepsy Across the Lifespan and Around the Globe Simposium #4 Outpatient treatment of pediatric functional seizures (FS): Retraining and Control Therapy (ReACT) Aaron Fobian, University of Alabama at Birmingham, Birmingham, United States Category: Epilepsy/Seizures Keyword 1: mood disorders Objective: Functional neurological disorder (FND) is the second most common diagnosis in outpatient neurology clinics. One of the most common presentations of FND includes functional seizures (FS). Despite common perception, evidence suggests treating mood does not result in improved FS symptoms. Retraining and Control Therapy (ReACT) treats pediatric FS by using principles of CBT to target sense of control and cognitive inhibition as novel mechanisms for FS. Participants and Methods: This study was a randomized controlled trial of twenty-nine participants (Mage=15.1 years, SDage=2.5; 72.2% female; 57.1% white) with video-EEG-confirmed FS. Results: ReACT significantly reduced FS compared with supportive therapy (p<0.0001). Eighty-two percent remained FS-free for ≥60 days. At 1-year, 57% remained FS-free, average monthly FS frequency for those experiencing FS was <1 per month, and all participants were participating in school and social activities full-time. Additionally, in a recent study of 34 children with FS who completed ReACT, results demonstrated a 94% overall reduction in FS frequency in the 30 days after therapy, and 94% experienced a clinically meaningful improvement in FS frequency (i.e. ≥50% reduction in FS frequency). Conclusions: This session will provide practical recommendations for outpatient treatment of FS supported by the research above. Discussion of key treatment components (e.g., using habit reversal to develop patients’ plan for symptoms, developing parent and school plans) will be provided. Examples of competing responses to be included in the patient plans will be provided, and a video of a patient discussing their experience with treatment and demonstrating the treatment plan will be included.

Symposium

02/16/2024
01:45 pm - 03:15 pm
Room: West Side Ballroom - Salon 3

Symposia 12: Beyond Assessment: Integrating Rehabilitation Models into the Neuropsychology of Epilepsy Across the Lifespan and Around the Globe

Simposium #4

Outpatient treatment of pediatric functional seizures (FS): Retraining and Control Therapy (ReACT)

Aaron Fobian, University of Alabama at Birmingham, Birmingham, United States

Category: Epilepsy/Seizures

Keyword 1: mood disorders

Objective:

Functional neurological disorder (FND) is the second most common diagnosis in outpatient neurology clinics. One of the most common presentations of FND includes functional seizures (FS). Despite common perception, evidence suggests treating mood does not result in improved FS symptoms. Retraining and Control Therapy (ReACT) treats pediatric FS by using principles of CBT to target sense of control and cognitive inhibition as novel mechanisms for FS.

Participants and Methods:

This study was a randomized controlled trial of twenty-nine participants (Mage=15.1 years, SDage=2.5; 72.2% female; 57.1% white) with video-EEG-confirmed FS.

Results:

ReACT significantly reduced FS compared with supportive therapy (p<0.0001). Eighty-two percent remained FS-free for ≥60 days. At 1-year, 57% remained FS-free, average monthly FS frequency for those experiencing FS was <1 per month, and all participants were participating in school and social activities full-time. Additionally, in a recent study of 34 children with FS who completed ReACT, results demonstrated a 94% overall reduction in FS frequency in the 30 days after therapy, and 94% experienced a clinically meaningful improvement in FS frequency (i.e. ≥50% reduction in FS frequency).

Conclusions:

This session will provide practical recommendations for outpatient treatment of FS supported by the research above. Discussion of key treatment components (e.g., using habit reversal to develop patients’ plan for symptoms, developing parent and school plans) will be provided. Examples of competing responses to be included in the patient plans will be provided, and a video of a patient discussing their experience with treatment and demonstrating the treatment plan will be included.