A blinded pilot study of artwork in a comprehensive epilepsy
David J. Anschel
, Sylvia Dolce
, Armin Schwartzman
, Robert S. Fisher
Department of Neurology, Stanford Comprehensive Epilepsy Center, 300 Pasteur Drive, Room 43160, Stanford, CA 94305-6648, USA
Art for Health Program, Oﬃce of Patient and Community Relations, Stanford University Medical Center, Stanford, CA 94305, USA
Department of Statistics, Stanford University, Stanford, CA 94305, USA
Received 16 November 2004; revised 3 December 2004; accepted 3 December 2004
The production of artwork is a complex neurological task. A controlled study of artwork produced by people with epilepsy has not
previously been performed. The present report details the results of a three-part study involving 60 subjects from a comprehensive epi-
lepsy center population. Subjects were grouped by the following diagnoses: seizures, partial seizures, complex partial seizures with tem-
poral focus, and nonepileptic events. Data were collected in a blinded fashion. The Formal Elements Art Therapy Scale task showed
signiﬁcant eﬀects in patients with epileptic seizures. The Free Drawing was most sensitive to complex partial seizures with temporal
focus, while the Outline was most predictive of nonepileptic events. In addition to giving some insight into the neurological functioning
of these subjects, this pilot study provides a basis for the future development of diagnostic tests to be used within this patient group.
Ó 2004 Elsevier Inc. All rights reserved.
Keywords: Epilepsy; Seizure; Pseudoseizure; Nonepileptic event; Temporal lobe epilepsy; Art; Drawing; Artwork; Formal Elements Art Therapy Scale
The production of artwork requires complex brain
processes not often assessed during routine neurological
testing. Unique insights into disordered cognitive pro-
cesses might be gained through the study of the artwork
of neurological patients. Although previous literature
has addressed the topic of art and epilepsy [1–3], art-
work has never been studied in a population whose
events have been characterized by video-EEG monitor-
ing. Prior to the initiation of the present study, empiric
observations by the present authors had suggested the
possibility that some patients with epilepsy produce
drawings with unique qualities. In particular, we ob-
served use of high color contrast, a preference for a large
number of lines with curves, rather than angles, and
high use of available workspace. In order to investigate
the hypothesis that these characteristics of artwork dif-
fered in people with epilepsy from those without epi-
lepsy, we designed three tasks for subjects to complete.
The ﬁrst involved drawing a person picking an apple
from a tree (PPAT) which was scored with a previously
standardized method called the Formal Elements Art
Therapy Scale (FEATS). The second involved a less
restrictive ‘‘free drawing’’ that utilized some of the
FEATS rating scales. The ﬁnal task involved using a
body outline as a starting point for the art task.
2.1. Patient population
Over an 18-month period, all adult patients who en-
tered the Stanford University Epilepsy Monitoring Unit
Epilepsy & Behavior 6 (2005) 196–202
1525-5050/$ - see front matter Ó 2004 Elsevier Inc. All rights reserved.
Corresponding author. Present address: Adult Epilepsy Program
Director, Long Island Comprehensive Epilepsy Center, Department of
Neurology, HSC, T-12, 020, Stony Brook, NY 11794-812, USA. Fax:
+631 444 1474.
E-mail address: firstname.lastname@example.org (D.J. Anschel).