| Popis: |
The notion that stress, the physiological and/or behavioral response to event(s) interpreted as threatening to well-being, plays a role in triggering seizures or even causing epilepsy has been extensively studied in both experimental and clinical contexts. People with epilepsy consistently report stress as one of the most common triggers, although disentangling from confounders such as sleep deprivation, mood, and alcohol, and cause from effect has proved challenging. A great deal of effort (and money) has gone into pre-clinical and clinical research, including more recently functional imaging studies, such that we now have a good understanding of pathways and potential mechanisms. Similarly, there has been considerable work looking at ways to reduce stress, which can undoubtedly be of benefit in terms of psychological well-being, though may not improve seizure control. There has been very little consideration of cost-effectiveness or cost-utility thus far, which is of particular importance when there are inevitable limitations on resources. Thus beyond heightened awareness about the potential for stress and epilepsy to interact, little of this work has as yet translated into meaningful changes for clinical practice. Hopefully, further carefully directed preclinical and especially clinical research will lead to greater understanding of the interaction and benefit to patients. |
