Infra-low frequency neurofeedback training (ILF-NFT) could become part of the treatment regimen for Dravet syndrome (DS), according to a study recently published in Epilepsy & Behavior Reports.
“We highlight the beneficial effects on symptom reduction in seizure frequency and severity, as well as significantly improved sleep quality, including improvements in cognition, learning, and motor functioning, leading to an overall increased quality of life for the DS patient and her family,” the authors wrote.
This case study described an 8-year-old girl who initially presented with febrile seizures at 5 months of age, which continued to increase in both frequency and duration, occurring up to 3 times per week for about 30 minutes. She received a diagnosis of DS after genetic testing revealed a de novo mutation: SCN1A c.5752T>C; p.Ser1918Pro.
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Later, the seizure pattern changed, being also triggered by lower temperatures, overwhelming sensory stimulation, and physical activity. Moreover, the patient began experiencing sleep disturbances and reported an inability to sleep for about 2 to 4 hours each night, 5 days a week.
This subsequently hindered her cognitive and motor skills. Her psychosocial behavior demonstrated a 1-year delay. She also showcased impaired development and executive functioning while also having higher irritability and impulsivity.
For almost 3 years, she received daily topiramate, stiripentol, clobazam, melatonin, and as-needed paracetamol and diazepam. The patient also began daily ILF-NFT sessions for 30 minutes.
After just 3 sessions, the number of seizures drastically decreased to 1 episode every 7 to 10 days, and the patient later achieved a 23-week period without seizures, even during 1 febrile episode of 39.5 °C. This allowed her to decrease and then practically withdraw the use of diazepam, which diminished her lethargy. She also reported improved sleep.
Currently, the patient can jump for 15 minutes and attend special classes. On occasions when she has missed ILF-NFT sessions for 2 or 3 days, she does not feel well and experiences difficulty sleeping.
Although the lack of double-blind, randomized trials has made it difficult to assess the actual effectiveness and safety of ILF-NFT, this case suggests a promising use for patients with DS.
“We anticipate that the application of ILF-NFT may be necessary in order to minimize her symptoms throughout her lifetime,” the authors concluded.
Schmidt C, Laugesen H. Infra-low frequency neurofeedback training in Dravet syndrome: a case study. Epilepsy Behav Rep. Published online May 9, 2023. doi:10.1016/j.ebr.2023.100606