STANFORD, Calif. - (Business
Wire) It was no way for an 11-year-old to live. For a
month the boy had endured daily episodes of
uncontrollable jerking and foaming at the mouth, and his
physicians at Lucile Packard Children
s Hospital at Stanford were concerned
that the boy had epilepsy. Before starting the boy on a
lifetime of anti-seizure medications, though, they
turned to an unconventional diagnostic tool: hypnosis.
Children are highly
suggestible and they have great imaginations, said Packard Childrens child psychiatrist Richard Shaw,
MD. Weve found that if we suggest that they
are going to have one of their events while they are in
a hypnotic trance, they will usually have one.
But wait. Arent physicians
supposed to try to STOP seizures rather than searching
for new ways to cause them? In a word, yes. But in order
to treat seizures effectively, doctors must learn which
parts of the brain are causing the trouble. Many
children who seem to be having epileptic seizures are
actually having an involuntary physical reaction to
psychological stress in their lives. These events
require a vastly different treatment than do true
epileptic seizures.
The only way to pinpoint the true cause is to monitor
the childs brain activity
during an event. Connecting a panel of electrodes to a
childs scalp is relatively
easy and painless. Conducting a seizure watch of indefinite length is another
matter.
Its very difficult for parents to
spend three or four days in the hospital hoping their
child has a seizure, said
Packard Childrens chief of
pediatric neurology, Donald Olson, MD. It puts them in a very uncomfortable
place emotionally.
Furthermore, some hospitalized children, removed from
the very stressors that may be causing the events, never
have a seizurelike event.
Hypnosis can speed the process considerably, say Shaw
and Olson. Together with former medical student Neva
Howard, they tested the procedure on nine children
between the ages of 8 to 16 whose seizurelike events
included twitching, loss of consciousness, shaking,
jerking and falling. Their results were published online
in January in Epilepsy & Behavior. The
physicians needed to know whether these were true
epileptic events, which are best treated by medication,
or non-epileptic events caused by psychological stress
or other neurological problems.
We cant always distinguish epileptic from
non-epileptic events visually, or through descriptions
by family or friends, said
Olson, an associate professor of neurology, of
neurosurgery and of pediatrics at the Stanford
University School of Medicine. But regardless of the cause, these
are disabling, life-altering events that need to be
treated.
The authors believe that, although hypnosis may not
work for every child, the technique is an important tool
that can speed proper diagnosis and treatment for
children suffering from seizurelike events.
To hypnotize the subjects, Shaw, an associate
professor of psychiatry and behavioral sciences and of
pediatrics at the School of Medicine, first used a
combination of deep breathing and progressive muscle
relaxation to induce a state of relaxation and deep
focused attention in the subjects. He then used a
combination of imagery and suggestion to induce one of
their typical seizurelike events. Children typically
visualize being at one of their favorite placesfor one teen, it was on a beach in
the Bahamas. After a hypnotic trance was established,
Shaw would then direct the child to recall the feelings
or events that usually precede a typical seizure.
Electrodes on the childs scalp
recorded their brain activity during the session.
In eight out of nine cases, Shaw could successfully
trigger a seizurelike event with this procedure. After
an appropriate monitoring interval, Shaw then directed
the hypnotized child to return to
his or her favorite place and the episode would stop.
Using this technique, the physicians found that all
eight of the subjects were experiencing non-epileptic
events.
We had a number of clues
that these particular children might not have
epilepsy, said Olson, but hypnosis helped us confirm our
suspicions. Physicians begin
to suspect causes other than epilepsy if an individual
has a variety of episodes, if the persons cognition is unaffected despite
frequent seizures or if the person has a pre-existing
psychiatric diagnosis.
Were the kids in the study relieved to find they
didnt have epilepsy? Yes and no, said Shaw. Its
important to explain very clearly that although these
events are psychologically based, they are completely
out of a childs control. He and Olson compare the events,
which are a type of condition called conversion
disorder, to other well-known ways that stress and
emotions affect other bodily functions, such as
migraines, ulcers and blushing.
Stanford is part of an ongoing multicenter study of
these non-epileptic events to better understand their
causes and possible treatments. For now, Shaw often
couples psychotherapy with self-hypnosis lessons to
teach children how to avoid the events.
When theyre feeling out of control, this is a
tool they can use. They know that they were able to
turn off an event during the initial
hypnosis, and that gives them confidence to try it
themselves, said Shaw.
In general, people are growing more comfortable with
the idea of hypnosis in a medical setting, said Olson.
The first reaction of many
people may be to equate hypnosis with some sort of black
magic. But once we explain the reasons and benefits,
theyre very accepting.
Stanford University Medical Center integrates
research, medical education and patient care at its
three institutions Stanford
University School of Medicine, Stanford Hospital &
Clinics and Lucile Packard Childrens Hospital at Stanford. For more
information, please visit the Web site of the medical
centers Office of
Communication & Public Affairs at http://mednews.stanford.edu/.
Ranked as one of the nations top 10 pediatric hospitals by
U.S.News & World Report, Lucile Packard
Children's Hospital at Stanford is a 264-bed hospital
devoted to the care of children and expectant mothers.
Providing pediatric and obstetric medical and surgical
services and associated with the Stanford University
School of Medicine, Packard Children's offers patients
locally, regionally and nationally the full range of
health care programs and services from preventive and routine care to
the diagnosis and treatment of serious illness and
injury. For more information, visit http://www.lpch.org/.
Stanford University Medical Center
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