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Epilepsy: A Comprehensive Textbook
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Disponibilitate: La comanda in aproximativ 4 saptamani
Editura: LWW
Limba: Engleza
Nr. pagini: 3998
Coperta: Hardcover
Dimensiuni: 213 x 276 mm
An aparitie: 25 noi 2023
Description:
Authoritative and updated, Epilepsy: A Comprehensive Textbook, 3rd Edition, contains 365 chapters that cover the full spectrum of relevant topics in biology, physiology, and clinical information, from molecular biology to public health concerns in developing countries. Written by world-renowned authorities and expertly edited by epileptologists Drs. Jerome Engel, Jr., Solomon L. Moshé, Aristea S. Galanopoulou, John M. Stern, Alexis Arzimanoglou, Jacqueline A. French, Renzo Guerrini, Andres M. Kanner, and Istvan Mody, this three-volume work includes detailed discussions of seizure types and epilepsy syndromes, relationships between physiology and clinical events, psychiatric and medical comorbidities, conditions that could be mistaken for epilepsy, and an increasing range of pharmacologic, surgical, and alternative therapies.
Tab;e of Contents:
VOLUME I
SECTION 1 • Epidemiology and Pathology of Seizures and Epilepsy
CHAPTER 1. OVERVIEW: EPIDEMIOLOGY AND PATHOLOGY OF SEIZURES AND EPILEPSY
EPIDEMIOLOGY
PATHOLOGY
ACKNOWLEDGMENT
REFERENCES
CHAPTER 2. EPILEPSY: HISTORICAL PERSPECTIVES
PREHISTORIC TIMES AND ANCIENT HISTORY
THE MIDDLE AGES AND RENAISSANCE
FUNDAMENTS OF THE MODERN ERA
THE MODERN ERA OF EPILEPSY
1860–1910
1910–1945
1945–2000
REFERENCES
CHAPTER 3. INCIDENCE AND PREVALENCE OF SEIZURES AND EPILEPSY
INTRODUCTION
INCIDENCE OF EPILEPSY
Total Population Studies
Studies in Selected Age Groups
Age-Specific Incidence
Sex
Seizure Type
Race
Time Trends
Epileptic Syndromes
ETIOLOGY OF EPILEPSY IN INCIDENCE COHORTS
Classic Risk Factors
Risk Factors Identified in Epidemiologic Studies
Gender
Etiology
Race
Incidence and Prevalence of Epilepsy and the Global Burden of Disease
SUMMARY AND CONCLUSIONS
ADDITIONAL INFORMATION
REFERENCES
CHAPTER 4. EPIDEMIOLOGY OF EPILEPSY IN LOW- AND MIDDLE-INCOME COUNTRIES
INTRODUCTION
METHODOLOGIC CONSIDERATIONS
Difficulties with Identification
Definition
The Diagnosis of Epilepsy
INCIDENCE OF EPILEPSY
PREVALENCE OF EPILEPSY
SEIZURE TYPE
THE CAUSES OF EPILEPSY
Identifying the Etiology
Family History of Epilepsy
Perinatal Brain Insults
Infections of CNS
Viral Infections
Human Immunodeficiency Virus
Traumatic Brain Injury
Cerebrovascular Disease
Tumors
MORTALITY
CONCLUSION
REFERENCES
CHAPTER 5. ETIOLOGY AND RISK FACTORS FOR SEIZURES AND EPILEPSY
INTRODUCTION
EPIDEMIOLOGIC STUDY DESIGNS
RISK FACTORS FOR CHILDHOOD EPILEPSY
Febrile and Acute Symptomatic Seizures
Prenatal and Perinatal Risk Factors
Postnatal Causes
Association of Different Risk Factors with Different Types of Epilepsy
RISK FACTORS FOR EPILEPSY IN ADULTS
Head Injury
Central Nervous System Infections
Central Nervous System Malignancies
Occlusive Cerebrovascular Disease
Dementia
Multiple Sclerosis
Depression and Treatment for Depression
Alcohol
Illicit Drugs
Acute Symptomatic Seizures
Migraines and Epilepsy
The Protective Effect of Diuretics
Socioeconomic Status
FUTURE RESEARCH
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 6. THE COMORBIDITIES IN EPILEPSY
COMORBIDITY AS AN EPIDEMIOLOGIC CONSTRUCT
BURDEN OF COMORBIDITY IN PEOPLE WITH EPILEPSY
CLINICAL APPROACH TO COMORBIDITIES IN PEOPLE WITH EPILEPSY
MECHANISMS OF ASSOCIATION
Chance and Artifactual Comorbidities
Causative and Resultant Mechanisms
Shared Risk Factors
Bidirectional Effects
CASE STUDY: CARDIOVASCULAR DISEASE AND EPILEPSY
CASE STUDY: EPILEPSY AND DIABETES
CASE STUDY: EPILEPSY AND DEPRESSION
CASE STUDY: MIGRAINE AND EPILEPSY
REFERENCES
CHAPTER 7. NATURAL HISTORY AND PROGNOSIS OF EPILEPSY
INTRODUCTION
METHODOLOGIC ISSUES
OVERALL PROGNOSIS OF EPILEPSY
Prognosis of a First Seizure
EARLY PROGNOSIS OF UNPROVOKED SEIZURES AND EPILEPSY
Prognosis after the First Unprovoked Seizure
Risk Factors for Recurrence after a First Unprovoked Seizure
Treatment, Risk of Recurrence, and Long-Term Prognosis of a First Seizure
PROGNOSIS OF UNTREATED EPILEPSY
PROGNOSIS OF NEWLY DIAGNOSED AND TREATED EPILEPSY
Principal Prognostic Indicators in Treated Epilepsy
Prognosis of Epilepsy Syndromes
Antiseizure Medications and Seizure Outcome
PROGNOSIS OF EPILEPSY AFTER TREATMENT WITHDRAWAL
Factors Predicting Seizure Relapse after Treatment Withdrawal
PSYCHOSOCIAL OUTCOME
SUMMARY AND CONCLUSIONS
ADDITIONAL INFORMATION
REFERENCES
CHAPTER 8. EPIDEMIOLOGY OF ACUTE SYMPTOMATIC SEIZURES
INTRODUCTION
INCIDENCE OF ACUTE SYMPTOMATIC SEIZURES
Overall Incidence
Gender
Age
Seizure Type and Duration
CAUSES OF ACUTE SYMPTOMATIC SEIZURES
Acute Symptomatic Seizures Associated with Primary Brain Insults
Acute Symptomatic Seizures Associated with Systemic Disturbances
CUMULATIVE INCIDENCE OF ACUTE SYMPTOMATIC SEIZURES
PROGNOSIS OF ACUTE SYMPTOMATIC SEIZURES
SUMMARY AND CONCLUSIONS
ADDITIONAL INFORMATION
REFERENCES
CHAPTER 9. SEIZURE PRECIPITANTS
INTRODUCTION
STRESS
SLEEP AND SLEEP LOSS
NONADHERENCE TO ASM TREATMENT
ALCOHOL
DRUGS AND STIMULANTS
FEVER
MENSTRUAL CYCLE
PHYSICAL EXERCISE
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 10. THE MORTALITY OF EPILEPSY
INTRODUCTION
OVERALL MORTALITY
ETIOLOGY OF EPILEPSY
AGE AND SEX
DURATION OF EPILEPSY
SEIZURE TYPE AND FREQUENCY
CAUSE-SPECIFIC MORTALITY IN PEOPLE WITH EPILEPSY
SUDDEN UNEXPECTED DEATH IN EPILEPSY
STATUS EPILEPTICUS
INJURIES AND ACCIDENT-RELATED DEATHS
SUICIDES
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 11. GENERAL NEUROPATHOLOGY OF EPILEPSY
NEUROPATHOLOGY REVISITED: ETIOLOGY MATTERS IN DIAGNOSIS AND TREATMENT
THE CONCEPT OF CELLULAR PATHOLOGY AS THE FOUNDATION OF MODERN MEDICINE
THE CONCEPT OF MOLECULAR PATHOLOGY AS THE FOUNDATION OF PERSONALIZED MEDICINE
THERE ARE UNIQUE MORPHOLOGIC SUBSTRATES THAT SUBSERVE INTRINSIC EPILEPTOGENCITY IN HUMAN NEOCORTEX
COMMON NEUROPATHOLOGIC CHANGES THAT RESULT FROM EPILEPSY
FUTURE DIRECTIONS
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 12. NEUROPATHOLOGY OF HIPPOCAMPAL SCLEROSIS
ANATOMY OF THE HUMAN HIPPOCAMPUS
HIPPOCAMPAL SCLEROSIS IN TEMPORAL LOBE EPILEPSY
HISTOPATHOLOGIC CLASSIFICATION OF HIPPOCAMPAL SCLEROSIS
THE INTERNATIONAL LEAGUE AGAINST EPILEPSY CONSENSUS CLASSIFICATION OF HIPPOCAMPAL SCLEROSIS
HS ILAE Type 1
HS ILAE Type 2 (CA1 Predominant Neuronal Cell Loss and Gliosis)
HS ILAE Type 3 (CA4 Predominant Neuronal Cell Loss and Gliosis)
No Hippocampal Sclerosis, Gliosis Only (no HS)
DENTATE GYRUS PATHOLOGY
ASSOCIATED FOCAL CORTICAL DYSPLASIA TYPE 3A
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 13. NEUROPATHOLOGY OF DEVELOPMENTAL DISORDERS ASSOCIATED WITH EPILEPSY
INTRODUCTION
THE ENIGMA OF EPILEPSY OR NOT IN CEREBRAL MALFORMATIONS
CLINICOPATHOLOGIC FEATURES
NOSOLOGY
DEVELOPMENT OF THE NEOCORTEX
Overview of Neocortical Development
Radial Migration of Neuroblasts from the Subventricular Zone
Tangential Migration of GABAergic Interneurons from Ganglionic Eminence
Origin of Cajal–Retzius Cells and Their Biologic Significance
Origin of Superficial Granular Layer of Brun and Its Biologic Significance
Subplate Neurons as Pioneer Cells to Form Early Thalamocortical Projections
Neuropathology and Pathophysiologic Significance of MCD
PATHOGENESIS OF CORTICAL DYSPLASIAS
CONCLUSIONS
REFERENCES
CHAPTER 14. NEUROPATHOLOGY OF BRAIN TUMORS ASSOCIATED WITH EPILEPSY
INTRODUCTION
GLIONEURONAL TUMORS
Ganglioglioma
Dysembryoplastic Neuroepithelial Tumor
Papillary Glioneuronal Tumor
Rosette-Forming Glioneuronal Tumor
Diffuse Leptomeningeal Glioneuronal Tumor
Multinodular and Vacuolating Neuronal Tumor of the Cerebrum
Pilocytic Astrocytoma
Pleomorphic Xanthoastrocytoma
DIFFUSE ASTROCYTIC AND OLIGODENDROGLIAL TUMORS
Diffuse Astrocytoma
Oligodendroglioma
Angiocentric Gliomas
CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 15. NEUROPATHOLOGY OF VASCULAR LESIONS ASSOCIATED WITH EPILEPSY
INTRODUCTION
NEUROPATHOLOGY OF POSTSTROKE EPILEPSY IN CEREBROVASCULAR DISEASES
EPILEPSY-ASSOCIATED VASCULAR MALFORMATIONS
Arteriovenous Malformation
Cerebral Cavernous Malformation or Cavernous Angioma
Developmental Venous Anomalies
Capillary Telangiectasia/Capillary Malformation
Leptomeningeal Angiomatosis of Sturge–Weber Syndrome
MENINGIOANGIOMATOSIS
OTHER EPILEPSY-ASSOCIATED VASCULAR LESIONS
Intracranial Unruptured Saccular (Berry) Aneurysm
Moyamoya Disease/Spontaneous Occlusion of the Circle of Willis
Systemic Autoimmune Disorders Causing Cerebrovascular Complications
Primary Angiitis of the Central Nervous System
SUMMARY AND CONCLUSIONS
REFERENCES
SECTION 2 • Genetics in Epilepsy
CHAPTER 16. OVERVIEW: GENETICS IN EPILEPSY
CHAPTER 17. GENETIC EPIDEMIOLOGY IN EPILEPSY
INTRODUCTION
FAMILIAL AGGREGATION STUDIES
Rationale and Importance
Methodologic Considerations
Major Findings of Family Aggregation Studies
TWIN STUDIES
Rationale, Assumptions, and Limitations
Methodologic Considerations
Major Findings of Twin Studies
Comparison of Twin Studies to Familial Aggregation Studies
EPIDEMIOLOGY AND THE MOLECULAR GENETICS OF THE EPILEPSIES
CONCLUSIONS
REFERENCES
CHAPTER 18. GENETIC ARCHITECTURE OF THE EPILEPSIES
INTRODUCTION
CONCEPTUAL ISSUES
How Much of Epilepsy Is Genetic?
Heritability of Epilepsy
Epilepsy Classification, Syndromes, and Genetics
OVERVIEW OF GENETIC ARCHITECTURE
Monogenic Epilepsies
Complex Epilepsies
UNCONVENTIONAL MECHANISMS
Mosaicism
Repeat Expansions
PHARMACOGENOMICS
FUTURE PERSPECTIVE
REFERENCES
CHAPTER 19. SINGLE GENE EPILEPSIES
REFERENCES
CHAPTER 20. HOW TO INTERPRET AND ACT ON CLINICAL EXOMES IN EPILEPSY
INTRODUCTION
EFFECTIVENESS OF EXOME ANALYSIS FOR EPILEPSY DIAGNOSIS
CLASSIFICATION AND NOMENCLATURE OF IDENTIFIED VARIANTS
FILTERING TO FIND PATHOGENIC VARIANTS
Allele Frequency
Prediction
Segregation
Previous Reports
Functional Assay
American College of Medical Genetics Guidelines
EXOME ANALYSIS PROCESS
PITFALLS OF EXOME ANALYSIS
Chromosomal Structural Abnormalities
Splicing and Gene-Regulation Variants
Mitochondrial Disorders
Gene-Panel or Exome Sequencing
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 21. FAMILIAL EPILEPSIES IN THE FIRST YEAR OF LIFE
INTRODUCTION
FAMILIAL EPILEPSIES IN THE FIRST YEAR OF LIFE
History and Terminology
Investigations
SELF-LIMITED FAMILIAL NEONATAL EPILEPSY
Epidemiology
Clinical Manifestation
Genetic Backgrounds and Molecular Mechanisms
Other KCNQ2-Related Disorders
Treatment
Outcome
SELF-LIMITED FAMILIAL NEONATAL–INFANTILE EPILEPSY
Clinical Manifestations
Genetic Backgrounds and Molecular Mechanisms
SELF-LIMITED FAMILIAL INFANTILE EPILEPSY
Clinical Manifestations
Genetic Backgrounds and Molecular Mechanisms
Treatment
Outcome
CONCLUSION
REFERENCES
CHAPTER 22. DEVELOPMENTAL AND EPILEPTIC ENCEPHALOPATHIES
INTRODUCTION
DEES PRESENTING IN THE NEONATAL AND INFANCY PERIOD
Early Infantile Developmental and Epileptic Encephalopathy
Epilepsy of Infancy with Migrating Focal Seizures
Infantile Epileptic Spasms Syndrome
Dravet Syndrome
PCDH19-DEE
Epilepsy with Myoclonic Atonic Seizures
Lennox–Gastaut Syndrome
REFERENCES
CHAPTER 23. GENETIC GENERALIZED EPILEPSIES
DEFINITION OF THE PHENOTYPE
ABSENCE EPILEPSIES
Childhood Absence Epilepsy
Juvenile Absence Epilepsy
OTHER TYPES OF EPILEPSY WITH ABSENCES NOT CLASSICALLY CONSIDERED UNDER GGES
Epilepsy with Myoclonic Absences
Myoclonic Astatic Epilepsy
Other Possible Syndromes with Typical Absence Seizures
Juvenile Myoclonic Epilepsy
GGE with Generalized Tonic–Clonic Seizures Alone
Adult-Onset Genetic Generalized Epilepsy
Genetic Generalized Epilepsies: Discrete or Overlapping Entities?
Genetic Etiology
Sex-Related Effects
Anatomical Changes of Brain Architecture
Treatment
REFERENCES
CHAPTER 24. GENETIC ENCEPHALOPATHIES WITH EPILEPSY AS A MAIN FEATURE
INTRODUCTION
AICARDI SYNDROME
Diagnosis
Phenotype
Treatment
ANGELMAN SYNDROME
Diagnosis
Phenotype
Treatment
CORNELIA DE LANGE SYNDROME
Diagnosis
Phenotype
Treatment
KBG SYNDROME
Diagnosis
Phenotype
Treatment
KMT2E-RELATED NEURODEVELOPMENTAL DISORDER
Diagnosis
Phenotype
Treatment
MOWAT–WILSON SYNDROME
Diagnosis
Phenotype
Treatment
PITT–HOPKINS SYNDROME
Diagnosis
Phenotype
Treatment
RETT SYNDROME
Diagnosis
Phenotype
Treatment
REFERENCES
CHAPTER 25. GENETIC TESTING AND COUNSELING FOR THE EPILEPSIES
INTRODUCTION
CHANGING LANDSCAPE OF GENETICS OF EPILEPSY
IMPORTANCE OF GENETIC TESTING
REVIEW OF AVAILABLE DIAGNOSTIC TESTING OPTIONS
Molecular Genetic Tests
Chromosomal Genetic Tests
Biochemical Genetic Tests
WHICH PATIENTS WITH EPILEPSY SHOULD HAVE GENETIC TESTING?
APPROACH TO TEST SELECTION FOR PATIENTS WITH EPILEPSY
GENETIC COUNSELING FOR EPILEPSY
Informed Consent for Genetic Testing
Disclosure of Genetic Test Results
SUMMARY AND CONCLUSIONS
REFERENCES
SECTION 3 • Neurobiology of Epilepsy
CHAPTER 26. OVERVIEW: NEUROBIOLOGY OF EPILEPSY
CHAPTER 27. TRANSCRIPTIONAL CHANNELOPATHIES IN GENETIC AND ACQUIRED EPILEPSIES
TRANSCRIPTIONAL CHANNELOPATHIES
TRANSCRIPTIONAL REGULATION OF VOLTAGE-GATED ION CHANNELS LEADING TO GENETIC EPILEPSIES
Voltage-Gated K+ Channelopathies
Voltage-Gated Na+ Channelopathies
Voltage-Gated Ca2+ Channelopathies
HCN Ion Channelopathies
TRANSCRIPTIONAL REGULATION OF LIGAND-GATED ION CHANNELS LEADING TO GENETIC EPILEPSIES
NMDA Receptor Channelopathies
GABA Receptor Channelopathies
Nicotinic Acetylcholine Receptor Channelopathies
TRANSCRIPTIONAL CHANNELOPATHIES IN ACQUIRED EPILEPSIES
GABAA Receptor Alterations in Hippocampal Dentate Granule Cells in Multiple Experimental TLE Models
HCN Channel Alterations in Hippocampal CA1 Pyramidal Neurons in Multiple Experimental TLE Models
Cav3.2 Channel Upregulation in Hippocampal CA1 Pyramidal Neurons in an Experimental TLE Model
Potential for Therapy in Acquired Transcriptional Channelopathies
SUMMARY
REFERENCES
CHAPTER 28. PRINCIPAL CELL HETEROGENEITY IN MALFORMATIONS OF CORTICAL DEVELOPMENT AND ACQUIRED EPILEPSY
INTRODUCTION
CORTICAL DEVELOPMENT AND MALFORMATIONS
Mispositioning of Neurons
Abnormal Cellular Development
NONUNIFORM COMPUTATIONAL MODULES FOR PARALLEL PROCESSING AND PRINCIPAL CELL HETEROGENEITY: INSIGHTS FROM THE HIPPOCAMPUS
PYRAMIDAL CELL HETEROGENEITY AND LOCAL MICROCIRCUITS IN THE HIPPOCAMPUS
PRINCIPAL CELL HETEROGENEITY IN THE DG IN CHRONIC TEMPORAL LOBE EPILEPSY
CONCLUSIONS AND OUTLOOK
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 29. MECHANISMS OF NEURONAL EXCITATION LEADING TO SYNCHRONY
INTRODUCTION
MEASURING NEURAL SYNCHRONY: THE IMPORTANCE OF TECHNICAL LIMITATION AND PERSPECTIVE
SYNAPTIC MECHANISMS FOR SYNCHRONIZATION: RECURRENCE
SYNAPTIC MECHANISMS FOR SYNCHRONIZATION: DISINHIBITION
NONSYNAPTIC MECHANISMS FOR SYNCHRONIZATION: INTRINSIC PROPERTIES
NONSYNAPTIC MECHANISMS FOR SYNCHRONIZATION: EXTRACELLULAR COMPARTMENT
NONSYNAPTIC MECHANISMS FOR SYNCHRONIZATION: EPHAPTIC COUPLING
NONSYNAPTIC MECHANISMS FOR SYNCHRONIZATION: GAP JUNCTION COUPLING
FUTURE OUTLOOK
REFERENCES
CHAPTER 30. INTERNEURON DIVERSITY IN EPILEPSY: CHALLENGES AND PROGRESS
INTRODUCTION
OVERVIEW OF THE NORMAL DIVERSITY OF INTERNEURONS
Interneurons Innervating Principal Cell Soma or Axon Initial Segments
Interneurons Innervating Principal Cell Dendrites
Interneurons Innervating Other Interneurons
WHAT INTERNEURONS DEGENERATE IN ACQUIRED EPILEPSY?
WHAT ARE THE FUNCTIONAL CONSEQUENCES OF INTERNEURON LOSS?
HOW DO SURVIVING INTERNEURONS ADAPT IN THEIR STRUCTURE AND FUNCTION?
Functional Impairment of Surviving Interneurons
Overexpression of Neuropeptides and Glutamate Decarboxylases in Surviving Interneurons
Sprouting and Reorganization of Surviving Interneurons
WHAT ARE THE ROLES OF SURVIVING INTERNEURONS IN EPILEPSY?
Effects of Selectively Modulating Interneuron Activity
Monitoring Interneuron Activity Prior to and During Seizure Activity
WHAT IS THE POTENTIAL FOR INTERNEURON-BASED TREATMENT OF EPILEPSY?
Modulation of Interneurons for the Treatment of Epilepsy
Transplantation of Interneurons for the Treatment of Epilepsy
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 31. MECHANISMS OF NEURONAL INHIBITION LEADING TO SYNCHRONY
INTRODUCTION
AN OVERVIEW OF INTERNEURONAL CLASSES AND CONNECTIVITY IN CORTICAL NETWORKS
PHYSIOLOGIC SYNCHRONIZATION
DETERMINANTS OF GABA CURRENT: INTRA- AND EXTRACELLULAR CHLORIDE
DYNAMIC CHANGES IN GABAERGIC FUNCTION
GABAERGIC INFLUENCES IN EPILEPTIC DISCHARGES
CHARACTERISTICS OF CELLULAR RECRUITMENT TO SEIZURES
REFERENCES
CHAPTER 32. NEURONS AND CIRCUITS DURING BRAIN DEVELOPMENT
INTRODUCTION
DEVELOPMENTAL CHANGES IN NEURONAL PROPERTIES
GAP-JUNCTION CONNECTIONS
EXCITATORY SYNAPTIC CONNECTIONS
Local and Long-Range Connections
Functional Properties of Developing Excitatory Synapses
INHIBITORY CIRCUITS
Delayed Recruitment of Perisomatic Inhibition
Depolarizing Actions of GABA
Actions of GABA in Vivo
EARLY NETWORK ACTIVITY PATTERNS
Correlated Activity Mediated by Gap Junctions
Delta Waves
Early Gamma and Spindle-Burst Oscillations
CONCLUDING REMARKS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 33. METABOLISM, REACTIVE OXYGEN SPECIES, AND EPILEPSY
INTRODUCTION
NEURONAL–GLIAL METABOLISM
REACTIVE OXYGEN SPECIES IN EPILEPSY
MITOCHONDRIA AS A SOURCE AND TARGET OF ROS IN EPILEPSY
NOX ENZYMES AS SOURCES OF ROS IN EPILEPSY
PHARMACOLOGIC REDOX-BASED APPROACHES FOR EPILEPSY AND FUTURE DIRECTIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 34. DENDRITIC MECHANISMS OF EXCITABILITY
INTRODUCTION
BASIC MECHANISMS OF DENDRITIC INTEGRATION
ALTERED DENDRITIC MORPHOLOGY AND PASSIVE MEMBRANE PROPERTIES IN EPILEPSY
ACTIVE MECHANISMS IN DENDRITES AFFECTING PROPAGATION OF VOLTAGE SIGNALS
Voltage- and Ca2+-Gated K+ Channels
Dendritic h-currents
Voltage-Gated Na+ Channels
ACTIVE MECHANISMS IN DENDRITES: DENDRITIC SPIKES
ALTERED DENDRITIC ELECTROPHYSIOLOGY IN EPILEPSY
Epilepsy-Related Changes in Dendritic Kv4.2 Channels
Epilepsy-Related Changes in Dendritic HCN Channels
Changes in Dendritic T-Type Currents Mediated by CaV3.2 Channels
Epilepsy-Related Changes in KCa3.1 Channels
Mechanisms of Dendritic Integration Across Species—Mouse to Human
ROLE OF ACTIVE DENDRITIC INTEGRATION IN VIVO
Outlook
REFERENCES
CHAPTER 35. THALAMOCORTICAL ORGANIZATION AND FUNCTION: NEW INSIGHTS AND IMPLICATIONS FOR EPILEPSY
INTRODUCTION
ANATOMICAL AND FUNCTIONAL OVERVIEW OF THE THALAMUS
SINGLE-CELL ANALYSES ESTABLISH A HIGH-RESOLUTION FRAMEWORK OF THE THALAMUS
Classification of TC Relay Nuclei
In Search of Molecular Markers for the nRT
MAPPING MOLECULAR PROPERTIES WITH CIRCUIT PROPERTIES REVEALS NEW PATHWAYS
Input–Output Connectivity of the nRT
Intra-nRT Connectivity
INSIGHTS FROM DISSECTING THE ROLE OF nRT IN SPINDLE OSCILLATIONS: CAN nRT SPINDLES ELUCIDATE SEIZURES?
NEW INSIGHTS ON THE ROLE OF nRT IN TC SEIZURE DYNAMICS
CONCLUDING REMARKS
Molecular Insights
Electrophysiologic Insights
Circuit Insights
REFERENCES
CHAPTER 36. MECHANISMS OF SEIZURE INITIATION AND PROPAGATION
INTRODUCTION
ELECTROPHYSIOLOGIC SIGNATURES OF FOCAL SEIZURES
Clinical EEG Assessment
Electrographic Seizure-Onset Patterns
High-Frequency Activity as a Biomarker of Seizure-Generating Sites
Infra-Slow Activity at Seizure Onset
NEURONAL ACTIVITY IN SEIZURE INITIATION AND MAINTENANCE
Ictal Neuronal Firing Patterns
Neuronal Cell-Type–Specific Activity
MECHANISMS UNDERLYING THE SEIZURE TRANSITION
Dysregulated Chloride Homeostasis
Interneuron Depolarization Block
Astrocyte-Mediated Excitation
SPATIAL STRUCTURE OF HUMAN SEIZURES
The Dual-Territory Hypothesis: Ictal Core and Penumbra
Cross-Scale Seizure Effects
Epileptic Networks
CONCLUDING REMARKS
REFERENCES
CHAPTER 37. SEIZURES AND NETWORKS IN THE HUMAN FOCAL EPILEPSIES: BEYOND THE ANIMAL MODELS
INTRODUCTION
FOCAL SEIZURE–ONSET PATTERNS
LESION-SPECIFIC ICTAL PATTERNS
REGION-SPECIFIC ICTAL PATTERNS
THE EPILEPTOGENIC NETWORKS
CONCLUSIONS
REFERENCES
CHAPTER 38. TEMPORAL COORDINATION: A KEY TO UNDERSTAND COGNITIVE AND BEHAVIORAL DEFICITS IN EPILEPSY
INTRODUCTION: LOSING THE BEAT
COGNITIVE AND BEHAVIORAL IMPAIRMENTS IN EPILEPSY
GENERAL CONTRIBUTORS OF COGNITIVE COMORBIDITIES
PHYSIOPATHOLOGIC FEATURES OF EPILEPSIES
The Case of TLE
The Case of Epilepsies of Genetic Origin
NETWORK MECHANISMS UNDERLYING COGNITIVE IMPAIRMENT IN EPILEPSY
Alterations of Neuronal Network Dynamics and Computation
Impact on High-Level Cognitive Representations
RHYTHMOPATHIES AND EPILEPSY
θ Oscillations and Epilepsy
γ Oscillations and Epilepsy
High-Frequency Oscillations in Epilepsy
FROM INTERNEUROPATHIES TO RHYTHMOPATHIES
CONCLUSIONS
REFERENCES
CHAPTER 39. EPILEPSY AND CONSCIOUSNESS
INTRODUCTION
THE DIMENSIONS OF CONSCIOUSNESS IN SEIZURES
ESTIMATION OF CONSCIOUSNESS DURING SEIZURES
IMPAIRED CONSCIOUSNESS IN GENERALIZED SEIZURES
Generalized Tonic–Clonic Seizures
Absence Seizures
IMPAIRED CONSCIOUSNESS IN FOCAL SEIZURES
Temporal Lobe Seizures
Extratemporal Lobe Seizures
Mechanisms
Insights from Animal Models
THERAPEUTIC APPROACHES
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 40. ACTIVATING AND RECORDING NEURONAL ENSEMBLES
INTRODUCTION
ACTIVATING NEURONAL ENSEMBLES
Electrical Stimulation
Optogenetic Stimulation
Chemogenetic Activation
RECORDING NEURONAL ENSEMBLES
EEG/LFP
Wireless Telemetry
Imaging Techniques
CONSIDERATIONS AND PERSPECTIVES
REFERENCES
CHAPTER 41. GENETICALLY ENCODED PROBES for OPTICAL MEASUREMENT of NEURONAL EXCITABILITY and SYNCHRONY
INTRODUCTION
ADVANCES IN FLUORESCENCE MICROSCOPY
The Impact of 2-Photon Excitation Microscopy
Miniaturized Epifluorescence Microscopy
GENETICALLY ENCODED PROBES FOR RECORDING NEURONAL EXCITABILITY
Calcium Indicators
Voltage Sensors
METHOD OF DELIVERY
Viruses
Transgenic Animals
Electroporation
RECORDING NEURAL EXCITABILITY AND SYNCHRONY WITH GENETICALLY ENCODED FLUORESCENT INDICATORS IN THE CONTEXT OF EPILEPSIES
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 42. FAST RHYTHMS IN EPILEPSIES
INTRODUCTION
DEFINITION/DESCRIPTION OF FAST RHYTHMS
FAST RHYTHMS IN THE NORMAL BRAIN
FAST RHYTHMS IN THE EPILEPTIC BRAIN
Pathologic Gamma Activity
Cellular and Network Mechanisms of Epileptic Ripples
Cellular and Network Mechanisms of Epileptic Fast Ripples
Mechanisms of Very-High HFOs
Regional Properties of Pathologic HFOs
SIGNIFICANCE OF FAST RHYTHMS
HFA and the Modern Concept of the Epileptic Focus
HFOs in Epileptogenesis
HFOs as a Marker of Seizure Susceptibility
FUTURE DIRECTIONS
REFERENCES
CHAPTER 43. Miniaturized Microscopy as a Tool to Track Neuronal Population Dynamics in Epilepsy Models
INTRODUCTION
BRIEF HISTORY OF IMAGING IN BEHAVING ANIMALS
MINIATURE MICROSCOPY
CURRENT TOOLS AND FEATURES
Electrowetting Lenses
Dual-Channel Microscopes
Optogenetics
Wide-Field Imaging
Neurovascular Coupling
Volumetric Imaging
Wireless and Wire-Free
Electrophysiology
Simultaneous Behavior Tracking/Readout
DATA ANALYSIS
FUTURE INNOVATION OF MINIATURE MICROSCOPY
Wireless Power Delivery and Data Transmission
Close-Loop Experiments
Fast Imaging of Voltage Sensors
Lensless Imaging
STUDYING EPILEPSY WITH MINISCOPES
SUMMARY
REFERENCES
CHAPTER 44. SEIZURE CONTROL THROUGH CLOSED-LOOP SYSTEMS
INTRODUCTION
CLOSED-LOOP INTERVENTIONS: AN OVERVIEW
Example Potential Signals for Seizure Detection
Closed-Loop Interventions Are Not Limited to Electrical Stimulation Approaches
Closed-Loop Approaches Are Not Limited to On-Demand Interventions
ADVANTAGES OF CLOSED-LOOP SYSTEMS
CURRENT CLOSED-LOOP INTERVENTIONS IN EPILEPSY
Responsive Neurostimulation System
On-Demand Stimulation of the Vagus Nerve
Biofeedback
CLOSED-LOOP INTERVENTIONS IN EPILEPSY: ANIMAL STUDIES PROVIDE INSIGHT AND INFORM POTENTIAL FUTURE APPROACHES
Closed-Loop Approaches in Absence Epilepsy Models
Closed-Loop Approaches in Temporal Lobe Epilepsy Models
Closed-Loop Gene Therapy via eGluCl
FUTURE DIRECTIONS
CONCLUSIONS
REFERENCES
CHAPTER 45. BIOMARKERS
INTRODUCTION
SUSCEPTIBILITY/RISK BIOMARKERS
Genetic Risk Biomarkers
Blood/CSF Risk Biomarkers
Neurophysiology Risk Biomarkers
Neuroimaging Risk Biomarkers
DIAGNOSTIC BIOMARKERS
Diagnostic Genetic Biomarkers
Diagnostic Blood/CSF Biomarkers
Diagnostic Neurophysiologic Biomarkers
Diagnostic Imaging Biomarkers
PROGNOSTIC BIOMARKERS
Prognostic Genetic Biomarkers
Prognostic Blood/CSF Biomarkers
Prognostic Neurophysiologic Biomarkers
Prognostic Imaging Biomarkers
MONITORING AND PREDICTIVE BIOMARKERS/SURROGATE ENDPOINTS
Predictive Genetic Biomarker
Predictive Blood/CSF Biomarkers
Predictive Neurophysiology Markers
Predictive Imaging Biomarkers
CONCLUSIONS
REFERENCES
CHAPTER 46. COMORBIDITIES AS PROGNOSTIC FACTORS FOR EPILEPTOGENESIS
INTRODUCTION
BEHAVIORAL AND COGNITIVE METHODS USED TO ASSESS COMORBIDITIES IN ANIMAL MODELS OF ACQUIRED EPILEPSY
COMORBIDITIES IN ANIMAL MODELS OF ACQUIRED EPILEPSY
COMORBIDITIES AND SEIZURE THRESHOLD AS PROGNOSTIC FACTORS FOR EPILEPTOGENESIS
CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 47. USE OF HUMAN PLURIPOTENT STEM CELLS IN EPILEPSY RESEARCH
INTRODUCTION
iPSC METHODS RELEVANT TO EPILEPSY STUDIES
INVESTIGATION OF EPILEPSY PHENOTYPES IN 2D CULTURES
Brain Organoids for Epilepsy Research
Exploring SUDEP Mechanisms with iPSCs
CHALLENGES AND FUTURE DIRECTIONS
CONCLUSIONS
REFERENCES
CHAPTER 48. NOVEL ROLES OF MYELINATION IN NEURAL CIRCUIT PLASTICITY AND IMPLICATIONS FOR EPILEPSY
INTRODUCTION
ROLES OF MYELIN IN THE CENTRAL NERVOUS SYSTEM
Myelin Increases Neuronal Conduction Velocity
Role of Myelination in Regulating Timing of Neuronal Signals
DEVELOPMENTAL MYELINATION AND THE LIFE CYCLE OF THE OLIGODENDROCYTE
Oligodendrocyte Precursor Cells
Premyelinating Oligodendrocytes
Myelin Wrapping and Compaction
NEURONAL ACTIVITY IN THE REGULATION OF MYELINATION
Structural and Cellular Changes to Myelin in Response to Neuronal Activity
How Does Neuronal Activity Influence Myelination?
MOLECULAR MECHANISMS OF NEURONAL ACTIVITY-DEPENDENT MYELINATION
Neuronal Signals and Activity-Dependent Myelination
Translating Neuronal Signals Into OL Responses: Intracellular Calcium
Calcium-Regulation of OL Cell Biology: Mechanistic Insight Into Activity-Dependent Myelination
INTERNEURON MYELINATION
OPEN QUESTIONS
Structure and Function of Neuron-OPC Synapses
Molecular Mechanisms Regulating Activity-Dependent Myelination
Functional Relevance of Activity-Dependent Myelination in Regulating Neural Circuit Function and Behavior
Function of PV Myelin
ROLE OF MYELIN AND MYELIN PATHOLOGY TO EPILEPSY
CONCLUDING REMARKS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 49. ROLE OF DYSFUNCTIONAL ASTROCYTES IN EPILEPTOGENESIS
INTRODUCTION
BASIC PHYSIOLOGY OF “NORMAL” ASTROCYTES
Membrane Physiology
Astrocyte Metabolism and Synaptic Activity
ASTROCYTE DYSFUNCTIONS CONTRIBUTE TO INITIATION AND PROGRESSION OF EPILEPSY
Reactive Astrocytes May Generate Seizure Activity
Altered K+ Channels and Water Channels in Epilepsy
Loss of Astroglial Gap-Junction Coupling as a Key Mechanism in Initiation and Progression of TLE
Altered Glutamate Homeostasis in Epilepsy
Astrocyte Ca2+ Signaling in Epilepsy
CONCLUSIONS AND PERSPECTIVES
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 50. NEUROVASCULAR INFLAMMATION IN EPILEPSY
INTRODUCTION
EVIDENCE FOR PERSISTENT NEUROINFLAMMATION AND ITS DEFECTIVE RESOLUTION IN EPILEPSY
NEUROINFLAMMATORY SIGNALS IMPLICATED IN EXPERIMENTAL EPILEPSY
The IL-1β System
The Prostanoid Cascade: The Focus on MAGL and COX-2
Specialized Proresolving Molecules
MECHANISMS OF HYPEREXCITABILITY
CEREBROVASCULAR PERMEABILITY AND PERIVASCULAR INFLAMMATION DURING SEIZURES
PERIPHERAL INFLAMMATION AND EPILEPSY: HUMAN AND EXPERIMENTAL EVIDENCE
DOES PRE-EXISTING INFLAMMATION ENABLE SEIZURES?
CONCLUSIONS ON THERAPEUTIC PERSPECTIVES
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 51. THE BLOOD–BRAIN BARRIER AND EPILEPSIES
INTRODUCTION
BBB DYSFUNCTION FOLLOWING BRAIN INSULTS
BBB DYSFUNCTION AND EPILEPSIES
BBB DYSFUNCTION AND MECHANISMS UNDERLYING EPILEPTOGENESIS
BBB-TARGETED THERAPIES: A NEW OPPORTUNITY IN THE PREVENTION AND TREATMENT OF EPILEPSY?
REFERENCES
CHAPTER 52. THE mTOR PATHWAY IN EPILEPTOGENESIS
INTRODUCTION
mTOR IN ANIMAL MODELS OF TSC
mTOR IN ANIMAL MODELS OF OTHER GENETIC AND ACQUIRED EPILEPSIES
CLINICAL TRANSLATION OF mTOR INHIBITORS IN EPILEPSY AND TSC
CONCLUSIONS AND FUTURE DIRECTIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 53. EPIGENETIC MECHANISMS IN EPILEPSY
INTRODUCTION
OVERVIEW: EPIGENETICS, GENE EXPRESSION, AND CHROMATIN STRUCTURE
Gene Expression and Protein Production
DNA Organization and Epigenetic Modifications
CORE EPIGENETIC MECHANISMS CONTROLLING GENE EXPRESSION
DNA Methylation
Histone Posttranslational Modifications and Histone Variants
Noncoding RNA
Other Mediators of Epigenetic Processes
EPIGENETIC MECHANISMS IN EPILEPSY
DNA Methylation in Epilepsy
Histone Modifications in Epilepsy
Noncoding RNAs in Epilepsy
EPILEPSY-ASSOCIATED GENES WITH EPIGENETIC FUNCTIONS
INTERACTIONS AND INTERDEPENDENCE IN EPIGENETICS: ADDING A LAYER OF COMPLEXITY
CELL SPECIFICITY IN EPIGENETICS: AN ONGOING CHALLENGE
How Do Epigenetic Processes Favor or Protect Against Neuronal Excitability and Seizures?
Metabolically Controlled Epigenetic Mechanisms in Epilepsy
DIAGNOSTIC IMPLICATIONS OF EPIGENETICS RESEARCH IN EPILEPSY
THERAPEUTIC IMPLICATIONS AND LIMITATIONS
CHAPTER SUMMARY: RESEARCH PROSPECTS AND CHALLENGES
REFERENCES
CHAPTER 54. PURINERGIC SIGNALING IN EPILEPSY
OVERVIEW: EVOLUTIONARY LOGIC OF PURINERGIC REGULATION. WHY IS IT SO DIFFERENT COMPARED TO ANTISEIZURE DRUGS?
ADENOSINE AND ATP METABOLISM
THE ADENOSINE KINASE HYPOTHESIS OF EPILEPTOGENESIS
THE RECEPTORS
DYSREGULATION OF THE PURINERGIC SYSTEM IN EPILEPSY
P1 Receptor Expression Changes
P2 Receptor Expression Changes
PURINERGIC TREATMENT OPTIONS
Targeting P1 Receptors
Targeting P2 Receptors
Targeting Adenosine Metabolism
Adenosine Augmentation Strategies
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 55. NEUROTROPHIC FACTORS IN EPILEPSY
INTRODUCTION
Seizures Themselves Can Both Cause and Worsen Temporal Lobe Epilepsy
Neurotrophic Factors: Molecular Effectors of Activity-Induced Plasticity
NEUROTROPHINS
Brain-Derived Neurotrophic Factor
Nerve Growth Factor
Neurotrophin 3 and Neurotrophin 4
GLIAL-DERIVED NEUROTROPHIC FACTORS
Glial Cell Line-Derived Neurotrophic Factor
FIBROBLAST GROWTH FACTORS
Fibroblast Growth Factor 2
PERSPECTIVE AND CONCLUDING REMARKS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 56. NEUROGENESIS IN EPILEPSY
INTRODUCTION
MECHANISMS OF ADULT HIPPOCAMPAL NEUROGENESIS IN RODENT HIPPOCAMPUS
EVIDENCE FOR ADULT HIPPOCAMPAL NEUROGENESIS IN HUMANS
ACTIVITY-DEPENDENT NEUROGENESIS IN PHYSIOLOGIC AND PATHOLOGIC CONTEXTS
A WIDE VARIETY OF EPILEPTOGENIC INSULTS DISRUPT NEUROGENESIS
FUNCTIONAL SIGNIFICANCE OF ABNORMAL HIPPOCAMPAL GRANULE CELLS
Pathologic Roles of Adult-Generated Granule Cells
Beneficial Roles of Adult-Generated Granule Cells
NEUROGENESIS IN THE DEVELOPMENT OF TEMPORAL LOBE EPILEPSY
Abnormal Granule Cells Are Sufficient to Cause Epilepsy
Ablating Adult-Generated Granule Cells Is Antiepileptogenic
TARGETING NEUROGENESIS AS A THERAPEUTIC STRATEGY TO TREAT EPILEPSY
Early Intervention
Late Intervention
CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 57. SOMATIC MOSAICISM IN FOCAL MALFORMATIONS OF CORTICAL DEVELOPMENT
INTRODUCTION
CLINICAL AND NEUROPATHOLOGIC FEATURES OF FOCAL MCDS
BRAIN SOMATIC MOSAICISM
SOMATIC VARIANTS IN FOCAL MCDs
mMCD, MOGHE and FCD Type 1
FCD Type 2 and HME
EPIGENETIC SIGNATURES IN CORTICAL MALFORMATIONS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 58. THE MICROBIOTA–GUT–BRAIN AXIS AND EPILEPSY
INTRODUCTION
THE MICROBIOTA–GUT–BRAIN AXIS
THE MICROBIOTA–GUT–BRAIN AXIS IN BRAIN DEVELOPMENT
THE GUT MICROBIOME IN EPILEPSY
THE GUT MICROBIOME AND THE KETOGENIC DIET IN EPILEPSY
THE IMPACT OF DRUG TREATMENT ON THE GUT MICROBIOTA
POTENTIAL MICROBIAL THERAPEUTIC TARGETS FOR EPILEPSY
CONCLUSIONS AND FUTURE PERSPECTIVES
ACKNOWLEDGMENTS
REFERENCES
SECTION 4 • Translational and Clinical Biology of Seizures and Epilepsy
CHAPTER 59. OVERVIEW: TRANSLATIONAL AND CLINICAL BIOLOGY OF SEIZURES AND EPILEPSY
CHAPTER 60. REFINEMENT OF RODENT MODELS OF SEIZURES AND EPILEPSY
GENERAL DESCRIPTION
BACKGROUND
The 3Rs
Legal Framework
NC3Rs REPORT ON IMPROVING WELFARE IN RODENT EPILEPSY MODELS
INTRINSIC FEATURES OF EPILEPSY MODELS
Seizures
Comorbidities
Assessing Harms and Well-Being
Incidental Harms
Housing and Husbandry
CONCLUSIONS
ACKNOWLEDGMENT
REFERENCES
CHAPTER 61. WHAT DO MODELS MODEL IN EPILEPSY?
ANIMAL MODELS OF VARIOUS SEIZURE TYPES
ANIMAL MODELS OF EPILEPSIES
REFERENCES
CHAPTER 62. TRANSLATIONAL EPILEPSY RESEARCH: PROGRESS, CHALLENGES, AND FUTURE
INTRODUCTION
THE FIRST INTERNATIONAL TRANSLATIONAL WORKSHOP TO OPTIMIZE EPILEPSY THERAPY DEVELOPMENT (LONDON, 2012)
THE ILAE/AES JOINT TRANSLATIONAL TASK FORCE
Harmonization of Video-Electroencephalography and Electrophysiologic Studies in Rodents (TASK1)
Systematic Reviews of Animal Model Data (TASK2)
Creation of Preclinical Common Data Elements for Epilepsy Research (TASK3)
Development of an Infrastructure for Multicenter Preclinical Studies (TASK4)
TRANSPARENCY IN REPORTING
TRANSLATIONAL INITIATIVES FOR ANTIEPILEPTOGENESIS AND DISEASE MODIFICATION
CONCLUSIONS AND FUTURE PERSPECTIVES
REFERENCES
CHAPTER 63. AGE AND SEX IN THE NEUROBIOLOGY OF EPILEPSIES IN ANIMAL MODELS
DEVELOPMENTAL STAGES OF RODENT BRAIN
INCREASED SEIZURE SUSCEPTIBILITY IN IMMATURE BRAIN
Developmental Changes in Neurotransmitter Systems
AGE-SPECIFIC CONSEQUENCES OF SEIZURES
SEX-SPECIFIC DIFFERENCES IN SEIZURES OF THE DEVELOPING BRAIN
Steroid Hormones Shape Sex Differences in the Developing Brain
Sex Differences in the Developing Brain
Sex Differences in GABA Signaling
Sex Differences in Seizures
SEX-SPECIFIC CONSEQUENCES OF EARLY LIFE SEIZURES
GABA Signaling
Subsequent Behavioral Comorbidities
Seizure Susceptibility and Epilepsy
SEX-SPECIFIC MATURATION OF THE BRAIN NETWORK MEDIATING SEIZURE CONTROL
SEX-SPECIFIC DIFFERENCES IN SEIZURES OF THE ADULT BRAIN
Chemically Induced Status Epilepticus
Response to GABA-Related Convulsants
Kindling
Rodent Spike-Wave Discharges
Sex Differences in Seizures of Adult Animals Due to Steroids
REFERENCES
CHAPTER 64. GENDER IN CLINICAL BIOLOGY OF EPILEPSY
INTRODUCTION
SEX HORMONES: EFFECTS ON EXCITABILITY AND SITES OF ACTION
SEX HORMONE EFFECTS ON SEIZURE PROVOCATION IN ACQUIRED EPILEPSIES
Direct Hormonal Effects
Indirect Hormonal Effects
GENERAL EFFECTS OF SEX
CONCLUSIONS
REFERENCES
CHAPTER 65. AGE AND CLINICAL BIOLOGY OF EPILEPSY: ADULTS
THE OLDER ADULT—AN INCREASING POPULATION
CLINICAL PRESENTATION OF SEIZURES IN OLDER ADULTS
DIAGNOSIS OF SEIZURES IN OLDER ADULTS
Diagnostic Delays
Etiology of Seizures in Older Adults
Differential Diagnosis
MANAGEMENT OF SEIZURES IN OLDER ADULTS
Epilepsy Treatment Considerations in Older Adults
Choosing Antiseizure Agents for Older Adults
Generic Antiseizure Medications for Older Adults
Practical Aspects of Antiseizure Medication Use in Older Adults
Surgery in Older Adults
CONCLUSION
REFERENCES
CHAPTER 66. AGE AND CLINICAL BIOLOGY OF EPILEPSY: INFANTS
INTRODUCTION
CLINICAL FEATURES OF FOCAL SEIZURES
Seizures Show More Elaborate, Distinctive, and Complex Motor Features with Age
Alteration of Consciousness Is Difficult to Determine in the Very Young and Auras Are not Usually Volunteered, Even in Young Children with Language
Focal Seizures in the Immature Sometimes Have “Generalized” Clinical Features
Focal Seizures in the Immature Do Not Tend to Go On to Orderly Secondary Generalization
ELECTROGRAPHIC FEATURES OF FOCAL EPILEPSIES
There Is a Posterior to Anterior Shift in the Focus of the Interictal Epileptiform Discharges in Patients with Focal Seizures and Self-Limited Epilepsies
Location Varies but the Electrographic Morphology of Focal Ictal Discharges Are Remarkably Similar Across the Age Range
GENERALIZED SEIZURES IN GENETIC GENERALIZED EPILEPSIES
Generalized Spike–Waves Show a Penetrance Pattern that Is Age-Dependent
The Semiology of Generalized Seizures Varies as a Function of Age
Interictal Epileptiform Activity Shows an Orderly Change in Frequency and Organization with Age
EPILEPSIES WITH ENCEPHALOPATHY AND MIXED SEIZURES
Seizure Types and EEG Features Vary as a Function of Age in the Epileptic Encephalopathies
OVERVIEW OF MANAGEMENT OF SEIZURES IN INFANTS AND CHILDREN
Antiseizure Medications
Dietary Therapy
Epilepsy Surgery
Neurostimulation
Emerging Novel Therapies
CONCLUSION
REFERENCES
CHAPTER 67. CHRONOBIOLOGY OF EPILEPSY
INTRODUCTION
HISTORICAL PERSPECTIVE
QUANTITATIVE METHODOLOGY
Tracking Seizures
Chronic EEG
Circular Statistics
KEY CONCEPTS
Pre- and Proictal States
Seizure Triggers
Reflex Seizures
Seizure Clusters
Tipping Points
LIFE CYCLE
Early Incidence
Changes During Childbearing Age
Late Incidence
SEASONAL CYCLE
Putative Mechanisms
MULTIDIEN CYCLES
About-Monthly Cycle
About-Weekly Cycle
Animal Data
Putative Mechanisms
CIRCADIAN AND SLEEP–WAKE CYCLE
Sleep–Wake Cycle
Sleep-Related Epilepsy Syndromes
Circadian Seizure Chronotypes
Seizure Timing and Seizure Focus
Sleep Homeostasis
Putative Mechanisms
ULTRADIAN CYCLES
NREM-REM Sleep cycles
ICTAL AND INTERICTAL EPILEPTIFORM ACTIVITY
IMPLICATIONS FOR RESEARCH
Refining Clinical Trials in Epilepsy
Seizure Forecasting
Chronotherapy
CONCLUSION
REFERENCES
CHAPTER 68. SLEEP AND EPILEPSY
INTRODUCTION
SEIZURES AND INTERICTAL DISCHARGES IN WAKEFULNESS, NONRAPID EYE MOVEMENT SLEEP, AND RAPID EYE MOVEMENT SLEEP
Clinical Findings
Basic Mechanisms
SLEEP ABNORMALITIES
Clinical Findings
Basic Mechanisms
ANTISEIZURE MEDICATIONS
Clinical Findings
Basic Mechanisms
SLEEP DEPRIVATION
Clinical Findings
Basic Mechanisms
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 69. BREATHING AND AUTONOMIC DISTURBANCES DURING SEIZURES
BREATHING DYSFUNCTION
Historical Overview of Breathing Dysfunction in Seizures
Historical Explorations of Cortical Breathing Control and Modulation
Modern Methods of Respiratory Monitoring
Peri-ictal Breathing Compromise: Types and Mechanisms of Dysfunction
Neuroanatomical Basis of Breathing Dysfunction
AUTONOMIC DYSFUNCTION
Historical Overview of Autonomic Dysfunction in Seizures
Methods of Monitoring Autonomic Dysfunction in Seizures
Types of Autonomic Dysfunction with Mechanisms
CONCLUSIONS: IMPLICATIONS FOR MORBIDITY AND MORTALITY
REFERENCES
CHAPTER 70. SUDDEN UNEXPECTED DEATH IN EPILEPSY (SUDEP)
INTRODUCTION
DEFINITIONS
CASE IDENTIFICATION
INCIDENCE
CLINICAL RISK FACTORS
OTHER INVESTIGATIONS (MRI, EEG, ECG, GENETIC)
MECHANISTIC HYPOTHESES
Dysautonomia
Direct Ictal
Indirect Ictal
Interictal
Asystole
Ventricular Fibrillation
Obstructive Apnea
Central Apnea
Cerebral Shutdown/Brainstem Depolarization
A Unification Theory for SUDEP Mechanism
PREVENTION
TALKING ABOUT SUDEP
POSTMORTEM EVALUATION IN EPILEPSY
CONCLUSION
REFERENCES
CHAPTER 71. STRESS AND EPILEPSY
INTRODUCTION
EFFECT OF STRESS HORMONES ON THE BRAIN
Stress Hormones and Their Receptors
Effect of Stress Hormones on Brain Activity: Preclinical Evidence
Chronic Stress across the Lifespan
Effect of Long-Lasting Occupational Stress on the Human Brain
STRESS AND EPILEPSY
A Susceptible Stress System and Susceptible Brain
Stress and Epilepsy in Rodents
Stress and Epilepsy in Humans
Some Individuals with Epilepsy Are More Stress-Susceptible Than Others
STRESS, EPILEPSY, AND GENDER
STRESS-REDUCING INTERVENTIONS
Mindfulness
Progressive Muscle Relaxation
CONCLUDING REMARKS
REFERENCES
CHAPTER 72. SEIZURES AND EPILEPSY IN GENERAL MEDICAL DISORDERS
INTRODUCTION
GENERAL PRINCIPLES
SEIZURES AND KIDNEY FAILURE
SEIZURES AND LIVER DISEASE
SEIZURES AND CONNECTIVE TISSUE DISEASES
EPILEPSY AND CARDIAC DISEASE
SEIZURES IN THE TRANSPLANT PATIENT
HUMAN IMMUNODEFICIENCY VIRUS AND SEIZURES
SEIZURES RELATED TO ALCOHOL AND DRUGS OF ABUSE
EPILEPSY AND PULMONARY DISEASE
METABOLIC CAUSES OF SEIZURES
Disorders of Glucose Metabolism
Hyponatremia
Hypernatremia
Hypocalcemia and Hypomagnesemia
Seizures Caused by Anoxic–Ischemic Encephalopathy
THYROID DISEASE AND EPILEPSY
SEIZURES ASSOCIATED WITH SYSTEMIC CANCER
CEREBROVASCULAR DISEASE
INFECTIOUS DISEASES
DEGENERATIVE DISEASES
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 73. MEDICAL CONDITIONS IN CHILDREN WITH EPILEPSY
INTRODUCTION
DEVELOPMENTAL AND MENTAL HEALTH COMORBIDITIES
Incidence
Cognitive Impairment
Depression and Anxiety
Psychosis
Autism
Psychosocial Consequences
Social Consequences
MEDICAL COMORBIDITIES
Migraine
Sleep
Endocrine
IMPACT OF SURGICAL TREATMENT ON COMORBID CONDITIONS
OUTCOME OF ADULTS WITH CHILDHOOD-ONSET SEIZURES
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 74. NEURODEGENERATIVE DISORDERS AND EPILEPTOGENESIS
INTRODUCTION
NEURODEGENERATIVE DISORDERS AND SEIZURES
Alzheimer’s Disease
Neurocognitive Disorder with Lewy Bodies
Neurocognitive Disorder Due to Parkinson’s Disease
Frontotemporal Neurocognitive Disorders
Early-Onset Huntington’s Disease
NEURODEGENERATION IN HUMAN EPILEPSIES AND EPILEPSY SYNDROMES
CROSSROADS BETWEEN EPILEPSIES AND NEURODEGENERATIVE DISORDERS: INSIGHTS FROM ANIMAL MODELS
Tauopathies
Amyloidoses
Alpha-Synucleinopathies
TDP-43 Proteinopathies
Preclinical Insights on Molecular Mechanisms Promoting Seizures and Epileptogenesis
Common Networks
CONCLUSIONS
REFERENCES
CHAPTER 75. ANESTHESIA FOR PROCEDURES IN PATIENTS WITH EPILEPSY
INTRODUCTION
PREANESTHESIA ASSESSMENT, PREPARATION, AND PLANNING
ANESTHESIA MANAGEMENT DURING PROCEDURES
Antiseizure Medication Interactions
Anesthetics
Inhaled Anesthetics
Intravenous Anesthetics, Sedatives, and Anxiolytics
Nonopiate Analgesics
Muscle Relaxants
Others
EMERGENCE, POSTANESTHESIA CARE, POSTPROCEDURE DISPOSITION, AND MANAGEMENT OF PROLONGED SEIZURES
CONSIDERATIONS FOR SELECTED PROCEDURES
Dental Procedures
Procedures for the Evaluation and Treatment of Epilepsy
CONCLUSION
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 76. HORMONE CHANGES IN EPILEPSY
INTRODUCTION
EFFECTS OF EPILEPSY AND SEIZURES ON HORMONES IN ANIMAL MODELS
Changes in Circulating Hormone Levels in Chronic Epilepsy and in Response to Acute Seizures
Reproductive Endocrine Dysfunction in Animal Models of Epilepsy
Dysregulation of Hypothalamic Neuroendocrine Circuits in Animal Models of Epilepsy
EFFECTS OF EPILEPSY AND SEIZURES ON HORMONES IN HUMANS
Acute Changes in Hormones Following Seizures: Prolactin, Follicle-Stimulating Hormone, and Luteinizing Hormone
Altered Pulsatile Secretion of Gonadotropins and Prolactin in Epilepsy
Epilepsy During Perimenopause and Menopause
Effects of Epilepsy on Sexuality in Men and Women
Stress Hormones in Epilepsy
SUMMARY AND CONCLUSIONS
Animal Studies
Clinical Studies
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 77. EFFECTS OF HORMONES ON SEIZURE EXPRESSION
INTRODUCTION
STRESS AS SEIZURE PRECIPITATOR
ADRENOCORTICOTROPIC HORMONE EFFECT ON SEIZURE EXPRESSION
Adrenocorticotropic Hormone
Corticosteroids
SEX HORMONES
Experimental Data on Excitability
Mechanisms within the Brain
Peripheral Neurosteroid Production
Steroid Distribution and Metabolism in the Central Nervous System
Central Nervous System Effects of Synthetic Steroids
CLINICAL CHANGES ACROSS REPRODUCTIVE LIFE
Puberty
Menstrual Cycle Linkages
Menopause
HORMONES AND EPILEPSY IN MEN
FUTURE PROSPECTS
Neurosteroids in Epilepsy Treatment
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 78. DISORDERS OF REPRODUCTION AND FERTILITY IN EPILEPSY
INTRODUCTION
DEFINITIONS AND RISKS OF REPRODUCTIVE DISORDERS IN WOMEN WITH EPILEPSY
Menstrual Disorders
Reproductive Endocrine Disorders
Infertility
ETIOLOGY AND PATHOPHYSIOLOGY OF REPRODUCTIVE ENDOCRINE DISORDERS IN WOMEN WITH EPILEPSY
Epilepsy
Antiseizure Medications
Epilepsy and Valproate Combination
TREATMENT OF REPRODUCTIVE ENDOCRINE DISORDERS IN WOMEN WITH EPILEPSY
DEFINITIONS AND RISKS OF REPRODUCTIVE DISORDERS IN MEN WITH EPILEPSY
Hypogonadism
Sexual Dysfunction
Infertility
Abnormal Semen Analysis
ETIOLOGY AND PATHOPHYSIOLOGY OF HYPOGONADISM IN MEN WITH EPILEPSY
Psychosocial Stress
Antiseizure Medications
Epilepsy
TREATMENT OF REPRODUCTIVE ENDOCRINE DISORDERS IN MEN WITH EPILEPSY
Antiseizure Medication Selection
Testosterone Supplement
Phosphodiesterase Inhibitor and Prostaglandin Treatment
ADDITIONAL INFORMATION
REFERENCES
CHAPTER 79. SEXUALITY IN EPILEPSY
SEXUAL DYSFUNCTION IN EPILEPSY
SEXUAL DYSFUNCTION IN WOMEN
SEXUAL DYSFUNCTION IN MEN
ANTISEIZURE MEDICATIONS AND SEXUAL FUNCTION
TREATMENT
CONCLUSION
REFERENCES
CHAPTER 80. MATERNAL OUTCOMES DURING PREGNANCY IN WOMEN WITH EPILEPSY
INTRODUCTION
FECUNDITY AND INFERTILITY FOR WOMEN WITH EPILEPSY
MATERNAL RISKS OF SEIZURES
FACTORS IN SEIZURE CONTROL DURING PREGNANCY
OBSTETRIC COMPLICATIONS IN WOMEN WITH EPILEPSY
INTRAPARTUM AND POSTPARTUM DEPRESSION AND ANXIETY IN WOMEN WITH EPILEPSY
BREASTFEEDING CONSIDERATIONS FOR WOMEN WITH EPILEPSY
SUMMARY
REFERENCES
CHAPTER 81. CONSEQUENCES OF SEIZURES
INTRODUCTION
SEIZURES BEGET SEIZURES?
Kindling
Secondary Epileptogenesis
Developmental and Epileptic Encephalopathies
Acute Symptomatic Seizures and Acquired Epilepsy
Can Treatment of Early Seizures Affect Development of Chronic Seizures?
SEIZURES AND BRAIN STRUCTURE
Insights from the Animal Models
Is Neuronal Loss in Epilepsy Progressive?
Mossy Fiber Sprouting and Epilepsy
Seizure Preconditioning and Epileptic Tolerance
SEIZURES AND BEHAVIOR
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 82. DRUG RESISTANCE IN EPILEPSY
INTRODUCTION
IN VIVO AND IN VITRO MODELS OF DRUG RESISTANCE
CURRENT HYPOTHESES OF MECHANISMS OF DRUG RESISTANCE
Alteration of Drug Targets in the Brain
Alteration of Drug Uptake into the Brain
Alterations of Pharmacokinetics in the Periphery
Neural Network Hypothesis
Intrinsic Severity Hypothesis
Gene Variant Hypothesis
The Epigenetic Hypothesis
Potential Role of Neuroinflammation and Blood–Brain Barrier Dysfunction in Drug-Resistance Mechanisms
Other Potential Mechanisms of Drug Resistance
HOW TO OVERCOME DRUG RESISTANCE?
Development of New Antiseizure Drugs by Using New Drug Screening Paradigms
Precision Medicine
Targeting of Transporter Function and Expression
Anti-Inflammatory Drugs and Strategies to Repair the BBB
CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
SECTION 5 • Phenomenology of Seizures
CHAPTER 83. OVERVIEW: PHENOMENOLOGY OF SEIZURES
CHAPTER 84. CLASSIFICATION OF EPILEPTIC SEIZURES
INTRODUCTION
The Value of a Classification System
Historical Perspectives
CLASSIFICATION OF EPILEPTIC SEIZURES
1981 ILAE Classification of Epileptic Seizures
Early Attempts to Revise the 1981 Classification of Epileptic Seizures
The 2017 International League Against Epilepsy Seizure Classification
The Basic ILAE 2017 Classification of Seizures
The Expanded ILAE 2017 Classification of Seizures
Scope of the 2017 ILAE Classification
Summary of Seizure Types
Descriptors
HOW TO CLASSIFY A SEIZURE
ACCEPTANCE OF THE 2017 SEIZURE CLASSIFICATION
CONCLUSION
REFERENCES
CHAPTER 85. AWARENESS IN SEIZURES
INTRODUCTION
DEFINITIONS AND COMPONENTS
CLINICAL RELEVANCE
ASSESSMENT AND MEASURES OF IMPAIRED CONSCIOUSNESS
Patient and Observer Report
Objective Behavioral Testing
CONCLUSIONS AND FUTURE DIRECTIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 86. AUTOMATISMS IN SEIZURES
INTRODUCTION
PHYSIOLOGIC MECHANISMS AND NETWORKS INVOLVED IN THE GENERATION OF AUTOMATISMS
Hyperkinetic Automatisms
AUTOMATISMS AND THE RELEVANCE OF THEIR LOCALIZATION IN FOCAL SEIZURES
AUTOMATISMS IN GENERALIZED EPILEPSY
Perseverative versus De Novo Automatisms
Duration of Absences and Occurrence of Automatisms
Incidence of Automatisms in Absence Seizures
Automatisms in Generalized Seizures Other Than Classical Absences
Clinical Relevance
DIFFERENTIATION OF EPILEPTIC FROM NONEPILEPTIC AUTOMATISMS
Parasomnias: Somnambulism
Movement Disorders: Gilles-de-la-Tourette Syndrome
Automatisms in Brainstem Compression
REFERENCES
CHAPTER 87. HYPERKINETIC SEIZURES
INTRODUCTION AND HISTORICAL NOTES
PREDICTORS OF HYPERKINETIC SEIZURES
ANATOMOCLINICAL CORRELATIONS OF HYPERKINETIC SEIZURES
DISTINGUISHING FRONTAL FROM EXTRAFRONTAL HYPERKINETIC SEIZURES
REFERENCES
CHAPTER 88. AUTONOMIC AURAS AND SEIZURES
INTRODUCTION
DEFINITIONS
ANATOMIC PATHWAYS AND PATHOPHYSIOLOGY
CLASSIFICATION AND DESCRIPTION
Gastrointestinal Aura/Seizures
Cardiovascular
Secretory
Genitourinary
Cutaneous
Pupillary
CONCLUSIONS
REFERENCES
CHAPTER 89. COGNITIVE SEIZURES
INTRODUCTION
DYSMNESIC SEIZURES
ICTAL ILLUSIONS
STRUCTURED ICTAL HALLUCINATIONS
VISUAL HALLUCINATIONS AND ILLUSIONS
DISTORTIONS OF BODY IMAGE AND SOMATOSENSORY ILLUSIONS
Illusions of Movement
AUDITIVE HALLUCINATIONS AND ILLUSIONS
Illusions
Syndromatic Aspects
DISTORTIONS OF TIME SENSE
ICTAL DISORDERS OF LANGUAGE
Aphasia and Dysphasia
Speech Automatisms
Dyslexia
FORCED THINKING
STATUS OF COGNITIVE SEIZURES AND AURA CONTINUA
CONCLUSIONS
REFERENCES
CHAPTER 90. AFFECTIVE SEIZURES
INTRODUCTION
HISTORICAL PERSPECTIVES
CLASSIFICATION
ANXIETY WITH AUTONOMIC SYMPTOMS (FOCAL EMOTIONAL SEIZURES WITH FEAR/ANXIETY/PANIC): CASE 1
FOCAL EMOTIONAL SEIZURES WITH ANGER: CASE 2
ECSTATIC SEIZURES (FOCAL EMOTIONAL SEIZURE WITH PLEASURE): CASE 3
FOCAL EMOTIONAL SEIZURES WITH LAUGHTER (GELASTIC): CASE 4
FOCAL EMOTIONAL SEIZURES WITH CRYING (DACRYSTIC): CASE 5
CONCLUSION
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 91. NEOCORTICAL SENSORY SEIZURES
INTRODUCTION
DEFINITIONS
EPIDEMIOLOGY
ANATOMIC PATHWAYS AND PATHOPHYSIOLOGY
CLINICAL FEATURES
ELECTROENCEPHALOGRAPHIC FINDINGS AND CLINICAL CORRELATIONS
DIAGNOSTIC CONSIDERATIONS
DIFFERENTIAL DIAGNOSIS
SPECIFIC SYNDROMES INCORPORATING THE SEIZURE TYPE AS AN INTEGRAL FEATURE
RESPONSES TO TREATMENT
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 92. TYPICAL ABSENCE SEIZURES
INTRODUCTION
EPIDEMIOLOGY
HISTORICAL PERSPECTIVE
Animal Models and Electrophysiologic Studies
State of the Art Nowadays: “Hot Spot Theory”
Other Anatomical Substrates
CLINICAL FEATURES
Impairment of Consciousness
Motor and Autonomic Manifestations
Induced Seizures
EEG FEATURES
ABSENCE STATUS EPILEPTICUS
DIAGNOSIS OF TAS
EPILEPSY SYNDROMES FEATURING TAS
TREATMENT OF TAS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 93. ATYPICAL ABSENCE SEIZURES
INTRODUCTION
DEFINITIONS
EPIDEMIOLOGY
ANATOMIC PATHWAYS AND PATHOPHYSIOLOGY
Neuronal Circuitry of AAS
Receptor Regulation of AAS
Mechanisms of Cognitive Impairment
Genetic Predisposition for AAS
CLINICAL FEATURES
EEG MANIFESTATIONS
DIAGNOSTIC CONSIDERATIONS
DIFFERENTIAL DIAGNOSIS
SPECIFIC SYNDROMES WITH AAS
TREATMENT
SUMMARY AND CONCLUSIONS
ACKNOWLEGMENTS
REFERENCES
CHAPTER 94. MYOCLONIC ABSENCE SEIZURES
INTRODUCTION
EPIDEMIOLOGY
SEIZURE SEMIOLOGY
ELECTROENCEPHALOGRAPHY AND POLYGRAPHIC FEATURES
NEUROIMAGING
TREATMENT
EPILEPSY WITH MYOCLONIC ABSENCES
REFERENCES
CHAPTER 95. SEIZURES WITH EYELID MYOCLONIA
INTRODUCTION
DEFINITIONS
EPIDEMIOLOGY
ANATOMIC PATHWAYS AND PATHOPHYSIOLOGY
CLINICAL FEATURES
Ictal
EEG MANIFESTATIONS AND CLINICAL CORRELATIONS
Interictal
Ictal
DIAGNOSTIC CONSIDERATIONS
SPECIFIC EPILEPSY SYNDROMES INCORPORATING EYELID MYOCLONIA AS AN INTEGRAL FEATURE
RESPONSES TO TREATMENT
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 96. ATONIC SEIZURES
INTRODUCTION
DEFINITIONS
EPIDEMIOLOGY
ANATOMICAL PATHWAYS AND PATHOPHYSIOLOGY
ELECTROCLINICAL FEATURES
Generalized Atonic Seizures
Focal Atonic Seizures
DIAGNOSTIC CONSIDERATIONS
DIFFERENTIAL DIAGNOSIS
SPECIFIC SYNDROMES INCORPORATING ATONIC SEIZURES AS AN INTEGRAL FEATURE
RESPONSE TO TREATMENT
Medical Treatment
Surgical Treatment
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 97. CLONIC SEIZURES
INTRODUCTION
ANATOMIC BASIS
FOCAL ONSET CLONIC SEIZURES
GENERALIZED ONSET CLONIC SEIZURES
REFERENCES
CHAPTER 98. EPILEPTIC SPASMS
INTRODUCTION
DEFINITIONS
EPIDEMIOLOGY
ANATOMIC PATHWAYS AND PATHOPHYSIOLOGY
CLINICAL FEATURES
ELECTROENCEPHALOGRAPHIC FINDINGS
DIAGNOSTIC CONSIDERATIONS
SPECIFIC SYNDROMES
New Onset West Syndrome
Structural Brain Disorder
Developmental and Epileptic Encephalopathy
Epileptic Spasms Beyond the First Year of Life
RESPONSE TO TREATMENT
SUMMARY AND CONCLUSION
REFERENCES
CHAPTER 99. MYOCLONIC, MYOCLONIC–ATONIC, AND MYOCLONIC TONIC–CLONIC SEIZURES
INTRODUCTION
MYOCLONUS VERSUS MYOCLONIC SEIZURES
MYOCLONUS: DEFINITIONS AND CLASSIFICATIONS
Myoclonus in Relation to Epilepsy
Clinical Manifestations of Myoclonus
MYOCLONIC SEIZURES–CLASSIFICATION AND ELECTROCLINICAL FEATURES
Diagnostic Considerations and Relevance of Video-EEG-Polygraphy
MYOCLONIC EPILEPSIES
Early Myoclonic Encephalopathy
Myoclonic Encephalopathy in Nonprogressive Disorders
Myoclonic Epilepsy in Infants
Dravet Syndrome
Myoclonic-Atonic Epilepsy
Lennox–Gastaut Syndrome
Epilepsy With Myoclonic Absences
Juvenile Myoclonic Epilepsy
Benign Adult Familial Myoclonus Epilepsy
Progressive Myoclonus Epilepsies
MS in Symptomatic Epilepsies of Miscellaneous Etiology
PATHOPHYSIOLOY
Cortical Positive Myoclonus
Cortical Negative Myoclonus
Thalamocortical Myoclonus
Reticular Reflex Myoclonus
TREATMENT OF MYOCLONIC SEIZURES
Valproic Acid
Levetiracetam
Lamotrigine
Benzodiazepines
Zonisamide
Topiramate
Perampanel
Brivaracetam
Antiseizure Medications Potentially Aggravating MS
Treatment of Epileptic Negative Myoclonus
Ketogenic Diet
Vagus Nervus Stimulation
CONCLUSIONS
REFERENCES
CHAPTER 100. TONIC SEIZURES
HISTORICAL REVIEW
GENERALIZED TONIC SEIZURES
Summary of Generalized Tonic Seizures
Pathophysiology of Generalized Tonic Seizures
FOCAL TONIC SEIZURE
TREATMENTS
SUMMARY AND CONCLUSION
REFERENCES
CHAPTER 101. GENERALIZED TONIC–CLONIC SEIZURES
INTRODUCTION
DEFINITIONS AND CLASSIFICATION
EPIDEMIOLOGY
ANATOMIC PATHWAYS AND PATHOPHYSIOLOGY
CLINICAL FEATURES
Ictal
Postictal
EEG MANIFESTATIONS AND CLINICAL CORRELATIONS
Interictal
Ictal
Postictal
DIAGNOSTIC CONSIDERATIONS
DIFFERENTIAL DIAGNOSIS: NONEPILEPTIC CONDITIONS
RESPONSES TO TREATMENT
REFERENCES
CHAPTER 102. BEHAVIORAL ARREST IN SEIZURES
INTRODUCTION
PATHOPHYSIOLOGY
“BEHAVIORAL ARREST” AS A DESCRIPTOR IN THE NEW OPERATIONAL SEIZURE CLASSIFICATION
USE OF THE TERM “BEHAVIORAL ARREST” IN NEONATAL SEIZURE CLASSIFICATION
LATERALIZATION AND LOCALIZATION VALUE OF BEHAVIORAL ARREST AS A SEIZURE MANIFESTATION
Seizures of Temporal Lobe Origin
Seizures of Frontal Lobe Origin
Seizures of Occipital and Parietal Lobe Origin
BEHAVIORAL ARREST AS AN ICTAL MANIFESTATION OF FOCAL SEIZURES IN INFANTS AND YOUNG CHILDREN
CONCLUSION
REFERENCES
CHAPTER 103. NEONATAL SEIZURES
INTRODUCTION
EPIDEMIOLOGY AND RISK FACTORS
ETIOLOGIES
CHARACTERIZATION AND CLASSIFICATION
NEUROPHYSIOLOGY OF NEONATAL SEIZURES
APPLICATIONS OF CONTINUOUS EEG MONITORING IN DIAGNOSIS AND MANAGEMENT OF NEONATAL SEIZURES
THERAPEUTIC STRATEGIES
OUTCOME
SUMMARY
REFERENCES
CHAPTER 104. LOCALIZING AND LATERALIZING VALUE OF SEIZURE PHENOMENOLOGY
INTRODUCTION
UTILITY AND ACCURACY
SEMIOLOGY CLASSIFICATION
COGNITIVE
Somatosensory Auras
Visual Auras
Auditory Auras
Vertiginous Auras
Olfactory and Gustatory Auras
Autonomic Auras and Seizures
Other Auras
MOTOR SEIZURES
Simple Motor Seizures
Other Motor Seizures
POSTICTAL PHENOMENA
MESIAL VERSUS NEOCORTICAL TEMPORAL LOBE SEIZURES
FRONTAL LOBE SEIZURES
LIMITATIONS OF SEIZURE SEMIOLOGY
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 105. STATUS EPILEPTICUS: PHENOMENOLOGY AND PATHOPHYSIOLOGY
DEFINITION
EPIDEMIOLOGY, ETIOLOGY, AND PROGNOSIS
HUMAN PHENOMENOLOGY
MRI Findings
PATHOPHYSIOLOGY OF SE: STUDIES IN EXPERIMENTAL ANIMALS
Role of GABAergic Inhibition
Seizures Open the Dentate Gate by Breaking Down GABAergic Inhibition
Seizure Potentiates Excitatory Synaptic Transmission in CA1 Pyramidal Neurons
TREATMENT OF STATUS EPILEPTICUS
REFERENCES
VOLUME II
SECTION 6 • Diagnostic Evaluation of Seizures and Epilepsy
CHAPTER 106. OVERVIEW: DIAGNOSTIC EVALUATION IN EPILEPSY
INTRODUCTION
SUMMARY AND CONCLUSIONS
CHAPTER 107. HISTORY AND PHYSICAL EXAMINATION IN EPILEPSY
INTRODUCTION
HISTORY TAKING
Background
Past Medical History
The Person with Epilepsy
PHYSICAL EXAMINATION
Neurologic Examination
General Medical Examination
Brief Assessment of Cognitive, Social, and Behavioral Functioning
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 108. EPILEPSY INFORMATICS
INTRODUCTION
EPILEPSY AND THE ELECTRONIC HEALTH RECORD—CLINICAL CARE
Electronic Health Record Systems
EHR Content
Direct Patient Interactions with the EHR
Clinical Decision Support
Automated Review of Diagnostic Studies
Epilepsy and Telehealth
EPILEPSY AND THE ELECTRONIC HEALTH RECORD—FOUNDATIONS FOR POPULATION HEALTH
Common Data Elements
Computable Phenotypes
Ontologies
Individualized Predictions with EHR Data
Learning Health Care Systems
EPILEPSY AND THE INTERNET
Internet as Source of Information
Epilepsy and Social Media
EPILEPSY AND INTERNET-CONNECTED DEVICES
Introduction to Patient-Generated Data/Internet of Things
Electronic Seizure Diaries
Wearable Devices for Epilepsy
Seizure Detection Devices (Implanted)
Internet of Things
CONCLUSION
REFERENCES
CHAPTER 109. LABORATORY ETIOLOGICAL SCREENING FOR SEIZURES
INTRODUCTION
LABORATORY ETIOLOGIC INVESTIGATION FOR ACUTE SYMPTOMATIC SEIZURES
LABORATORY INVESTIGATION FOR THE ETIOLOGY OF EPILEPSY SYNDROMES: METABOLIC, INFLAMMATORY, OR INFECTIOUS CAUSES
Metabolic Screening
Immunologic Testing
Genetic Testing and Screening
Serum Concentration Measurements of Antiseizure Medications
Laboratory Monitoring of Toxicity
Pharmacogenetic Analyses
CONCLUSIONS
REFERENCES
CHAPTER 110. PHYSIOLOGICAL BASIS OF THE ELECTROENCEPHALOGRAM AND LOCAL FIELD POTENTIALS
INTRODUCTION
MEASURING EXTRACELLULAR CURRENT FLOW TO DERIVE NETWORK MECHANISMS: A TUTORIAL
Extracellular Potentials of an Individual Neuron
Extracellular Potentials of Neural Populations
Network Mechanisms of an Electrophysiologic Pattern: The Hippocampal Sharp Wave
ORIGIN OF EXTRACELLULAR CURRENTS
Fast (Na+) Action Potentials
Synaptic Activity
Calcium Spikes
Voltage-Dependent Intrinsic Oscillations
Intrinsic Spike Afterhyperpolarizations
Ephaptic Effects
Gap Junctions and Neuron–Glia Communication
EXTRACELLULAR BRAIN SIGNALS FOLLOW A POWER LAW
EXTRACELLULAR POTENTIALS ORGANIZE INTO A SYSTEM OF FUNCTIONAL OSCILLATIONS
BRAIN OSCILLATIONS INTERACT IN SPACE AND TIME
IMPLICATIONS FOR BRAIN DYNAMICS
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 111. VIDEO-EEG TECHNOLOGIES, MONTAGES, AND POSTPROCESSING IN EPILEPSY
INTRODUCTION
EEG ELECTRODES AND RECORDING
Location and Securing Electrodes
Key Electrodes
Artifact Channels
Impedance Checks
EEG RECORDING SITES AND MONTAGES
Electrode Nomenclature
Additional Electrodes
Montages
Montage Reformatting
Depth Electrode Montages
EEG PROCESSING AND DISPLAYING
Digitization
ADC Resolution
Filtering
Postprocessing
PRUNING AND STORING
EEG Storage
Pruning and Archiving
VIDEO RECORDING
CABLE, RADIO, AND AMBULATORY RECORDING
Radio or Cable
Ambulatory Recording
REFERENCES
CHAPTER 112. INTERICTAL ELECTROENCEPHALOGRAPHY
INTRODUCTION
THE ROLE OF EEG IN THE DIAGNOSIS OF EPILEPSY
TYPES OF EEG
CRITERIA FOR INTERICTAL EPILEPTIFORM DISCHARGES (IEDs)
SENSITIVITY OF IEDs
SPECIFICITY OF IEDs
TYPES OF IEDs
Focal IEDs
Generalized IEDs
Photoparoxysmal Response
INTERICTAL EEG IN COMMON EPILEPSY SYNDROMES
Focal Epilepsy Syndromes
Generalized Epilepsy Syndromes
ROLE OF INTERICTAL EEG IN THE DECISION TO DISCONTINUE ANTISEIZURE MEDICATIONS
ROLE OF INTERICTAL EEG IN EVALUATING PATIENTS FOR EPILEPSY SURGERY
SUMMARY AND CONCLUSION
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 113. ICTAL ELECTROENCEPHALOGRAPHY
INTRODUCTION
RATIONALE FOR RECORDING SEIZURES
Differential Diagnosis
Classification
Localization
Quantification
METHODS FOR RECORDING SEIZURES
Electrodes
EEG Recording
Limitations of EEG Recording
Enhancing Seizure Occurrence
FOCAL SEIZURES
Seizures Recorded With Scalp Electrodes
Seizures Recorded With Intracranial Electrodes
GENERALIZED SEIZURES
EARLY INFANTILE SEIZURES (NEONATAL SEIZURES)
Atonic Seizures
Behavioral Arrest (Hypomotor) Seizures
Clonic Seizures
Migratory Seizures
Myoclonic Seizures
Spasms
Tonic Seizures
LATE INFANCY
Myoclonic–Atonic Seizures
Myoclonic–Tonic or Spasm–Tonic Seizures
CHILDHOOD, ADOLESCENCE, AND ADULTHOOD
SUMMARY AND CONCLUSION
ACKNOWLEDGMENT
REFERENCES
CHAPTER 114. POLYGRAPHIC RECORDINGS IN EPILEPSY
INTRODUCTION
TECHNICAL ASPECTS
Currency
Methodology
Polysomnography in Patients with Epilepsy
POLYGRAPHIC STUDIES IN THE INVESTIGATION OF EPILEPTIC MOTOR MANIFESTATIONS
Analysis of Motor Phenomena
Analysis of Motor Patterns
Evolution of Motor Manifestations in Relation to Sleep–Wake Cycle
Unverricht–Lundborg Disease
Computer-Assisted Analysis of Polygraphic Signals
POLYGRAPHIC INVESTIGATIONS IN THE STUDY OF REFLEX EPILEPSY
POLYGRAPHY AS AN AID IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPTIC AND NONEPILEPTIC EPISODES
Syncope and Cardiac Dysrhythmia
Psychogenic Nonepileptic Seizures
POLYGRAPHIC MONITORING OF THE EFFECTS OF ANTISEIZURE DRUGS
SEIZURE DETECTION AND PREDICTION WITH WEARABLE DEVICES RECORDING MULTIPLE BIOLOGIC SIGNALS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 115. HOME-VIDEO EEG MONITORING IN EPILEPSY
INTRODUCTION
EVOLUTION OF HOME VEEG TELEMETRY
INDICATIONS FOR HOME VEEG TELEMETRY
Seizure Capture and Characterization
Diagnosis of Psychogenic Nonepileptic Seizure
Assessment of Response to Medications
Assessment After Medication Discontinuation
ADVANTAGES OF HOME VEEG TELEMETRY
Increase Diagnostic Yield Over Routine EEG
Convenient
Cost Effective
DISADVANTAGES OF HOME VEEG TELEMETRY
Loss of Recording Integrity and Increased Artifacts
Inability to Decrease Medications
Unable to Examine Patient During Clinical Events
Unable to Use Provocation Techniques
CHALLENGES OF HOME VEEG TELEMETRY
Patient Selection
Video Recording Quality
Equipment Handling, Learning
HOME VEEG TELEMETRY BEYOND EPILEPSY AND SEIZURE-LIKE SPELLS
Future Directions
CONCLUSION
REFERENCES
CHAPTER 116. STANDARDIZED EEG REPORTING
BASIC INFORMATION ABOUT THE PATIENT AND THE RECORDING
Identification of the Patient
History and Referral Information
Recording Conditions and Technical Information
BACKGROUND ACTIVITY
ABNORMAL EEG PATTERNS
Name and Morphology of the Abnormality
Location of the Abnormality
Time-Related Features
Reason for Abnormality
PAROXYSMAL EVENTS
ILAE Classifications
ILAE Terminology for Semiology
Standardized Terminology for EEG Changes
NORMAL VARIANTS AND ARTIFACTS
POLYGRAPHIC RECORDINGS
SYNOPSIS
INTERPRETATION
Classification
Diagnostic Significance
Clinical Comments
CONCLUSION
REFERENCES
CHAPTER 117. ELECTROENCEPHALOGRAPHY IN THE INTENSIVE CARE UNIT
INTRODUCTION
INDICATIONS AND DURATION OF cEEG MONITORING
TECHNICAL ADVANCES
INTERICTAL EEG ABNORMALITIES
SEIZURES AND THE ICTAL–INTERICTAL CONTINUUM
BEYOND SEIZURE DETECTION
Delayed Cerebral Ischemia
Prognostication
SUMMARY
REFERENCES
CHAPTER 118. LONG-TERM MONITORING IN THE EPILEPSY MONITORING UNIT
INTRODUCTION
APPLICATIONS
Distinguishing Seizures from Nonepileptic Events
Characterization of Seizures or Epilepsy Syndrome
Quantification of Seizures
Identification of IEDs
Presurgical Evaluation
TECHNICAL ASPECTS
The Patient’s Room
Recording Techniques
Monitoring of Other Biologic Signals
Techniques to Increase the Yield of Seizures
Safety Considerations in the EMU
EMU GUIDELINES
ADVANTAGES AND DISADVANTAGES OF EMU MONITORING
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 119. DRUG WITHDRAWAL AND OTHER ACTIVATING TECHNIQUES IN EPILEPSY
INTRODUCTION
PHARMACOLOGIC TECHNIQUES OF ACTIVATION
Activation by Discontinuation of Antiseizure Medications
Potential Complications of ASM Withdrawal and Methods of Prevention
Procedure for Withdrawing Antiseizure Medications for Long-term Monitoring
Are Children Less at Risk?
Activation with Parenteral Drugs
OTHER ACTIVATION TECHNIQUES
Sleep Deprivation
Hyperventilation
Photic Stimulation
Electrical Stimulation of Intracranial Electrodes
ROLE OF ACTIVATION IN PSYCHOGENIC SEIZURES
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 120. ELECTROENCEPHALOGRAPHY AND MAGNETOENCEPHALOGRAPHY POSTPROCESSING IN EPILEPSY: MAPPING, SOURCE IMAGING, AND DYNAMIC ANALYSIS
VOLTAGE MAPS
FREQUENCY MAPS
MAGNETOENCEPHALOGRAPHY
SOURCE IMAGING
Forward and Inverse Solutions
Electrode Array and Head Models
Propagation of the Activity and Averaging of the Spikes
Analysis—Pipeline
Evidence for the Accuracy and Clinical Utility of SI in Presurgical Evaluation
Automated SI
DYNAMIC ANALYSIS
EEG Connectomes
Applications
Caveats and Future Perspectives
REFERENCES
CHAPTER 121. QUANTITATIVE EEG ANALYSIS AND AUTOMATIC EVENT DETECTION
QUANTITATIVE ANALYSIS OF EEG BACKGROUND
Filtering and Digitization of the EEG
Single Channel EEG Recording and Analysis
Methods of Analyzing the EEG Background
Sampling in Time and Space
Assessing Epileptic Neuronal Networks and Resting-State Brain Activity Using EEG
Mathematical Decomposition
AUTOMATIC SEIZURE DETECTION
Types of Seizure Detection
What Is a Seizure and Measuring Seizure Detection Performance
Seizure Detection Methods
Conclusion
AUTOMATIC SPIKE DETECTION
Conclusion
AUTOMATED DETECTION OF HFOS
Pathologic versus Physiologic HFOs
Data Selection
Artifacts
Data Preprocessing
HFO Detection
Classification, Semiautomated Review, and Validation
Detecting Interictal HFOs in Noninvasive EEG
Phase–Amplitude Coupling
Epileptogenicity Index
Conclusions
REFERENCES
CHAPTER 122. STRUCTURAL NEUROIMAGING IN EPILEPSY
INTRODUCTION
IN EPILEPSY, “NORMAL” AND “ABNORMAL” MRI ARE DIAGNOSES THAT REQUIRE CERTAINTY: “SUSPICIOUS” IS EQUALLY IMPORTANT
TECHNICAL ISSUES
An “Epilepsy Protocol” Is Essential
T1-Weighted Images
T2-Weighted Images
Fluid-Attenuated Inversion Recovery Images
Image Acquisition
Interpretation
Requests
Typical Imaging Sequences for an Optimized Epilepsy Protocol
Morphometry, Quantification of Volumes, and T2 Relaxometry in Epilepsy
Diffusion-Weighted Imaging
Advanced Analysis Techniques
MAJOR FINDINGS ON MAGNETIC RESONANCE IMAGING
Obvious Lesions
Hippocampal Sclerosis
Malformations of Cortical Development
SPECIAL CONSIDERATIONS FOR INFANTS AND CHILDREN
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 123. POSITRON EMISSION TOMOGRAPHY IN EPILEPSY
INTRODUCTION
PET METHODOLOGY
Principles of PET
Infrastructure Requirements: Cyclotrons, Radiochemistry, and Scanners
Isotopes Used Now or in Future
Acquisition Technique: Clinical PET
Acquisition Technique: Research PET
Interpretation of Clinical (FDG) PET
Role of Quantification
Clinical Indications for FDG PET
Expected Findings on FDG PET
TEMPORAL LOBE EPILEPSY
Lesional Temporal Lobe Epilepsy
Nonlesional Temporal Lobe Epilepsy
EXTRATEMPORAL LOBE EPILEPSY
FDG PET IN SOME SPECIFIC CONDITIONS
Childhood Epilepsy Syndromes
Developmental Abnormalities
Encephalitis
Status Epilepticus
Focal Hypermetabolism
FDG PET AND EPILEPSY SURGERY
Prediction of Postsurgical Outcome
Effects of Surgery
Effects of Neuromodulation
PET WITH NOVEL RADIOTRACERS
GABA-Ergic Neurotransmission in Focal Epilepsies
GABA-Ergic Neurotransmission in Genetic Epilepsies
Glutamatergic Neurotransmission
Opiate Receptors
Cannabinoids
Serotonergic Systems
Dopaminergic Neurotransmission
Cholinergic Neurotransmission
Inflammation
Multidrug Transporter Function
Imaging of Antiseizure Medications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 124. SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY IN EPILEPSY
INTRODUCTION
INTERICTAL BLOOD FLOW SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
PERI-ICTAL SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
Technique of Peri-Ictal Single Photon Emission Computed Tomography Injection
PERI-ICTAL SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY PERFUSION PATTERNS
TECHNIQUES IN SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY IMAGE ANALYSIS AND INTERPRETATION
Subtraction Single Photon Emission Computed Tomography with Magnetic Resonance Imaging Coregistration
Single Photon Emission Computed Tomography with Statistical Parametric Mapping Analysis
LIMITATIONS OF SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
RESEARCH APPLICATIONS IN SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 125. MAGNETIC RESONANCE SPECTROSCOPY IN EPILEPSY
INTRODUCTION
MR SPECTROSCOPY: PROTON SPECTRUM
MR SPECTROSCOPY (MRS) STUDIES IN HUMANS
NAA in Defined Lesions (Focal Cortical Dysplasias, Heterotopias, Polymicrogyrias, Hippocampal Sclerosis)
N-acetyl Aspartate Levels Depend on Epilepsy Duration in Temporal Lobe Epilepsy
Multimodal Studies in Human Epilepsy
Human Studies in Surgical Epilepsy for Classification
Glutamate and GABA in Epilepsy
CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 126. FUNCTIONAL MAGNETIC RESONANCE IMAGING IN EPILEPSY
INTRODUCTION
THE PHYSICAL AND PHYSIOLOGIC BASES OF FUNCTIONAL MAGNETIC RESONANCE IMAGING
FUNCTIONAL MAGNETIC RESONANCE IMAGING
APPLICATIONS OF FUNCTIONAL MAGNETIC RESONANCE IMAGING TO EPILEPSY
Presurgical Planning
Newer Applications for fMRI in Epilepsy
EEG-fMRI
Resting-State fMRI
CONCLUSIONS
REFERENCES
CHAPTER 127. SEIZURE PREDICTION
INTRODUCTION
LESSONS LEARNED FROM HISTORY
OVERVIEW OF ANALYSIS TECHNIQUES USED TO PREDICT SEIZURES
STATISTICAL CONSIDERATIONS
DATABASES, DATA QUALITY, AND THEIR IMPLICATIONS
ANIMAL MODELS OF SEIZURES AND EPILEPSY
PATIENT-BASED SEIZURE PREDICTION
SEIZURE PREDICTION WITH MULTIMODAL NON-EEG DATA/WEARABLES
Preictal Changes in Cortical Excitability Following External Brain Stimulation
Preictal Alterations in Cortical Hemodynamics
Use of Wearables and Peripheral Non-EEG Characteristics for Seizure Prediction
OUTLOOK
REGULATORY ASPECTS
CHALLENGES
REFERENCES
CHAPTER 128. EEG- AND NON–EEG-BASED WEARABLE DEVICES FOR SEIZURE DETECTION
INTRODUCTION
NON–EEG-BASED WEARABLE DEVICES
SUBCUTANEOUS EEG WEARABLE DEVICES
REFERENCES
CHAPTER 129. TRANSCRANIAL MAGNETIC STIMULATION IN EPILEPSY
INTRODUCTION
ELECTROMAGNETIC INDUCTION AND TMS BASICS
Transcranial Magnetic Stimulation Coils
Site of Transcranial Magnetic Stimulation Activation
TMS Measures of Cortical Excitability
Altered TMS Metrics in Epilepsy
Studies Performed by Stimulating During the Seizures
EFFECTS OF ANTISEIZURE TREATMENT
TMS and ASMs
TMS and Nonpharmacologic Antiseizure Interventions
SEIZURE SUPPRESSION BY RTMS
rTMS in Status Epilepticus
Controlled rTMS Trials in Epilepsy
Considerations for Deep Foci
MAPPING MOTOR FUNCTION, LANGUAGE, AND MEMORY
Mapping the Primary Motor Cortex
Mapping Language
TMS SAFETY AND TOLERABILITY IN EPILEPSY
rTMS Safety
TMS in Patients With Prior Cranial Surgery
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 130. NEUROPSYCHOLOGICAL EVALUATION OF ADULTS WITH EPILEPSY
INTRODUCTION
MULTIFACTORIAL INFLUENCES
GENETIC EPILEPSIES
FOCAL SYMPTOMATIC EPILEPSY
Temporal Lobe Epilepsy
Frontal Lobe Epilepsy
Etiology
ANTISEIZURE MEDICATION EFFECTS
ACCELERATED LONG-TERM FORGETTING
NEWER SURGICAL EPILEPSY TREATMENTS
NEUROMODULATION
NEUROBEHAVIORAL PHENOTYPING
NEUROPSYCHOLOGICAL DIAGNOSTICS
Cognitive Screening
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 131. NEUROPSYCHOLOGICAL EVALUATION OF CHILDREN WITH EPILEPSY
INTRODUCTION
MODELS OF NEUROPSYCHOLOGICAL ASSESSMENT
DOMAINS COVERED IN THE NEUROPSYCHOLOGICAL ASSESSMENT
WHO SHOULD CONDUCT A NEUROPSYCHOLOGICAL ASSESSMENT?
WHO SHOULD UNDERGO A NEUROPSYCHOLOGICAL ASSESSMENT AND WHEN?
CHALLENGES FOR ASSESSING VERY YOUNG OR DEVELOPMENTALLY DELAYED CHILDREN
NEUROPSYCHOLOGICAL ASSESSMENT IN PEDIATRIC EPILEPSY SURGERY
Information About the Epileptogenic Focus
Risks of Surgery
Evaluating the Outcome of Surgery
TRANSITION PLANNING
FUTURE DIRECTIONS
CONCLUSION
REFERENCES
SECTION 7 • General Treatment Considerations in Epilepsy
CHAPTER 132. OVERVIEW: GENERAL APPROACHES TO MEDICAL TREATMENT FOR EPILEPSY
INTRODUCTION
LEVELS OF DIAGNOSIS
GENERAL CONSIDERATIONS OF MEDICAL TREATMENT ISSUES
PRINCIPLES OF DRUG TREATMENT
STRATEGIES FOR PHARMACOTHERAPY
SPECIAL THERAPEUTIC CONSIDERATIONS
ALTERNATIVE APPROACHES
SUMMARY AND CONCLUSIONS
CHAPTER 133. WHEN TO START ANTISEIZURE MEDICATION THERAPY
INTRODUCTION
ILLUSTRATIVE CASES
ELEMENTS OF THE DECISION-MAKING PROCESS: ASSESSING RISKS AND BENEFITS
Risk of Seizure Recurrence After a First Unprovoked Seizure
Type of Seizure
Timing of Seizures
Frequency of Seizures
Effects of Age on Consequences of Seizures
Environment
Consequences of Treatment
DECIDING WHETHER TO TREAT
Issues to Consider Prior to Initiating Antiseizure Medication Therapy
Acute Symptomatic and Provoked Seizures
Self-limited Epilepsy Syndromes and Childhood Epilepsy with Only a Few Solitary Seizures
Other Considerations
CONSIDERATION OF THE ILLUSTRATIVE CASES
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 134. MANAGEMENT OF ANTISEIZURE MEDICATION INITIATION
INTRODUCTION
SETTING AN INITIAL THERAPEUTIC GOAL
RATE OF ASM INITIATION
RASH: COUNSELING AND POTENTIAL MANAGEMENT
PATIENT COUNSELING
ASM Side Effects and Special Considerations
Adherence
Pregnancy, Contraception, Folic Acid
Medication Interactions
Seizure Safety
Alcohol and Other Drugs
Sudden Unexpected Death in Epilepsy
Driving
Resources for Patients
RESCUE THERAPY AND PLANNING FOR SEIZURE RECURRENCE
Rescue Therapy
Planning for Seizure Recurrence and Follow-Up
CONCLUSIONS
REFERENCES
CHAPTER 135. MATCHING ANTISEIZURE MEDICATIONS TO THE PATIENT
INTRODUCTION
GENERAL PRINCIPLES
MEDICAL–PHYSIOLOGIC FACTORS
Genetic Factors
Age
Sex
Comorbid Illness
NONMEDICAL PATIENT FACTORS
PHYSICIAN FACTORS
MEDICATION FACTORS
Route
Frequency of Dosing
Cost
Renal and/or Hepatic Clearance
Interactions
Speed of Onset
Side Effects
Habit-Forming and Ease of Withdrawal
Mechanism of Action
CONCLUSIONS
REFERENCES
CHAPTER 136. CHOICE OF ANTISEIZURE MEDICATIONS
INTRODUCTION
EPILEPSY CLASSIFICATION
EFFICACY
Newly Diagnosed
Add-on Therapy
SAFETY AND TOLERABILITY
DRUG INTERACTIONS
COMORBID CONDITIONS
TITRATION AND DOSE SELECTION
AVAILABILITY
STAGES OF DISEASE
Initial Monotherapy
When the First ASM Fails
Treatment-Resistant Patients
SPECIAL GROUPS
Children
Women
The Elderly
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 137. MEASURING TREATMENT RESPONSE IN THE EPILEPSY CLINIC
INTRODUCTION
TECHNIQUES TO MEASURE SEIZURE FREQUENCY, TYPE, AND INTENSITY
Paper Diaries
Electronic Diaries
Real-Time Tracking with Implanted Devices
SEIZURE FREQUENCY OVER TIME
THE FOLLOW-UP CLINIC VISIT
The Follow-Up Visit
Spontaneously Reported Symptoms
Checklist of Symptoms and Closed-Ended Questions
MEASURING PLASMA LEVELS AND SIDE EFFECTS OF ASMs
THE UTILITY OF ROUTINE AND LONG-TERM EEG MONITORING IN MEASURING TREATMENT RESPONSE
CONCLUSIONS
REFERENCES
CHAPTER 138. SELF-MANAGEMENT STRATEGIES IN EPILEPSY—BEYOND ANTISEIZURE MEDICATIONS
INTRODUCTION
COMPONENTS OF EPILEPSY SELF-MANAGEMENT
MAIN APPROACHES FOR EPILEPSY SELF-MANAGEMENT
Educational Approaches
Psychosocial Approaches
LOGISTICS OF EPILEPSY SELF-MANAGEMENT PROGRAM DELIVERY
A PROFESSIONAL AND RESEARCH COLLABORATION TO ADVANCE EPILEPSY SELF-MANAGEMENT
Special Populations
FUTURE CHALLENGES AND OPPORTUNITIES
CONCLUSIONS
REFERENCES
CHAPTER 139. PHARMACIST ROLES IN INTERPROFESSIONAL TEAM CARE OF PEOPLE WITH EPILEPSY AND APPROACH TO CARE
INTRODUCTION
PHARMACY SERVICES FOR THE CARE OF THE PATIENT WITH EPILEPSY IN SPECIALIZED CLINICS AND EPILEPSY CENTERS
PHARMACY SERVICES FOR THE CARE OF THE PATIENT WITH EPILEPSY IN THE PRIMARY CARE AND COMMUNITY SETTING
PHARMACY SERVICES IN EPILEPSY EDUCATION
PHARMACIST APPROACH TO CARE OF THE PATIENT WITH EPILEPSY
MOTIVATIONAL INTERVIEWING
REFERENCES
CHAPTER 140. PHARMACOKINETICS OF ANTISEIZURE MEDICATIONS
INTRODUCTION
ABSORPTION
Gastrointestinal Absorption
Rectal Absorption
Intramuscular Absorption
Buccal Absorption
Nasal Absorption
Absorption from Other Routes
DISTRIBUTION
Binding to Plasma Proteins
Tissue Binding
Tissue Blood Flow and Drug Distribution
Blood–Brain Barrier
Placental Barrier
Distribution into Breast Milk
ELIMINATION
Pharmacokinetic Concepts
Biotransformation
Factors Affecting Drug Metabolism
Renal Excretion
SINGLE-DOSE PHARMACOKINETICS
Intravenous Administration
Oral Administration
PHARMACOKINETICS DURING CONTINUOUS OR MULTIPLE DOSING
Continuous Dosing
Multiple Doses
NONLINEAR PHARMACOKINETICS
Dose-Dependent Kinetics
Dose-Dependent Absorption
Dose-Dependent Protein Binding
Dose-Dependent Metabolism: Enzyme Saturation
Time-Dependent Kinetics
POPULATION PHARMACOKINETICS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 141. PHARMACOKINETIC AND PHARMACODYNAMIC DRUG-DRUG INTERACTIONS IN EPILEPSY
INTRODUCTION
PHARMACODYNAMIC INTERACTIONS
PHARMACOKINETIC INTERACTIONS
Enzyme Induction and Inhibition
Other Pharmacokinetic Mechanisms
PHARMACOKINETIC INTERACTIONS BETWEEN ASMS
PHARMACOKINETIC INTERACTIONS BETWEEN ASMS AND OTHER DRUGS
CONCLUSION
REFERENCES
CHAPTER 142. THERAPEUTIC DRUG MONITORING IN EPILEPSY
INTRODUCTION
PRINCIPLES OF THERAPEUTIC DRUG MONITORING
FACTORS AFFECTING RESPONSE TO A GIVEN ANTISEIZURE MEDICATION LEVEL
Characteristics of the Seizure Disorder
Age
Duration of Treatment
Conditions Associated with Altered Drug Binding to Serum Proteins
Comorbidities
Drug Interactions
Confounding Effects of Pharmacologically Active Metabolites
THE CONCEPT OF THERAPEUTIC RANGE
The Individual Reference Concentration
ASSESSMENT OF THE IMPACT OF THERAPEUTIC DRUG MONITORING ON CLINICAL OUTCOME
USE OF THERAPEUTIC DRUG MONITORING IN VARIOUS CLINICAL SETTINGS
Settings in Which Clinical Assessment of Effects Is Particularly Difficult
Settings with Alterations in Pharmacokinetics
Settings with Unexpected Clinical Response
MISUSE OF ASM-LEVEL TESTING
Inappropriate ASM-Level Testing
Misinterpretation of ASM Levels
TIME OF SAMPLING
BIOLOGIC MATRIX
ANALYTICAL TECHNIQUES
Direct Measurement of Unbound Drug Concentrations
RELEVANCE AND APPLICATION OF THERAPEUTIC DRUG MONITORING IN RELATION TO INDIVIDUAL ANTISEIZURE MEDICATIONS
Older Antiseizure Medications
Newer Antiseizure Medications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 143. DOSE-RELATED SIDE EFFECTS OF ANTISEIZURE MEDICATIONS
INTRODUCTION
THE SCOPE OF DOSE-RELATED ADVERSE EFFECTS
DOSE-RELATED ADVERSE EFFECTS FOR ASMS
Cognitive Impairment and Fatigue
Rash
Teratogenicity
Peak Dose Effects
Tolerance to Dose-Related Adverse Effects
PATIENT GROUPS WITH AN INCREASED RISK FOR DOSE-RELATED ADVERSE EFFECTS
MANAGEMENT OF DOSE-RELATED ADVERSE EFFECTS
CONCLUSION
REFERENCES
CHAPTER 144. IDIOSYNCRATIC ADVERSE REACTIONS FROM ANTISEIZURE MEDICATIONS
INTRODUCTION
PATHOGENESIS OF IDIOSYNCRATIC ADVERSE REACTIONS TO ASMS
The Role of Reactive Metabolites
Mechanisms of Idiosyncratic Adverse Reactions to ASMs
GENETIC DETERMINANTS
RISK FACTORS
Age
Starting Dose and Titration Rate
Role of Diseases
Role of Concomitant Treatments
MOST COMMON ASM-INDUCED IDIOSYNCRATIC REACTIONS
Cutaneous Manifestations of Hypersensitivity
Hematologic Reactions
Hepatotoxicity
Pancreatitis
CNS Reactions
Ocular Reactions
Cardiac Effects
Miscellanea
PREVENTION, DIAGNOSIS, AND MANAGEMENT
Prevention
Diagnosis
Management
REFERENCES
CHAPTER 145. LONG-TERM ADVERSE EFFECTS OF ANTISEIZURE MEDICATIONS
INTRODUCTION
COSMETIC EFFECTS
REPRODUCTIVE HEALTH
SEXUAL DYSFUNCTION
BONE HEALTH
THYROID FUNCTION
PERIPHERAL NEUROPATHIES
CEREBELLAR ATROPHY
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 146. GENDER ISSUES FOR DRUG TREATMENT IN EPILEPSY
INTRODUCTION
REPRODUCTIVE DYSFUNCTION
Birth Rates
Fertility
Polycystic Ovary Syndrome, Epilepsy, and Valproate Use
Semen Quality, Epilepsy, and Antiseizure Medications
Sexuality
PERIMENOPAUSE, MENOPAUSE, AND BONE HEALTH
FAMILY PLANNING
FACTORS IN DRUG SELECTION IN WOMEN OF CHILDBEARING AGE
Traditional Drugs—Pros and Cons
Newer Drugs—Pros and Cons
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 147. MANAGING ANTISEIZURE MEDICATIONS THROUGH CONTRACEPTION AND PREGNANCY
INTRODUCTION
ASMs AND CONTRACEPTION
ASMS AND PREGNANCY
Absorption and Distribution
Hepatic Clearance
Renal Clearance
Therapeutic Drug Monitoring
CONCLUSIONS
REFERENCES
CHAPTER 148. ANTISEIZURE MEDICATIONS AND STRUCTURAL TERATOGENESIS
INTRODUCTION
MECHANISMS OF TERATOGENESIS
STRUCTURAL TERATOGENESIS AND SPECIFIC ANTISEIZURE MEDICATIONS
Valproate
Carbamazepine
Lamotrigine
Levetiracetam
Oxcarbazepine
Phenytoin
Phenobarbital
Topiramate
Zonisamide
Other ASMs
EFFECT OF ASM DOSE
POLYTHERAPY
ASMS AND OTHER MEDICATIONS
ASMS AND FETAL GROWTH
EPILEPSY SURGERY
OTHER THERAPIES
IMPLICATIONS FOR PATIENT CARE
Prepartum Counseling and Management
Folic Acid
Fetal Monitoring
CONCLUSION
REFERENCES
CHAPTER 149. NEURODEVELOPMENTAL EFFECTS OF ANTISEIZURE MEDICATIONS
INTRODUCTION
ANIMAL DATA
Behavioral Data for Individual Antiseizure Medications
Antiseizure Medication Effects on Neurodevelopment: Potential Mechanisms
HUMAN DATA FROM OFFSPRING OF MOTHERS WITH EPILEPSY
Confounding Factors
Fetal Antiseizure Medication Syndromes
Intelligence
Specific Cognitive Abilities
Behavior
The Effect of Folate
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 150. DRUG TREATMENT IN CHILDREN WITH EPILEPSY
INTRODUCTION
CLINICAL APPROACHES
Treatment by Seizure or Epilepsy Type
Treatment by Broad Syndrome Categories
Treatment by Etiology
GENERAL SIDE-EFFECT CONSIDERATIONS
PREGNANCY AND EPILEPSY
GENERAL PHARMACOKINETIC CONSIDERATIONS
MONITORING
WHEN AND HOW TO STOP
CREATING A UNIFORM WORLDWIDE PERSPECTIVE
REFERENCES
CHAPTER 151. DRUG TREATMENT IN ADOLESCENTS WITH EPILEPSY
INTRODUCTION
MEDICATIONS USED TO TREAT JUVENILE GENERALIZED EPILEPSIES
Juvenile Absence Epilepsy, Juvenile Myoclonic Epilepsy, and Epilepsy with Generalized Tonic–Clonic Seizures Alone
Refractory Generalized Epilepsy
Adolescent Onset Progressive Myoclonic Epilepsies: Lafora Disease, Unverricht–Lundborg Disease, and Neuronal Ceroid Lipofuscinosis
MEDICATIONS USED TO TREAT JUVENILE FOCAL EPILEPSIES
Medications for Refractory Focal Epilepsy
SPECIFIC CONSIDERATIONS THAT AFFECT THERAPY IN ADOLESCENCE
QUALITY OF LIFE, NEUROPSYCHOLOGICAL ABNORMALITIES, AND LEARNING DISORDERS
TRANSITION TO ADULT EPILEPSY CLINICS
DURATION OF THERAPY
CONCLUSIONS
REFERENCES
CHAPTER 152. TRANSITION FROM PEDIATRIC TO ADULT CARE FOR PEOPLE WITH EPILEPSY
OUTCOMES OF CHILDHOOD-ONSET EPILEPSIES
Comorbidities in Patients with Childhood-Onset Epilepsy Moving to Adult Care
Beyond the Seizures
TRANSITION IS MORE THAN HANDING OVER YOUNG ADULTS WITH SEIZURES
How Do Differences in the Adult System Affect Patients and Caregivers?
What Might Happen If Transition Is Poorly Managed?
MODELS OF TRANSITION PROGRAMS
WHAT ISSUES SHOULD BE ADDRESSED BY A TRANSITION PROGRAM?
Ages 12 to 15 Years: Introduce the Concept of Transition and Create a “Seizure Emergency Plan”
Ages 12 to 17 Years: Exploring Financial, Community, and Legal Support Available for the Young Adult with Epilepsy
Ages 16 to 17 Years: Determining the Transition Readiness of Patients with Epilepsy and Their Parents
Ages 12 to 19 Years: Identifying and Addressing Risk Factors for Unsuccessful Transition in Normally Developing Adolescents with Epilepsy
Ages 12 to 19 Years: Identifying and Addressing Risk Factors for Unsuccessful Transition in Adolescents with Epilepsy and Intellectual Disability
Ages 16 to 19 Years: Time to Rethink the Diagnosis
Ages 16 to 17 Years: Identify Obstacles for Continuation of Treatment of Drug-Resistant Epilepsies
PEDIATRIC DISCHARGE PACKAGE AND ROLE OF THE FAMILY DOCTOR
CONCLUSION
REFERENCES
CHAPTER 153. DIAGNOSIS AND TREATMENT OF EPILEPSY IN THE OLDER ADULT
INTRODUCTION
DEFINITION AND EPIDEMIOLOGY OF EPILEPSY IN OLDER ADULTS
OLDER ADULTS ARE NOT A HOMOGENOUS POPULATION
SEIZURE TYPES IN OLDER ADULTS
DIAGNOSIS
EEG AND MRI
COMMON CAUSES OF EPILEPSY IN OLDER ADULTS
Stroke
Neurodegenerative Disorders with Dementia
Brain Tumors
NURSING HOME USE OF ASMS
COMMUNITY USAGE OF ASMS
PHARMACOKINETICS AND PHARMACODYNAMICS
CLINICAL TRIALS IN THE ELDERLY
SPECIFIC ASMS
Carbamazepine
Eslicarbazepine
Felbamate
Gabapentin
Lacosamide
Lamotrigine
Levetiracetam
Oxcarbazepine
Perampanel
Phenytoin
Pregabalin
Topiramate
Valproic Acid
Zonisamide
DRUG INTERACTIONS
THERAPEUTIC DRUG MONITORING
TREATING A SINGLE SEIZURE
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 154. TREATMENT ADHERENCE IN EPILEPSY
INTRODUCTION
DEFINING ADHERENCE
SUBOPTIMAL ADHERENCE IMPACTS HEALTH OUTCOMES
MEASURING ADHERENCE IN EPILEPSY
Blood Serum Levels
Pharmacy Refill Data/Medication Possession Ratio
Electronic Monitors
SELF- OR PARENT-REPORT
Provider Estimates
ADHERENCE PREDICTORS
Sociodemographic Predictors
Medical Predictors
Individual and Family Predictors of Adherence
INTERVENTIONS TO IMPROVE ADHERENCE IN EPILEPSY
PRACTICAL STRATEGIES TO IMPROVE ADHERENCE IN CLINICAL PRACTICE
CONCLUSIONS AND FUTURE DIRECTIONS
REFERENCES
CHAPTER 155. DISCONTINUATION OF ANTISEIZURE MEDICATIONS
INTRODUCTION
WHEN TO CONSIDER TAPERING ASMs
RISK STRATIFICATION
SPECIAL SYNDROMES
POST-SURGERY WITHDRAWAL
DIAGNOSTIC TOOLS
HOW FAST TO TAPER
RELAPSE AFTER WITHDRAWAL
SUDDEN UNEXPLAINED DEATH IN EPILEPSY
CONCLUSION
REFERENCES
CHAPTER 156. ROUTINE MONITORING FOR SAFETY AND TOLERABILITY DURING CHRONIC TREATMENT WITH ANTISEIZURE MEDICATIONS
INTRODUCTION
ADVERSE EFFECTS
LABORATORY MONITORING DURING CHRONIC ANTISEIZURE MEDICATION TREATMENT
Indications for Routine Laboratory Testing
Common Laboratory Findings
SERIOUS IDIOSYNCRATIC REACTIONS
IDENTIFICATION OF HIGH-RISK PATIENTS AND MANAGEMENT OF SPECIAL POPULATIONS
MONITORING BLOOD LEVELS OF ANTISEIZURE MEDICATIONS
The Reference Range and the Therapeutic Range
Indications for Therapeutic Drug Monitoring of ASMs
Other Forms of Monitoring
Monitoring Strategies
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 157. COMBINATION PHARMACOTHERAPY IN EPILEPSY
INTRODUCTION
POTENTIAL DISADVANTAGES OF COMBINATION THERAPY
Increased Number or Intensity of Side Effects
Potentiation of Idiosyncratic or Dose-related Side Effects
Pharmacokinetic Interactions
Difficulty of Attributing a Response to a Given Drug
Possible Change in the Therapeutic Range of Plasma Levels
POTENTIAL ADVANTAGES OF COMBINATION THERAPY
Clinical Studies
CLINICAL APPROACH TO SELECTION OF ANTISEIZURE MEDICINE COMBINATIONS
Strategy for Adding or Replacing Drugs
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 158. TREATMENT OF SINGLE AND INFREQUENT SEIZURES
INTRODUCTION
DIAGNOSIS OF EPILEPTIC SEIZURES, FIRST UNPROVOKED SEIZURES, AND EPILEPSY
CHANGED VIEWS ON THE EARLY PROGNOSIS OF EPILEPSY AND THE EFFECTS OF EARLY TREATMENT
RISK OF RECURRENCE OF A FIRST SEIZURE
THE IMPACT OF TREATMENT ON THE RECURRENCE AFTER A FIRST SEIZURE AND ON THE LONG-TERM PROGNOSIS OF EPILEPSY
ADVERSE EFFECTS OF ANTISEIZURE MEDICATIONS, QUALITY OF LIFE, AND PATIENTS’ PREFERENCE
OTHER FACTORS
STARTING OR WITHHOLDING TREATMENT AFTER A FIRST SEIZURE
TREATMENT OF THE PATIENT WITH INFREQUENT SEIZURES
SUMMARY AND CONCLUSIONS
ADDITIONAL INFORMATION
REFERENCES
CHAPTER 159. TREATMENT OF NEONATAL SEIZURES
INTRODUCTION
RATIONALE FOR TREATMENT
BASICS OF EVALUATION
EVALUATION OF SEMIOLOGY TO GUIDE TREATMENT
TREATMENT WITH ANTISEIZURE MEDICATION
FIRST-LINE TREATMENT
Phenobarbital
SECOND-LINE TREATMENT
Phenytoin/Fosphenytoin
Levetiracetam
Benzodiazepines
Lidocaine
EMERGING TREATMENTS
Bumetanide
Carbamazepine
Topiramate
Therapeutic Hypothermia
APPROACH TO MANAGEMENT OF NEONATAL SEIZURES
Acute Symptomatic Seizures
Neonatal-Onset Epilepsies
PROGNOSIS AND COMPLICATIONS
SUMMARY
REFERENCES
CHAPTER 160. FEBRILE SEIZURES AND FEVER-RELATED SEIZURES
INTRODUCTION
EPIDEMIOLOGY
DEFINITION
ETIOLOGY/PATHOPHYSIOLOGY
FEBRILE SEIZURES AFTER IMMUNIZATIONS
FEBRILE SEIZURE MODULATORS
IRON, ZINC, AND SELENIUM DEFICIENCY
PREDICTING THE DEVELOPMENT OF EPILEPSY
PROLONGED FEBRILE SEIZURES AND FEBRILE STATUS EPILEPTICUS
FEBRILE INFECTION–RELATED EPILEPSY SYNDROME
DIAGNOSTIC EVALUATION
Hematologic Evaluation
Lumbar Puncture
Neuroimaging
EEG
Genetic Tests
MANAGEMENT
PREVENTION OF SEIZURE RECURRENCE
Antipyretic Therapy and Other Measures of Prevention
LONG-TERM OUTCOME
REFERENCES
CHAPTER 161. STRATEGIES WHEN TREATMENTS FAIL IN PEOPLE WITH EPILEPSY
INTRODUCTION
SOMETHING OLD
SOMETHING NEW
SOMETHING BORROWED
Serotonergic Neurotransmission
Immunomodulation and Immunosuppression
Utilization of Medical Devices
Diets and Dietary Supplement
NOTHING BLUE (IN THREE STEPS)
REFERENCES
CHAPTER 162. MANAGING EPILEPSY IN PATIENTS WITH MEDICAL COMORBIDITIES
INTRODUCTION
KIDNEY DISEASE
Effect of Kidney Disease on Use of ASMs
Potential Deleterious Effects of ASMs on the Kidneys
Use of ASMs in the Setting of Renal Replacement Therapies
Comments on Specific ASMs in Context of Renal Disease
MENTAL HEALTH DISORDERS
Effect of Epilepsy Treatment on Mental Health Disorder
Effect of Psychotropic Medications on Epilepsy
Antidepressants
Antipsychotics
EPILEPSY AND ONCOLOGIC AND HEMATOLOGIC DISEASES
Hematologic and Oncologic Diseases
Does Hematologic Disease Impact Epilepsy?
General Recommendations
EPILEPSY AND CARDIAC DISEASES
Impact of Epilepsy Treatment on Cardiac Disease
Impact of Cardiac Disease Treatment on Epilepsy
Specific Medication Classes
Implanted Devices
OTHER SPECIFIC SITUATIONS
Patient With a History of Drug Rash
Liver Disease
Sexual Dysfunction
FINAL COMMENTS
REFERENCES
CHAPTER 163. PREVENTION AND TREATMENT OF PROVOKED SEIZURES
INTRODUCTION
EMOTIONAL FACTORS
FATIGUE AND SLEEP DEPRIVATION
ALCOHOL
DRUG-INDUCED SEIZURES
Psychotropic and Neuroleptic Drugs
Antidepressants
Antipsychotic Neuroleptics
Antiseizure Medications
Anesthetic Drugs
Drugs for Medical Disorders
Drugs of Abuse
SPECIFIC STIMULI
TREATMENT OF PROVOKED SEIZURES
People with Epilepsy
Persons Without Epilepsy
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 164. KETOGENIC DIETS FOR EPILEPSY
INTRODUCTION
HISTORY
CLINICAL ASPECTS OF KETOGENIC DIETS
Ketogenic Diet Foods and Composition
“Alternative” Ketogenic Diets
Indications
Adults
Initiation of the Classic KD
Maintenance
Side Effects
Discontinuation
HOW DOES THE KETOGENIC DIET WORK?
Overview of Brain Energy Metabolism
Direct Effects of Ketone Bodies
Neurotransmitters and Ion Channel Regulation
Bioenergetic and Mitochondrial Changes
Glycolytic Restriction/Diversion
Fatty Acid Oxidation and Polyunsaturated Fatty Acids
TCA Cycle Effects and Anaplerosis
Other Emerging Mechanisms
CONCLUDING REMARKS
REFERENCES
CHAPTER 165. REPRODUCTIVE HORMONAL TREATMENT FOR EPILEPSY
INTRODUCTION
REPRODUCTIVE HORMONE EFFECTS ON EPILEPSY
Estradiol
Progesterone
Testosterone
Dehydroepiandrosterone Sulfate
CATAMENIAL EPILEPSY
HORMONAL TREATMENT OF WOMEN WITH EPILEPSY
Progestogen Therapy
Allopregnanolone Analog Therapy
Gonadotrophin-Releasing Hormone Analog Therapy
HORMONAL TREATMENT OF MEN WITH EPILEPSY
Testosterone/Aromatase Inhibitor
Phosphodiesterase Inhibitor or Prostaglandin
CONCLUSIONS
REFERENCES
CHAPTER 166. PSYCHO-BEHAVIORAL THERAPIES IN EPILEPSY
INTRODUCTION
ARREST OF SEIZURES
History
MODERN ACCOUNTS
ANECDOTAL OBSERVATIONS
THEORETICAL CONCEPTS
CURATIVE EFFECT
PREVENTION OF SEIZURES
Specific Precipitating Factors
Nonspecific Precipitating Factors
Psychogenic Precipitants
Mind–Body Approaches for Seizure Prevention
BEHAVIOR MODIFICATION TODAY
THE APPLICATION OF PSYCHO-BEAHVIORAL THERAPIES ACROSS THE EPILEPSY SPECTRUM
Depressive Symptoms
Anxiety
Social and Family Problems and Stigma
Treatment Nonadherence
Cognitive Disturbances
TREATMENT DELIVERY AND RESEARCH CONSIDERATIONS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 167. COMPLEMENTARY AND ALTERNATIVE MEDICAL THERAPIES FOR EPILEPSY
INTRODUCTION
SCOPE OF USE
Developed Countries
Developing Countries
CAM THERAPIES USED FOR EPILEPSY
Herbal Medicines and Other Dietary Supplements
Psychological Therapies and Mind–Body Techniques
REGULATORY ASPECTS OF HERBAL MEDICINES IN THE UNITED STATES
SAFETY ISSUES
OPPORTUNITIES FOR FURTHER RESEARCH
CONCLUSION
ACKNOWLEDGMENTS
REFERENCES
SECTION 8 • Antiseizure Medications
CHAPTER 168. OVERVIEW: ANTISEIZURE MEDICATIONS
INTRODUCTION
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 169. EPILEPSY PHARMACOGENETICS AND PHARMACOGENOMICS
INTRODUCTION AND DEFINITIONS
ADVANCES IN GENETIC TESTING TECHNOLOGY
PHARMACOKINETIC PHARMACOGENETICS
Variation in Cytochrome P450 Enzymes
Phenytoin
Carbamazepine
Valproate
Lamotrigine
PHARMACOGENOMICS OF BROAD DRUG RESPONSE
MDR1 Resistance
Recent Genetic Studies of Pharmacoresistance
Lamotrigine Resistance
Specific Drug Response
PHARMACOGENOMICS OF ADVERSE REACTIONS
Cutaneous Drug Reactions
GENETIC PREDICTORS OF ASD-INDUCED cADRs
ASD-Associated Weight Changes
Levetiracetam and Neurobehavioral Side Effects
Vigabatrin-Associated Visual Field Loss
CONCLUSION
REFERENCES
CHAPTER 170. SCREENING OF NEW COMPOUNDS AND THE ROLE OF THE PHARMACEUTICAL INDUSTRY IN EPILEPSY
INTRODUCTION
HISTORICAL PERSPECTIVE
ANIMAL MODELS FOR DRUG DISCOVERY
Screening for Efficacy: The Value of Animal Seizure Models
Focal Seizures: Kindling
PHARMACORESISTANT ANIMAL MODELS
Introduction
Defining Pharmacoresistance
Models of Drug-Resistant Seizures and Epilepsy
Antiseizure Medication–Resistant Kindled Rats
The Low-Frequency (6-Hz) Electroshock Seizure Model
Post–Status Epilepticus Models of Temporal Lobe Epilepsy
Summary
ROLE OF THE PHARMACEUTICAL INDUSTRY
The Role of the pharmaceutical industry: A Brief History of ASM Discovery and Development
The Roles of the Industry in ASM Discovery and Development
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 171. INVESTIGATIONAL DRUGS IN EPILEPSY
INTRODUCTION
GAMMA-AMINOBUTYRIC ACID–TARGETED THERAPIES
CVL-865 (Darigabat)
ETX-155
Ganaxolone
NRP2945
OV329
GLUTAMATERGIC TARGETED THERAPIES
AV-101
JNJ-40411813 (ADX71149)
ION CHANNEL MODULATORS
SMALL MOLECULE SODIUM CHANNEL MODULATORS (NBI-921352 AND PRAX-562)
NBI-921352 (Previously Xen901)
PRAX-562
KV7.2 ACTIVATORS (KB-3061, XEN496, AND XEN1101)
KB-3061 (BPN-25203)
XEN496 (Retigabine)
XEN1101
T-TYPE VOLTAGE GATED Ca2+ CHANNEL BLOCKERS (ACT-709478, CX-8998 AND NBI-827104)
ACT-709478
CX-8998
NBI-827104
NOVEL SEROTONERGIC DRUGS IN DEVELOPMENT (EPX-100, EPX-300, AND LORCASERIN)
EPX-100 (Clemizole)
Lorcaserin (EPX-200)
EPX-300 (Trazodone)
MECHANISTICALLY NOVEL ANTISEIZURE DRUGS IN DEVELOPMENT
Blacamesine (ANAVEX 2–73)
GAO-3-02
Soticlestat (TAK 935/OV935)
SPN817
GENE THERAPY TREATMENTS FOR EPILEPSY
Gene Therapy Products for Dravet Syndrome
Gene Therapy Products to Treat SLCA13A5 Deficiency
Gene Therapy Products for Angelman Syndrome
Gene Therapy Approaches for Focal Neocortical and Temporal Lobe Epilepsy
Cell Transplantation Approaches for Treating Focal Epilepsy
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 172. CLINICAL TRIALS OF ANTISEIZURE MEDICATIONS IN ADULTS AND CHILDREN
INTRODUCTION
PHASES OF TESTING IN HUMANS
EFFICACY TRIALS
TRIAL DESIGN
Need for Blinding and Control Groups
Active Versus Placebo Comparisons
Adjunctive Versus Monotherapy Trials
Parallel Versus Crossover Designs
PATIENT ISSUES
Epilepsy Syndrome Selection
Trials for Orphan Indications
Seizure Severity
Children
DRUG ISSUES
ANALYSIS OF RESULTS: STANDARD MEASURES
Choosing an Outcome Variable
Handling Seizure Data
Intent to Treat
Other Analysis Problems
Nonstandard Outcome Measures
SAFETY TRIALS
Safety Testing During Phase II Efficacy Trials
Safety Issues in Children
ETHICAL ISSUES
Ethical Issues in Children
APPLICABILITY OF TRIAL DATA TO CLINICAL PRACTICE
Efficacy Versus Effectiveness
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 173. SEIZURE RESCUE THERAPY
INTRODUCTION
SEIZURE ACTION PLAN
RESCUE MEDICATIONS
DIAZEPAM
Rectal Diazepam
Intranasal Diazepam
Intramuscular Diazepam
Oral/Buccal Diazepam
MIDAZOLAM
Intranasal Midazolam
Buccal Midazolam
OTHER BENZODIAZEPINES
Clonazepam
Lorazepam
OTHER TREATMENTS FOR ARS
Paraldehyde
Vagus Nerve Stimulation
REFERENCES
CHAPTER 174. ADRENOCORTICOTROPIC HORMONE AND STEROIDS IN EPILEPSY
INTRODUCTION
ACTH AND STEROIDS: STRUCTURE AND CHEMISTRY
MECHANISMS OF ACTION
PHARMACOKINETICS
Adrenocorticotropic Hormone
Steroids
Neurosteroids
DRUG INTERACTIONS
SERUM LEVEL MONITORING
TREATMENT OF SPECIFIC DISORDERS
Infantile Spasms/West Syndrome
Long-Term Studies
Other Epilepsy Syndromes
NEUROSTEROIDS
ADVERSE EFFECTS
CURRENT PLACE IN THERAPY
REFERENCES
CHAPTER 175. BRIVARACETAM
INTRODUCTION
STRUCTURE
FORMULATION
MECHANISM OF ACTION
EFFICACY IN ANIMAL MODELS
METABOLISM IN HUMANS (ABSORPTION, DISTRIBUTION, ELIMINATION)
INTERACTIONS
Interactions with Other ASMs
Interactions with Other Medications
EFFICACY IN HUMAN STUDIES
Efficacy Against Photosensitivity in a Proof-of-Principle Study
Efficacy as Adjunctive Therapy in Pivotal Trials
Conversion to Monotherapy Trials
Long-Term Follow-up Studies
TOLERABILITY AND SAFETY
Tolerability in Controlled Trials and Their Open-Label Extension
Tolerability of BRV versus LEV
Time Course of BRV Treatment-Emergent Adverse Effects
BRV Cognitive and Mood Effects
BRV Teratogenicity
INTRAVENOUS FORMULATION
POSTMARKETING EXPERIENCE
Efficacy
Patients with Intellectual Disability and Patients with Psychiatric Comorbidity
Pediatric Population
Potential Role of BRV in Other Epilepsies
Status Epilepticus and Acute Seizure Exacerbations
Potential Efficacy Advantages of BRV Over LEV
SUMMARY
REFERENCES
SUGGESTED READINGS
CHAPTER 176. CANNABIDIOL AND OTHER PHYTOCANNABINOIDS IN EPILEPSY
INTRODUCTION
CENTRAL NERVOUS SYSTEM TARGETS OF CANNABIDIOL
PRECLINICAL EFFICACY DATA
EARLY CLINICAL ANECDOTES
RANDOMIZED CONTROLLED CLINICAL TRIALS IN PATIENTS WITH DRAVET SYNDROME, LENNOX–GASTAUT SYNDROME, AND TUBEROUS SCLEROSIS–RELATED EPILEPSY
Efficacy
Safety
EFFICACY IN OTHER EPILEPSIES
CLINICAL PHARMACOLOGY
DRUG–DRUG INTERACTIONS
SAFETY AND TOLERABILITY
CONCLUSIONS
REFERENCES
CHAPTER 177. CARBAMAZEPINE
INTRODUCTION
CHEMICAL STRUCTURE, FORMULATION, AND MONITORING
Chemical Structure and Synthesis
Formulations
Methods for Determination in Body Fluids
PHARMACOLOGY
Activity in Experimental Models of Seizures/Epilepsy
Mechanism of Action
CLINICAL PHARMACOKINETICS
Absorption
Plasma Protein Binding and Distribution
Metabolism and Elimination
ROLE OF THERAPEUTIC DRUG MONITORING
EFFICACY
Use in Adults
Use in Children
Use in the Elderly
Limits of Use and Risk of Selective Seizure Aggravation
ADVERSE EFFECTS
Dose-Related, Nonidiosyncratic Reactions
Idiosyncratic Reactions
SECOND-GENERATION EFFECTS
DRUG INTERACTIONS
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
Precautions
Contraindications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 178. CENOBAMATE
INTRODUCTION
CHEMICAL STRUCTURE
Formulations
PHARMACOLOGY
Mechanisms of Action
GABAA Modulation
Mechanism of Action Summary
CLINICAL PHARMACOKINETICS
Absorption, Plasma Protein Binding and Distribution, Metabolism, and Elimination
Effects of Renal and Hepatic Dysfunction
EFFICACY
Overview of Clinical Efficacy Trials in Humans
Proof-of-Principle Study
Adult with Focal Seizures
SAFETY
Dose-Related (Nonidiosyncratic) Adverse Effects
Idiosyncratic Adverse Reactions
Status Epilepticus
Teratogenicity
Suicidal Behavior and Ideation
Drug Interactions
Pharmacokinetics in Epilepsy Patients and Simulation Models of Cenobamate Monotherapy
Abuse Potential
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
Precautions
Contraindications
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 179. CLOBAZAM AND OTHER BENZODIAZEPINES FOR CHRONIC USE
INTRODUCTION
CHEMICAL STRUCTURE, FORMULATION, AND MONITORING
Chemical Structure and Synthesis
Formulations
Methods for Determination in Body Fluids
PHARMACOLOGY
Activity in Experimental Models of Seizures/Epilepsy
Mechanism of Action
CLINICAL PHARMACOKINETICS
Absorption
Plasma Protein Binding and Distribution
Metabolism and Elimination
ROLE OF THERAPEUTIC DRUG MONITORING
EFFICACY
Clobazam
Clonazepam
Clorazepate
Nitrazepam
ADVERSE EFFECTS
Dose-Related, Nonidiosyncratic Adverse Effects
Idiosyncratic Reactions
REPRODUCTIVE EFFECTS
Clobazam
Clonazepam
Clorazepate
Nitrazepam
TOLERANCE TO THE ANTISEIZURE EFFECTS
DRUG INTERACTIONS
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
Precautions
Contraindications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 180. ESLICARBAZEPINE ACETATE
INTRODUCTION
CHEMICAL STRUCTURE
MECHANISM OF ACTION
PRECLINICAL EFFICACY ASSESSMENT
PRECLINICAL TOXICOLOGY
PHARMACOKINETICS
DRUG INTERACTIONS
THERAPEUTIC MONITORING
CLINICAL EFFICACY, TOLERABILITY, AND SAFETY OF ADJUNCTIVE ESL
Randomized Controlled Studies
Open-Label Extension and Real-World Studies
Studies in Pediatric Population
CLINICAL EFFICACY, TOLERABILITY, AND SAFETY OF ESL AS MONOTHERAPY
Approved Indications in United States and European Union
Potential Nonapproved Indication
Dosing Considerations
SWITCHING FROM ESL TO CARBAMAZEPINE AND OXCARBAZEPINE
Fertility, Pregnancy, and Lactation
ELDERLY POPULATION
Contraindications, Warnings, and Precautions for Use
CONCLUSIONS
REFERENCES
CHAPTER 181. ETHOSUXIMIDE
INTRODUCTION
CHEMICAL STRUCTURE, FORMULATIONS, AND METHODS FOR DETERMINATION IN BODY FLUIDS
PHARMACOLOGY
Activity in Experimental Models of Seizures/Epilepsy
Activity in Other Models
Mechanisms of Action
CLINICAL PHARMACOKINETICS
Absorption
Plasma Protein Binding and Distribution
Metabolism and Excretion
Relationship Between Plasma Concentrations and Antiseizure Effects
EFFICACY
ADVERSE EFFECTS
Dose-Related Effects
Idiosyncratic Reactions
Teratogenicity
DRUG INTERACTIONS
INDICATIONS
DOSING RECOMMENDATIONS
PRECAUTIONS
CONTRAINDICATIONS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 182. EVEROLIMUS IN EPILEPSY
INTRODUCTION
CHEMICAL STRUCTURE
MECHANISM OF ACTION
PRECLINICAL EFFICACY ASSESSMENT
PRECLINICAL TOXICITY
CLINICAL EFFICACY
POTENTIAL NONAPPROVED INDICATIONS
TOXICITY
DOSE-RELATED SIDE EFFECTS
IDIOSYNCRATIC SIDE EFFECTS
LONG-TERM SIDE EFFECTS
SPECIFIC PEDIATRIC TOXICITY
SEIZURE AGGRAVATION
CONTRAINDICATIONS
PHARMACODYNAMICS/PHARMACOKINETICS/DRUG INTERACTIONS
THERAPEUTIC MONITORING
LABORATORY TEST MONITORING
THE MANAGEMENT OF ADVERSE EVENTS
CONCLUSIONS
REFERENCES
CHAPTER 183. FELBAMATE
INTRODUCTION
CHEMICAL STRUCTURE
Methods for Determination in Body Fluids
PHARMACOLOGY
Activity in Experimental Models of Seizures/Epilepsy
Mechanisms of Action
Activity in Other Models
Toxicity Models
CLINICAL PHARMACOKINETICS
Formulations
Absorption
Plasma Protein Binding and Distribution
Metabolism and Elimination
Drug Interactions
Relationship Between Plasma Concentration and Effects: Value of Therapeutic Drug Monitoring
ADVERSE EFFECTS
Dose-Related Effects
Idiosyncratic
Teratogenic Effects
Effects Related to Drug Interactions
EFFICACY
Localization-Related Epilepsies
Generalized Epilepsies
Activity in Other Indications
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
Precautions and Contraindications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 184. FENFLURAMINE
INTRODUCTION
CHEMICAL STRUCTURE AND METHODS FOR DETERMINATION IN BODY FLUIDS
MECHANISM OF ACTION
PRECLINICAL EFFICACY ASSESSMENT
PHARMACOKINETICS/DRUG INTERACTIONS
Absorption
Plasma Protein Binding and Distribution
Metabolism
Elimination
Pharmacokinetics in Special Populations
DRUG INTERACTIONS
Stiripentol, Clobazam, and Valproate
Cannabidiol
CLINICAL EFFICACY
Efficacy in Dravet Syndrome
History and Initial Observations
Phase 3 Randomized, Double-Blind Placebo-Controlled Trials
Potential Nonapproved Indications
DOSING CONSIDERATIONS
TOXICITY
Dose-Related Side Effects
Long-Term Side Effects
CONTRAINDICATIONS
SUMMARY AND CONCLUSION
REFERENCES
CHAPTER 185. IMMUNOTHERAPY IN EPILEPSY
INTRODUCTION
THE IMMUNE SYSTEM AND EPILEPSY
IMMUNOLOGIC ALTERATIONS AND BIOMARKERS OF THE EPILEPSIES
THE USE OF IMMUNOTHERAPY IN HUMAN EPILEPSIES
Immunomodulatory Treatments
Immunosuppressive Treatments
SPECIFIC EPILEPTIC DISORDERS TREATED WITH IMMUNOTHERAPY
West Syndrome
Lennox–Gastaut Syndrome
Landau–Kleffner Syndrome
Rasmussen Encephalitis
Tuberous Sclerosis Complex
Autoimmune Encephalopathies
THE USE OF IMMUNOTHERAPY IN STATUS EPILEPTICUS
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 186. LACOSAMIDE
INTRODUCTION
CHEMICAL STRUCTURE, FORMULATIONS, AND METHODS FOR DETERMINATION IN BODY FLUIDS
PHARMACOLOGY
Seizure Models
Pain Models
Mechanisms of Action
CLINICAL PHARMACOKINETICS
CLINICAL EFFICACY
Focal Seizures
Primary Generalized Tonic–Clonic Seizures
Drug Interactions
HOW TO USE LACOSAMIDE
CLINICAL SAFETY
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 187. LAMOTRIGINE
INTRODUCTION
CHEMICAL STRUCTURE
MECHANISM OF ACTION
PRECLINICAL SEIZURE MODELS
CLINICAL PHARMACOKINETICS
THERAPEUTIC MONITORING
PHARMACOKINETIC INTERACTIONS
CLINICAL EFFICACY
ADJUNCTIVE TREATMENT OF FOCAL SEIZURES
Conversion to Monotherapy
Conversion to Extended-Release Lamotrigine
MONOTHERAPY IN NEWLY DIAGNOSED PATIENTS
Lamotrigine Versus Phenytoin (In Focal and Generalized Tonic–Clonic Seizures)
Lamotrigine versus Pregabalin (In Focal Seizures)
Comparison with Carbamazepine, Oxcarbazepine, Topiramate, and Gabapentin (in Focal Seizures)
Lamotrigine versus Gabapentin (Focal and Generalized Seizures)
Lamotrigine versus Levetiracetam (Focal and Generalized Epilepsy)
EVIDENCE IN OLDER ADULTS
Lamotrigine versus Sustained-Release Carbamazepine
Lamotrigine versus Other ASMs in Older Individuals
EVIDENCE IN CHILDREN WITH FOCAL SEIZURES
Lamotrigine versus Oxcarbazepine
EVIDENCE IN IDIOPATHIC GENERALIZED EPILEPSY
CHILDHOOD ABSENCE EPILEPSY
Comparison with Valproate and Topiramate (in Generalized and Unclassifiable Epilepsy)
LENNOX–GASTAUT SYNDROME
INDICATIONS OTHER THAN EPILEPSY
ADVERSE EFFECTS
Toxicity in Children
Dose Related Nonidiosyncratic Adverse Effects
Idiosyncratic Reactions
ADDITIONAL SAFETY ISSUES
Use in Pregnancy
Aggravation of Seizures
DOSING RECOMMENDATIONS
PRECAUTIONS
Cardiac Concerns
CONCLUSIONS
REFERENCES
CHAPTER 188. LEVETIRACETAM
INTRODUCTION
PHARMACOLOGY
CLINICAL PHARMACOKINETICS
Absorption
Plasma Protein Binding and Distribution
Metabolism and Elimination
Therapeutic Drug Monitoring
Intravenous Formulation
EFFICACY
Efficacy as Adjunctive Treatment in Focal Seizures
Efficacy as Monotherapy
Efficacy in Generalized Seizures
Efficacy in Pediatric Epilepsy
Efficacy in the Elderly
Efficacy in Status Epilepticus
Efficacy in Nonepilepsy Indications
ADVERSE EFFECTS
Pregnancy and Lactation
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
Available Formulations
Precautions
Contraindications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 189. OXCARBAZEPINE
INTRODUCTION
MECHANISM OF ACTION
REGULATORY STATUS
Human Monotherapy Trials
Adjunctive Therapy Trials
Double-Blind Randomized Placebo-Controlled Trials
Extended-Release Oxcarbazepine
ADVERSE EVENTS
Dose-Related Side Effects
Idiosyncratic Side Effects
CLINICAL PHARMACOKINETICS
Drug Interactions
Teratogenicity
DOSING
Use in Pregnancy
THERAPEUTIC MONITORING
SUMMARY
REFERENCES
CHAPTER 190. PERAMPANEL
INTRODUCTION
CHEMICAL STRUCTURE
MECHANISM OF ACTION
PRECLINICAL EFFICACY ASSESSMENT
PHARMACOKINETIC PROPERTIES
RENAL AND HEPATIC IMPAIRMENT
DRUG–DRUG INTERACTION
Effect of Coadministered Drugs on PER
Effect of PER on Coadministered Drugs
CLINICAL EFFICACY
Approved Indications in the United States and the European Union
Randomized Control Trials
Open-Label Extension Studies
Monotherapy
Pediatrics and Adolescents
Other Populations without Regulatory Approval
DOSAGE INFORMATION
TOXICITY
Dose-Related Side Effects
Most Relevant Adverse Events
Idiosyncratic Side Effects
Long-Term Side Effects
Teratogenicity
Specific Pediatric and Adolescent Toxicity
Seizure Aggravation
THERAPEUTIC DRUG MONITORING
CONCLUSION
REFERENCES
CHAPTER 191. PHENOBARBITAL AND BARBITURATE PRODRUGS
INTRODUCTION
CHEMISTRY, FORMULATIONS, ASSAY
Chemistry
Formulations
Assay
PHARMACOLOGY
Seizure Models
Mechanism of Action
CLINICAL PHARMACOLOGY
Absorption
Distribution
Metabolism
Elimination
Concentration–Effect Relationships
EFFICACY
ADVERSE EFFECTS
Dose-Related Effects
Idiosyncratic Reactions
Second-Generation Effects
DRUG INTERACTIONS
Effects of Phenobarbital on Other Drugs
Effects of Other Drugs and Therapies on Phenobarbital
Effects of Other Drugs on Primidone
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
Precautions
Contraindications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 192. PHENYTOIN, FOSPHENYTOIN, AND OTHER HYDANTOINS
INTRODUCTION
PHENYTOIN
Chemistry
Pharmacology
Clinical Pharmacokinetics
Efficacy
Adverse Effects
Drug Interactions
Indications
Dosing Recommendations
Loading Dose
FOSPHENYTOIN
Chemistry
Pharmacology
Clinical Pharmacokinetics
Efficacy
Adverse Effects
Role in Epilepsy Treatment
ETHOTOIN
Chemistry
Pharmacology
Clinical Pharmacokinetics
Efficacy
Adverse Effects
Role in Epilepsy Treatment
MEPHENYTOIN
Chemistry
Pharmacology
Clinical Pharmacokinetics
Efficacy
Adverse Effects
Drug Interactions
Role in Epilepsy Treatment
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 193. PREGABALIN
INTRODUCTION
CHEMICAL STRUCTURE, FORMULATIONS, AND METHODS FOR DETERMINATION IN BODY FLUIDS
PHARMACOLOGY
Mechanism of Action
Activity in Experimental Models of Epilepsy
CLINICAL PHARMACOKINETICS/PHARMACODYNAMICS
Adults
Pediatrics
EFFICACY
Adults
Pediatrics
ADVERSE EFFECTS
Dose-Related, Nonidiosyncratic Adverse Effects
Weight Gain
Idiosyncratic Reactions
Teratogenicity
Carcinogenicity
Controlled Substance Classification
Overdosage
DRUG INTERACTIONS
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
Effects on Mood
Cognitive Function
Precautions and Contraindications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 194. RETIGABINE/EZOGABINE
INTRODUCTION
CHEMICAL STRUCTURE OF RTG
MECHANISM OF ACTION
PRECLINICAL EFFICACY ASSESSMENT
Animal Models
Preclinical Toxicology
CLINICAL EFFICACY
Phase I Studies and Clinical Pharmacology
Phase II Studies
Phase III Studies
Long-Term Open-Label Extension Trials
RENAL IMPAIRMENT
LIVER IMPAIRMENT
APPROVED INDICATIONS: US AND EUROPE
Potential Nonapproved Indications
DOSING CONSIDERATIONS
Tolerability
PHARMACOKINETICS
Sex and Age
INTERACTIONS
With Other Anticonvulsants
With Other Medications
Ethanol
CONCLUSIONS
REFERENCES
CHAPTER 195. RUFINAMIDE
INTRODUCTION
CHEMISTRY
PHARMACOLOGY
Activity in Experimental Models of Seizures/Epilepsy
MECHANISM OF ACTION
CLINICAL PHARMACOKINETICS
Absorption
Plasma Protein Binding and Distribution
Metabolism and Elimination
Influence of Age on Pharmacokinetics
Influence of Sex on Pharmacokinetics
Influence of Renal Impairment on Pharmacokinetics
Pharmacokinetics in Epilepsy Patients
EFFICACY
Proof-of-Principle Study
Overview of Clinical Efficacy Trials in Humans
Adults with Focal-Onset Seizures: Adjunctive Therapy
Children with Focal-Onset Seizures: Adjunctive Therapy
Adults with Focal-Onset Seizures: Monotherapy
Adults with Primary Generalized Tonic–Clonic Seizures
Lennox–Gastaut Syndrome
Specific Epileptic Seizures or Syndromes
ADVERSE EVENTS
Dose-Related, Nonidiosyncratic Adverse Effects
Idiosyncratic Reactions
Status Epilepticus
Pregnancy and Teratogenicity
DRUG INTERACTIONS
DOSING RECOMMENDATIONS
Precautions
Contraindications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 196. STIRIPENTOL
INTRODUCTION
CHEMICAL CONSIDERATIONS
Chemical Structure
Formulations
MECHANISMS OF ACTION
GABAergic Mechanism
Inhibition of Lactate Dehydrogenase
Neuroprotection
ACTIVITY IN EXPERIMENTAL MODELS
CLINICAL EFFICACY
RCTs in Dravet Syndrome
Long-Term Studies in Dravet Syndrome
Studies in Adults With Dravet Syndrome
APPROVED INDICATION
POTENTIAL NONAPPROVED INDICATIONS
Drug-Resistant Focal Epilepsy
Super-Refractory Status Epilepticus
PCDH19
Malignant Migrating Partial Seizures in Infancy
SAFETY IN DRAVET SYNDROME
CLINICAL PHARMACOKINETICS
DRUG INTERACTIONS AND DOSES OF COMEDICATIONS
Interactions With the ASMs Used in Dravet Syndrome
Interactions With other ASMs
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
Therapeutic Monitoring
Precautions and Contraindications
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 197. TIAGABINE
INTRODUCTION
Mechanism of Action
EXPERIMENTAL STUDIES
PHARMACOKINETICS
CLINICAL EFFICACY
Evidence From Randomized Controlled Trials
Evidence From Other Studies
Efficacy as Monotherapy
Efficacy in Pediatric Patients
CLINICAL SAFETY
ROLE IN EPILEPSY TREATMENT
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 198. TOPIRAMATE
INTRODUCTION
CHEMISTRY
PHARMACOLOGY
Activity in Experimental Models of Seizures/Epilepsy
Mechanisms of Action
CLINICAL PHARMACOKINETICS
Absorption
Distribution and Binding
Metabolism and Elimination
Serum Concentrations
EFFICACY IN ADULTS AND CHILDREN
Focal-Onset Seizures in Adults: Adjunctive Therapy
Focal-Onset Seizures in Children: Adjunctive Therapy
Focal- and Generalized-Onset Seizures: Monotherapy
Generalized Tonic–Clonic Seizures of Nonfocal Origin
Lennox–Gastaut Syndrome
Infantile Spasms (West Syndrome)
Severe Myoclonic Epilepsy of Infancy (Dravet Syndrome)
Other Epilepsy Syndromes
Long-Term and Open-Label Treatment
Use in Refractory Status Epilepticus
COMORBIDITIES
ADVERSE EFFECTS
Dose-Related Adverse Effects
Non–Dose-Related Adverse Effects
DRUG INTERACTIONS
Effects of TPM on Other Drugs
Effects of Other Drugs on TPM
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
Precautions
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 199. TRIMETHADIONE, PARALDEHYDE, PHENACEMIDE, BROMIDES, SULTHIAME, ACETAZOLAMIDE, AND METHSUXIMIDE
INTRODUCTION
TRIMETHADIONE
Structure and Chemistry
Basic Mechanism of Action
Pharmacologic Fundamentals
Adverse Effects
Drug Interactions
The Role of the Drug
How to Use the Drug
PARALDEHYDE
Structure and Chemistry
Basic Mechanism of Action
Pharmacologic Fundamentals
Adverse Effects
Overdosage
Side Effects
Role of the Drug
Alcohol Withdrawal Syndrome and Delirium Tremens
Other Indications
How to Use the Drug
PHENACEMIDE
Structure and Chemistry
Basic Mechanism of Action
Pharmacologic Fundamentals
Adverse Effects
Teratogenicity
The Role of the Drug
How to Use the Drug
BROMIDES
Structure and Chemistry
Mechanism of Action
Pharmacologic Fundamentals
Adverse Effects
Drug Interactions
The Role of the Drug
How to Use the Drug
SULTHIAME
Structure and Chemistry
Mechanism of Action
Pharmacologic Fundamentals
Adverse Effects
Drug Interactions
The Role of the Drug
How to Use the Drug
ACETAZOLAMIDE
Structure and Chemistry
Basic Mechanism of Action
Pharmacologic Fundamentals
Adverse Effects
The Role of the Drug
How to Use the Drug
METHSUXIMIDE
Structure
Basic Mechanism of Action
Pharmacologic Fundamentals
Adverse Effects
Role of the Drug
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 200. VALPROIC ACID
INTRODUCTION
CHEMICAL STRUCTURE AND FORMULATIONS
PHARMACOLOGY
Activity in Experimental Models and Mechanisms of Action
Clinical Pharmacokinetics/Pharmacodynamics
EFFICACY
Idiopathic Generalized and Unclassifiable Epilepsy
Absence Seizures
Juvenile Myoclonic Epilepsy
Focal-Onset Seizures and Bilateral Tonic–Clonic Seizures
Developmental and Epileptic Encephalopathies
Febrile Seizures
Status Epilepticus
ADVERSE EFFECTS
Neurologic
Gastrointestinal
Reproductive
Hematologic
Other Side Effects
Teratogenicity and Neurodevelopmental Effects
DRUG INTERACTIONS
Effects of Valproate on Other Drugs
Effects of Other Drugs on VPA
ROLE IN EPILEPSY TREATMENT
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 201. VIGABATRIN
INTRODUCTION
CHEMICAL CONSIDERATIONS AND MECHANISMS OF ACTION
Chemical Characteristics
Formulations
ACTIVITY IN EXPERIMENTAL MODELS OF SEIZURES/EPILEPSY
Mechanisms of Action
CLINICAL PHARMACOKINETICS
Methods of Determination in Body Fluids
Absorption
Plasma Protein Binding and Distribution
Metabolism and Elimination
Drug Interactions
EFFICACY IN ADULTS
Adjunctive Therapy
Long-Term Efficacy
Monotherapy
EFFICACY IN CHILDREN
Focal Seizures
Other Seizure Types (Excluding Spasms)
Infantile Spasms
ADVERSE EFFECTS
Visual Field Defects
Psychiatric Adverse Effects
Intramyelinic Edema and Brain MRI Abnormalities
Other Dose-Related, Nonidiosyncratic Reactions
Idiosyncratic Reactions
Teratogenic Effects
ROLE IN EPILEPSY TREATMENT
Indications
Dosing Recommendations
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 202. ZONISAMIDE
INTRODUCTION
STRUCTURE AND CHEMISTRY
MECHANISMS OF ACTION
PHARMACOLOGIC FUNDAMENTALS
Absorption and Routes of Administration
Distribution and Protein Binding
Metabolism
Elimination
DRUG INTERACTIONS
CLINICAL INDICATIONS
Indications
Zonisamide Monotherapy
Standard and New Antiepileptic Drugs (SANAD) II Study
Pediatric Population
ADVERSE EFFECTS
Dose-Related Adverse Effects
Idiosyncratic
Teratogenicity
LICENSING INFORMATION
CONTRAINDICATIONS
HOW TO USE THE DRUG
Dosage Formulations and Strengths
Starting Doses
Maintenance Doses, Dosing Frequency, and Maximum Dose
Discontinuing the Drug
SUMMARY AND CONCLUSIONS
REFERENCES
VOLUME III
SECTION 9 • Surgical Therapy for Epilepsy
CHAPTER 203. OVERVIEW: SURGICAL THERAPY FOR EPILEPSY
INTRODUCTION
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 204. A BRIEF HISTORY OF EPILEPSY SURGERY
INTRODUCTION
THE FIRST SURGERIES
LOCALIZATION OF FUNCTION
LESION-DIRECTED SURGERY
THE ROLE OF EEG
TEMPORAL LOBE RESECTIONS
INVASIVE RECORDING
NEUROIMAGING
BEHAVIOR
THE PALM DESERT CONFERENCES
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 205. INDICATIONS AND CRITERIA FOR EPILEPSY SURGERY IN CHILDREN
INTRODUCTION
Demographics: Epilepsy Surgery Unmet Need
The Range of Candidacy in Children
Criteria for Referral for Presurgical Evaluation and for Epilepsy Surgery
Noninvasive Overview: Concordance
Invasive Overview
ELECTROENCEPHALOGRAM
Semiology
Scalp EEG
Ictal Video EEG
Interictal Video EEG
NEUROIMAGING
Structural MRI
Functional MRI (in Older Children)
Diffusion-Weighted MRI
Nuclear Imaging
MAGNETOENCEPHALOGRAPHY
NEUROPSYCHOLOGICAL EVALUATION
NEUROPSYCHIATRIC ASSESSMENT
INVASIVE EEG MONITORING
Grids and Strips
Stereoelectroencephalography
PERIOPERATIVE ELECTRICAL STIMULATION
RADIOFREQUENCY THERMOCOAGULATION
CONCLUSION
REFERENCES
CHAPTER 206. INDICATIONS AND CRITERIA FOR EPILEPSY SURGERY IN ADULTS
INTRODUCTION
WHO IS A CANDIDATE FOR EPILEPSY SURGERY?
RATIONALE FOR SURGICAL INTERVENTION
CRITERIA FOR SURGICAL CANDIDACY
Medication-Resistant Seizures
Identification of a Surgically Remediable Focal Epilepsy
Loss of Quality of Life
ROLE OF EARLY INTERVENTION
GOALS OF SURGERY
TYPES OF SURGICAL TREATMENT
Mesial Temporal Lobe Epilepsy
Lesional Neocortical Epilepsy
“Nonlesional” Neocortical Epilepsy
Hemispheric Epilepsy Syndromes
Generalized Epilepsies
CONTRAINDICATIONS TO EPILEPSY SURGERY
COST-EFFECTIVENESS AS A CRITERION FOR SURGERY
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 207. PATTERNS OF EPILEPSY SURGERY REFERRALS AND EPILEPSY SURGICAL CENTER CHARACTERISTICS
PATTERNS OF REFERRAL
HISTORY OF EPILEPSY CENTERS
MODERN EPILEPSY CENTERS
WORLDWIDE EPILEPSY SURGERY CENTERS AND PEDIATRIC CONSIDERATIONS
REFERENCES
CHAPTER 208. PRESURGICAL EVALUATION FOR EPILEPSY: GENERAL PRINCIPLES AND METHODS
INTRODUCTION
TIMING OF REFERRAL FOR PRESURGICAL EVALUATION
GOALS AND TYPES OF SURGICAL CONSIDERATIONS
THE CONCEPTUAL APPROACH TO DEFINING EPILEPTOGENESIS
Epileptogenic Zone
Irritative Zone
Ictal-Onset Zone
Epileptogenic Lesion
Functional Deficit Zone
Symptomatogenic Zone
OVERVIEW OF PRESURGICAL METHODS
Noninvasive Investigation
Invasive Tests
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 209. INTRAOPERATIVE ELECTROCORTICOGRAPHY IN EPILEPSY
INTRODUCTION
INDICATIONS
Identification of the Epileptogenic Zone
Functional Mapping
TECHNIQUE
Electrodes and Instrumentation
Recording and Electrical Stimulation
Activation and Effects of Anesthesia
Interpretation
High Frequency Oscillations on Electrocorticography
Electrocorticography in Cortical Disconnection Surgeries
ADVANTAGES AND LIMITATIONS OF INTRAOPERATIVE ELECTROCORTICOGRAPHY
Advantages
Limitations
COMPLICATIONS
FUTURE DIRECTIONS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 210. INTRAOPERATIVE FUNCTIONAL MAPPING IN EPILEPSY
INTRODUCTION
INDICATIONS
TECHNIQUE36,40,41
COMPARISON TO OTHER APPROACHES
FUNCTIONAL MAGNETIC RESONANCE IMAGING AND ELECTRICAL STIMULATION MAPPING
FUTURE DIRECTIONS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 211. EXTRAOPERATIVE PROCEDURES WITH INVASIVE ELECTRODES IN EPILEPSY
INTRODUCTION
INDICATIONS FOR INTRACRANIAL ELECTRODES
DEPTH ELECTRODES
Construction
Insertion
Recording
Risks
Interpretation
Advantages and Limitations
Yield and Accuracy
Cost
SUBDURAL ELECTRODE STRIPS
Construction
Insertion
Recording
Risks
Interpretation
Advantages and Limitations
Yield and Accuracy
Costs
SUBDURAL GRIDS
Construction
Insertion
Recording
Risks
Interpretation
Advantages and Limitations
Yield and Accuracy
Costs
COMBINED STUDIES
SPECIAL CONSIDERATIONS IN INFANTS AND YOUNG CHILDREN
Indications
Surgical Aspects
Nursing Aspects
Interpretive Aspects
COMPARATIVE ASSESSMENTS
Depth/SEEG Versus Subdural Strip Electrodes
Depth/SEEG or Subdural Strips Versus Grids
Depth/SEEG or Subdural Strip Versus Scalp Electrodes
Depth/SEEG or Subdural Electrodes Versus Pegs
Depth/SEEG or Subdural Electrodes Versus Foramen Ovale Electrodes
Chronic Depth/SEEG or Subdural Electrodes Versus Electrocorticography
Grid Versus Scalp
SYNTHESIS
General Indications
Distinctions Among Techniques
Techniques for Specific Situations
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 212. INTRA-ARTERIAL ANESTHETIC PROCEDURES IN EPILEPSY
INTRODUCTION
INDICATIONS
Language
Memory
TECHNIQUES
Testing Paradigms
Selective Procedures
Surveys on IAP
Alternative Techniques
Alternative Drugs
INTERPRETATION
Implications
APPLICATION TO CHILDREN
Language
Memory
ADVANTAGES
LIMITATIONS
COMPLICATIONS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 213. EEG BIOMARKERS OF EPILEPTOGENIC REGION
INTRODUCTION
EEG SIGNAL ANALYSIS AND BIOMARKERS
PITFALLS OF SIGNAL ANALYSIS
High-Frequency Artifacts in Surface EEG
NONINVASIVE BIOMARKERS OF THE EPILEPTIC ZONE
Interictal and Ictal Activity
High-Frequency Oscillations
Nonepileptiform HFOs in the EEG
Other scalp biomarkers in surface EEG
Source Modeling: From Surface into the Deep
COMBINING NONINVASIVE METHODS
Combined EEG-fMRI
Combined TMS-EEG
OUTLOOK AND CONCLUSION
ACKNOWLEDGMENT
REFERENCES
CHAPTER 214. INVASIVE MONITORING RESEARCH TECHNIQUES IN EPILEPSY
INTRODUCTION
RESEARCH IN EPILEPSY SURGERY PATIENTS
INVASIVE ELECTROPHYSIOLOGY SIGNALS
TYPES OF RESEARCH DEVICES APPROVED FOR HUMAN USE
Informed Consent and Ethical Considerations of Invasive Implants
Behnke–Fried Hybrid Depth Arrays
Microdialysis Probes
Utah Intracortical Electrode Array
“All-in-One” Macro- and Microelectrode Arrays
EXPERIMENTAL DEVICES
Laminar Multielectrode Arrays
Flexible Biofilm Dense Arrays
RESEARCH UTILIZING ELECTROCORTICAL STIMULATION
MICROELECTRODE DATA ACQUISITION
Data Acquisition Systems for Combined Clinical and Research Purposes
Recording Methods
Recording Environment
Maintenance of Microelectrode Recordings
Data Storage and Access
Personnel Considerations
RESEARCH USE OF CHRONICALLY IMPLANTED CLINICAL DEVICES
CONCLUSIONS
REFERENCES
CHAPTER 215. ANESTHESIA FOR EPILEPSY SURGERY
INTRODUCTION
PREANESTHESIA EVALUATION AND PREPARATION
ANESTHESIA MANAGEMENT IN PATIENTS WITH MEDICALLY REFRACTORY EPILEPSY
ELECTROCORTICOGRAPHY AND PHARMACOACTIVATION
ANESTHESIA CARE FOR PROCEDURES FOR THE INVESTIGATION OF SEIZURES
ANESTHESIA FOR SURGICAL PROCEDURES FOR THE TREATMENT OF EPILEPSY: RESECTION AND ABLATION
ANESTHESIA FOR SURGICAL PROCEDURES FOR THE TREATMENT OF EPILEPSY: DISCONNECTION
ANESTHESIA FOR SURGICAL PROCEDURES FOR THE TREATMENT OF EPILEPSY: NEUROMODULATION
SUMMARY
REFERENCES
CHAPTER 216. ANTERIOR MEDIAL TEMPORAL RESECTION FOR EPILEPSY
INTRODUCTION
Historical Perspective
Early Role of Pathology
Impact of Early Electrophysiology Studies
Impact of Neuroimaging
Frequency of Use
INDICATIONS
Principal Candidates
Evaluation Criteria
Novel Approaches to Surgical Planning Using Epilepsy Network Theory
Goals of Surgery
SURGICAL APPROACHES
Medial Temporal Lobe Epilepsy
Lesional Temporal Lobe Epilepsy: Developmental Abnormalities, Neoplasms, Vascular Anomalies, and Encephaloceles
Cryptogenic Temporal Lobe Epilepsy: No Image Substrate
NEUROMODULATION AS AN ALTERNATIVE TO RESECTION
Responsive Neurostimulation
Deep Brain Stimulation for MTLE
OUTCOME AND PREDICTORS OF SUCCESS
Success
Surgical Failures and Their Pathoetiology
Neuropsychological and Neurologic Sequelae
Surgical Complications
Transient Deficits
Permanent Deficits
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 217. NEOCORTICAL RESECTIONS FOR EPILEPSY
INTRODUCTION
GENERAL PRINCIPLES
Epileptogenic Zone Definition
Noninvasive Presurgical Workup
Invasive Presurgical Workup
Specifics for Children
SURGICAL TREATMENT
Presurgical Planning
Eloquent Cortex
Anesthetic Considerations
Surgical Technique
Resection
Disconnection
Minimally Invasive Ablations
Frontal Lobe Surgery
Posterior Quadrant Surgery
Temporal Neocortical Surgery
Surgical Technique
POSTOPERATIVE CONDUCT
RESULTS
PATHOLOGY
COMPLICATIONS
OUTCOME ON SEIZURES
CONCLUSION
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 218. INSULAR RESECTIONS FOR EPILEPSY
HISTORICAL BACKGROUND
INSULAR EPILEPSY SURGERY: IN WHICH CASES?
INSULAR EPILEPSY SURGERY: HOW CAN IT BE DONE?
INSULAR EPILEPSY SURGERY: WHAT RESULT CAN BE EXPECTED?
CONCLUSIONS AND PERSPECTIVES
REFERENCES
CHAPTER 219. HEMISPHERECTOMY/HEMISPHEROTOMY AND MULTILOBAR RESECTIONS/DISCONNECTIONS FOR EPILEPSY
INTRODUCTION
HEMISPHERECTOMY/HEMISPHEROTOMY
Historical Perspective
Pathology
Role of Functional Localization
Electrophysiologic Studies
Neuroimaging
Indications
Seizure Semiology
Neurologic Examination
Language and Motor Function Evaluation
Electroencephalography and Imaging Findings
Etiology, Natural History, and Timing of Surgery
Goals of Surgery
Surgical Approaches
Endoscopic Hemispherotomy
Robotic Thermocoagulative Hemispherotomy
Outcomes and Complications of Hemispherotomy
MULTILOBAR RESECTIONS AND DISCONNECTIONS
Introduction
Underlying Pathologies
Presurgical Evaluation
Structural and Functional Imaging
Surgery
Multilobar Resection for Epilepsy: Published Series
Surgical Outcomes
Complications
CONCLUSIONS
REFERENCES
CHAPTER 220. ELOQUENT CORTEX SURGERY FOR EPILEPSY
INTRODUCTION
NEUROANATOMY OF THE ELOQUENT CORTEX
Motor Cortex
Somatosensory Cortex
Secondary Cortices and Areas
SEIZURE DISORDERS INVOLVING THE EC
Benign Childhood Epilepsy With Centrotemporal Spikes
Malignant Rolandic-Sylvian Epilepsy
MANAGEMENT PARADIGM
NONINVASIVE MAPPING
Functional MRI
Diffusion Tensor Imaging
Magnetoencephalography
Transcranial Magnetic Stimulation
INVASIVE MAPPING
Intraoperative Electrocorticography
Extraoperative Electrical Stimulation
Awake Craniotomy With Direct Cortical Stimulation
SURGICAL OPTIONS
Focal Resection
Multiple Subpial Transections
Neuromodulation
FUTURE DIRECTIONS
REFERENCES
CHAPTER 221. CORPUS CALLOSOTOMY FOR EPILEPSY
INTRODUCTION
HISTORY
RATIONALE FOR ANTISEIZURE EFFECTS
INDICATIONS
Seizure Type
EEGs
Epilepsy Syndrome
Pathology and Other Factors
SURGICAL ISSUES
Extent of Callosal Section
Surgical Techniques
OUTCOMES
Drop Attacks
Other Seizures
Epilepsy Syndrome
Cognitive and Behavioral Changes
Comparison with VNS
ADVERSE EFFECT AND COMPLICATIONS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 222. ELECTRICAL STIMULATION TREATMENTS FOR EPILEPSY
VAGUS NERVE STIMULATION
Relevant Anatomy
Mechanisms of Action
Short-Term Efficacy
Long-Term Efficacy
Efficacy in Other Seizure Types and in Children
Effects on Other Comorbid Conditions
Safety and Tolerability of Vagus Nerve Stimulation in Patients with Epilepsy
Clinical Use
Summary and Conclusions
DEEP BRAIN STIMULATION
Rationale
Electrode Placement
Seizure Reduction
Adverse Effects
Ancillary Observations
RESPONSIVE NEUROSTIMULATION
Description of Stimulator System
Seizure Outcomes
Neuropsychologic and Quality-of-Life Outcomes
Effect on Sudden Unexplained Death in Epilepsy Incidence
Clinical and Scientific Insights from Chronic Ambulatory Intracranial EEG
REFERENCES
CHAPTER 223. ABLATIVE PROCEDURES FOR EPILEPSY: LASER ABLATION, STEREOTACTIC RADIOSURGERY, AND RADIOFREQUENCY ABLATION
THE RISE OF ABLATIVE PROCEDURES IN EPILEPSY SURGERY
MR-GUIDED LITT
Outcomes: General Considerations
MRg-LITT Surgical Approach and Target in MTLE
Extratemporal Lobe Epilepsy
LITT for Specific Pathologic Lesions
MRg-LITT for Disconnection Surgery: Laser Callosotomy and Hemispherotomy
STEREOTACTIC RADIOSURGERY
RADIOFREQUENCY ABLATION
Stereotactic Radiofrequency Amygdalohippocampotomy
Hypothalamic Hamartomas
RFA Through SEEG Electrodes for Malformations of Cortical Development and Other Lesions
CONCLUSIONS
REFERENCES
CHAPTER 224. EPILEPSY SURGERY FOR LOW-GRADE EPILEPSY ASSOCIATED TUMORS
INTRODUCTION
NEUROPATHOLOGIC CLASSIFICATION OF LEAT
Molecular Neuropathology
Histopathologic Classification
MRI IN LEAT
Glioneuronal Tumors
Glial Tumors
Lesion Localization
Differential Diagnosis
Follow-up Evaluation
EPILEPTOGENICITY IN LEAT
MEDICAL TREATMENT IN LEAT
SURGICAL TREATMENT IN LEAT
Malignant progression in LEAT
Tumor Surgery versus Epilepsy Surgery
Lesionectomy Versus Tailored Resection
CONCLUSION
REFERENCES
CHAPTER 225. EPILEPSY SURGERY FOR MALFORMATIONS OF CORTICAL DEVELOPMENT
INTRODUCTION
CLASS I
Focal Cortical Dysplasia Type II
Hemimegalencephaly
Cortical Dysplasias with Abnormal Cells
Tuberous Sclerosis Complex
CLASS II: PERIVENTRICULAR NODULAR HETEROTOPIA
CLASS III
Focal Cortical Dysplasia Type I
Focal Cortical Dysplasia Type III
Polymicrogyria
Mild Malformations of Cortical Development
OVERARCHING CONTROVERSIES
Outcome Assessment
Timing of Presurgical Assessment
Reoperation
The Network Perspective
Underutilization and Inequity of Access to Epilepsy Surgery
REFERENCES
CHAPTER 226. EPILEPSY SURGERY FOR VASCULAR LESIONS
INTRODUCTION
CEREBRAL CAVERNOUS HEMANGIOMA AND EPILEPSY
Epidemiology, Natural History, Pathophysiology, and Genetics
Concepts and Definition of Cavernoma-Related Epilepsy
Risk factors for CRE in patients with CCMs
Presurgical Evaluation
Surgical Techniques
Postsurgical Seizure Outcome and Its Predictors
Conclusions
AVMS AND EPILEPSY
Epidemiology, Natural History, Management
Clinical Presentation
Diagnostic Evaluation
Treatment Approaches
Conclusions
STURGE–WEBER SYNDROME AND EPILEPSY
Epidemiology, Natural History, and Genetics
Clinical Presentation
Diagnostic Evaluation
Medical and Surgical Treatment
CONCLUSIONS
REFERENCES
CHAPTER 227. RESULTS OF SURGERY FOR POSTTRAUMATIC EPILEPSY
INTRODUCTION
RISK FACTORS
Severity
Mechanism of Injury
Age Dependent: Pediatric and Elderly
Location of Injury
Comorbidities
Early Posttraumatic Seizure
Family History
Genetic Predisposition
PATHOPHYSIOLOGY
DIAGNOSIS
History
Examination
Metabolic Parameters
Imaging and Biomarkers
EEG and Biomarkers
ROLE OF ANTISEIZURE MEDICATIONS
Duration of ASM Usage
Choice of ASM
Other Therapies
ROLE OF SURGERY
Presurgical Work-up
Resective Surgery
Neuromodulation
CASE SERIES
ILLUSTRATIVE CASES
Case 1
Case 2
NEW AREAS OF RESEARCH
CONCLUSION
KEY POINTS
REFERENCES
CHAPTER 228. RESULTS OF EPILEPSY SURGERY IN PATIENTS WITH NON-LESIONAL MRI
MRI-NEGATIVE OR NON-LESIONAL EPILEPSY?
MRI is the Driving Force in Epilepsy Surgery
What Does “MRI-Negative” Mean?
N-MRI Epilepsy: Lesional Versus Genetic Epilepsy
HOW TO PROCEED IN N-MRI EPILEPSY SURGERY CANDIDATES
Presurgical Evaluation in N-MRI Epilepsies
Role of Other Than MRI Investigations
Combined Noninvasive Diagnostic Work-Up
Invasive Recordings
Outcomes in N-MRI Epilepsies
CONCLUSION
REFERENCES
CHAPTER 229. SURGERY FOR CEREBRAL INFECTIOUS AND POST-ENCEPHALITIC EPILEPSY
CEREBRAL INFECTIVE LESIONS
NEUROSURGERY FOR SEIZURES ASSOCIATED WITH BRAIN ABSCESS
Direct Spread
Hematogenous Spread
Postoperative Abscess
Trauma
Computed Tomography
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Diffusion-Weighted Imaging
NEUROSURGERY AND SEIZURES ASSOCIATED WITH NEUROCYSTICERCOSIS
NEUROSURGERY FOR SEIZURES ASSOCIATED WITH TUBERCULOSIS
NEUROSURGERY FOR SEIZURES ASSOCIATED WITH PARASITIC INFECTIONS
OUTCOMES OF NEUROSURGICAL RESECTION FOR EPILEPSY ASSOCIATED WITH ENCEPHALITIS
SUMMARY
REFERENCES
CHAPTER 230. SURGERY FOR RASMUSSEN ENCEPHALITIS
INTRODUCTION
CLINICAL MANIFESTATIONS
Presentation and Course
Clinical Vignette
ETIOLOGY AND PATHOGENESIS
DIAGNOSIS
Differential Diagnosis
Radiographic Features
Electrophysiologic Characteristics
Pathologic Diagnosis
Laboratory Tests
TREATMENT OPTIONS
Immune Agents
Antiseizure Medications
Epilepsy Surgery
TREATMENT OUTCOMES
REFERENCES
CHAPTER 231. EPILEPSY SURGERY FOR HYPOTHALAMIC HAMARTOMAS
INTRODUCTION
OPEN CRANIOTOMY
ENDOSCOPIC SURGERY
STEREOTACTIC RADIOSURGERY
STEREOTACTIC RADIOFREQUENCY THERMOCOAGULATION
STEREOTACTIC LASER ABLATION
COMPARISONS OF SURGICAL OUTCOMES
LONG-TERM PROGNOSIS
REFERENCES
CHAPTER 232. MEASURING EPILEPSY SURGERY OUTCOMES
INTRODUCTION
WHAT TO MEASURE AND HOW TO MEASURE
Common Data Elements
Core Outcome Sets
Selecting Specific Outcome Measurement Instruments to Address COS
SEIZURE OUTCOMES
Seizure Frequency
Postoperative Seizure Outcome Scales
Surgical Adverse Events
Neuropsychological Outcomes
Psychiatric and Behavioral Outcomes
PATIENT REPORTED OUTCOME MEASURES
MEASURING WHAT MATTERS: A PARENT’S PERSPECTIVE
REFERENCES
CHAPTER 233. ADVERSE EFFECTS OF EPILEPSY SURGERY
INTRODUCTION
Complications and Expected Adverse Effects
Classification of Complications
ADVERSE EFFECTS OF INVASIVE INVESTIGATIONS
Invasive EEG Procedures
ADVERSE EFFECTS OF EPILEPSY SURGERY
Mortality
Surgical Complications
Neurologic Adverse Effects
Seizure Worsening
Cognition
Psychiatric Adverse Effects
CONCLUSION
ACKNOWLEDGEMENT
ADDITIONAL INFORMATION
REFERENCES
CHAPTER 234. PRE- AND POSTOPERATIVE REHABILITATION IN EPILEPSY SURGERY
INTRODUCTION
PSYCHOSOCIAL OUTCOMES IN EPILEPSY SURGERY
Cognitive/Neuropsychological Outcomes
Psychiatric Outcomes
Quality of Life
Burden of Normality
Social/Functional Outcomes
Surgical Expectations/Satisfaction
PRE- AND POSTSURGICAL ASSESSMENT
Psychosocial Assessment and the Burden of Normality Paradigm
Neuropsychological Evaluation
Psychiatric Evaluation
COMPREHENSIVE REHABILITATION
Prehabilitation
Postoperative Rehabilitation
CONCLUSION
REFERENCES
CHAPTER 235. ANTISEIZURE MEDICATION WITHDRAWAL AFTER EPILEPSY SURGERY
WHAT IS CURRENT PRACTICE?
WHAT ARE THE BENEFITS OF DRUG WITHDRAWAL?
WHAT ARE THE RISKS FOR SEIZURE RECURRENCE AFTER DRUG WITHDRAWAL?
WHAT IS THE IDEAL TIMING OF DRUG WITHDRAWAL?
CAN WE PREDICT SUCCESSFUL DRUG WITHDRAWAL IN THE INDIVIDUAL PATIENT?
CONCLUSION
REFERENCES
CHAPTER 236. REOPERATION FOR EPILEPSY
INTRODUCTION
EPILEPSY SURGERY: RATIONALE AND RESULTS
REOPERATION FOR EPILEPSY: REPORTED EXPERIENCES
Reoperation for DRE in Adults
Reoperation for DRE in Children
REOPERATION FOR EPILEPSY: LESSONS LEARNED
Role of Adjunctive Studies in Reoperation
Factors Favoring Reoperation
Complication Avoidance
CONCLUSIONS
REFERENCES
SECTION 10 • Psychiatric Issues in Epilepsy
CHAPTER 237. OVERVIEW: PSYCHIATRIC ISSUES IN EPILEPSY
REFERENCES
CHAPTER 238. WHAT IS A PSYCHIATRIC SYMPTOM IN PATIENTS WITH EPILEPSY?
INTRODUCTION
INTERICTAL DISORDERS
PERI-ICTAL EPISODES
PARAICTAL EPISODES
IATROGENIC PSYCHIATRIC SYMPTOMS AND EPISODES
CONCLUDING REMARKS
REFERENCES
CHAPTER 239. EPIDEMIOLOGIC ASPECTS OF PSYCHIATRIC COMORBIDITIES IN EPILEPSY
OVERVIEW
WHAT IS PREVALENCE?
WHO HAS A PSYCHIATRIC DISORDER?
DEPRESSION
ANXIETY
PSYCHOSIS
PERSONALITY DISORDERS
POST-TRAUMATIC STRESS DISORDER
ALCOHOL CONSUMPTION
SUICIDE
ATTENTION-DEFICIT HYPERACTIVE DISORDER
INTELLECTUAL DISABILITY
AUTISM SPECTRUM DISORDER
BIDIRECTIONAL RELATIONSHIP BETWEEN EPILEPSY AND PSYCHIATRIC DISORDERS
ADDITIONAL INFORMATION
REFERENCES
CHAPTER 240. WHY SHOULD NEUROLOGISTS CARE ABOUT PSYCHIATRIC COMORBIDITIES IN PATIENTS WITH EPILEPSY AND THE OBSTACLES FOR THEIR CARE?
INTRODUCTION
WHY SHOULD NEUROLOGISTS CARE?
Impact of Psychiatric History on the Seizure Disorder
Impact of Psychiatric Comorbidities on the Life of PWE
OBSTACLES IN THE TREATMENT OF PSYCHIATRIC COMORBIDITIES IN EPILEPSY
Obstacles Caused by Physicians
Obstacles Caused by Patients
Obstacles Caused by the Medical Establishment
CONCLUDING REMARKS
REFERENCES
CHAPTER 241. NEUROBIOLOGICAL ASPECTS OF EPILEPTIC COMORBIDITIES: A REVIEW OF THE EXPERIMENTAL DATA
INTRODUCTION
RESEARCH DOMAIN CRITERIA: CLOSING THE GAP BETWEEN CLINICAL AND BASIC RESEARCH OF MENTAL DISORDERS
RDoC AND PRECLINICAL COMMON DATA ELEMENTS FOR EPILEPSY RESEARCH
MAJOR DEPRESSIVE DISORDER COMORBIDITY WITH EPILEPSY AND THE DYSFUNCTION OF MONOAMINERGIC CIRCUITRIES
Negative Valence, Construct of Loss
ATTENTION DEFICIT/HYPERACTIVITY DISORDER
A UNIFIED HYPOTHESIS OF EPILEPSY-ASSOCIATED DEPRESSION AND ADHD
COGNITIVE DYSFUNCTION
ANIMAL MODELS
EARLY-LIFE SEIZURES
DEVELOPMENTAL AND EPILEPTIC ENCEPHALOPATHIES
The Role of Epileptiform Activities in Neurobehavioral Deficits
Acquired Mechanisms Underlying Neurobehavioral Mechanisms
Structural Lesions and Network Dysfunction
CONCLUSIONS
REFERENCES
CHAPTER 242. MOOD DISORDERS IN ADULTS WITH EPILEPSY
INTRODUCTION
EPIDEMIOLOGIC DATA
CLINICAL PRESENTATIONS
Interictal Depressive Disorders
Comorbid Psychiatric Disorders
Atypical Manifestations of Depression in Epilepsy
Interictal Dysphoric Disorder
Peri-ictal Symptoms
Ictal Symptoms of Depression
Preictal Symptoms
Postictal Symptoms
Suicidality as an Expression of Depression in Epilepsy
IMPACT ON QUALITY OF LIFE
COMMON PATHOGENIC MECHANISMS IN EPILEPSY AND DEPRESSION
Abnormal Secretion of Neurotransmitters
Functional Neuroimaging Studies in Epilepsy and Primary Depression
ENDOCRINE DISTURBANCES: HYPERACTIVE HYPOTHALAMIC–PITUITARY–ADRENAL AXIS AND INFLAMMATORY MECHANISMS
Hyperactive Hypothalamic–Pituitary–Adrenal Axis
Structural Changes in Temporal Lobes
Structural Changes in Frontal Lobes
Neuroinflammatory Mechanisms
OTHER PATHOGENIC MECHANISMS OF DEPRESSION
Psychosocial Causes of Depression
Depression as an Iatrogenic Process
Depression Following Epilepsy Surgery
A Genetic Predisposition
TREATMENT
Some Preliminary Basic Concepts
Selection of Antidepressant Pharmacotherapy
Choice of Antidepressant Drug
Pharmacokinetic Interactions Between Antidepressants and Antiseizure Medications
Pharmacodynamic Effects of Antidepressant Drugs to Watch for in People with Epilepsy
Antipsychotics
Mood-stabilizing Agents
Electroshock Therapy
Vagus Nerve Stimulation
When Should Patients Be Referred for Psychological Treatment?
CONCLUSIONS
REFERENCES
CHAPTER 243. SUICIDALITY AND EPILEPSY
INTRODUCTION
TOWARD A CLASSIFICATION OF SUICIDE
The Nomenclature of Suicide
SUICIDE IN THE GENERAL POPULATION
Epidemiology
Risk Factors for Suicide
SUICIDE IN EPILEPSY
Epidemiology
Bidirectionality of Suicide and Epilepsy
Epilepsy-Specific Risk Factors for Suicide
IDENTIFYING SUICIDALITY IN EPILEPSY
SUICIDE PREVENTION
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 244. AGGRESSIVE DISORDERS IN EPILEPSY
INTRODUCTION
CLASSIFYING AGGRESSION
AGGRESSIVE BEHAVIOR IN CLINICAL PRACTICE
PHENOMENOLOGY OF IED
EPIDEMIOLOGY OF IED
NEUROBIOLOGY OF IED
Clinical Studies
EEG and Imaging Studies
NEUROBIOLOGY OF AGGRESSION IN GENERAL AND IED IN PARTICULAR
Dual-Brain Pathology in Patients with Episodic Dyscontrol
IED—Is It Epilepsy?
Social and Psychological Aspects of Aggression in Epilepsy
THERAPY OF AGGRESSION AND EPISODIC DYSCONTROL
CONCLUSION
REFERENCES
CHAPTER 245. ANXIETY DISORDERS IN ADULTS WITH EPILEPSY
INTRODUCTION
ANXIETY SYMPTOMS AS A NORMAL REACTIVE PROCESS VERSUS AN EXPRESSION OF PSYCHOPATHOLOGY
EPIDEMIOLOGY
Prevalence of Anxiety Symptoms
CLINICAL MANIFESTATIONS
Interictal Anxiety Disorders
Peri-Ictal Symptoms of Anxiety
Comorbid Occurrence of Anxiety and Depression Disorders
Screening of Anxiety Symptoms in the Clinic
The Use of Screening Instruments in Research: A Cautionary Note
IMPACT OF ANXIETY DISORDERS ON QUALITY OF LIFE
IMPACT OF ANXIETY ON SUICIDALITY
PATHOGENIC MECHANISMS
Psychosocial Factors
Endogenous Changes of Anxiety in Epilepsy
Iatrogenic Mechanisms
Treatment
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 246. PSYCHOTIC DISORDERS IN EPILEPSY
INTRODUCTION
DEFINITIONS AND PHENOMENOLOGY
HISTORICAL BACKGROUND
EPIDEMIOLOGY
CLASSIFICATION
SYNDROMES OF PSYCHOSES IN RELATION TO SEIZURE ACTIVITY
Postictal Psychoses
Preictal Psychosis
Interictal Psychoses
RISK FACTORS
Genetic Predisposition
Sex Distribution
Duration of Epilepsy
Type of Epilepsy
Type of Seizures
Severity of Epilepsy
Laterality
Structural Lesions
FORCED NORMALIZATION
PSYCHOSIS FOLLOWING SURGERY
DIAGNOSIS
TREATMENT
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 247. PERSONALITY AND PERSONALITY DISORDERS IN EPILEPSY
INTRODUCTION
THE SETTING
PERSONALITY
Normal versus Abnormal Personality
Assessing Normal Personality
The Big Five Personality Traits
Studies of Neuroticism in Epilepsy
Studies of Extraversion in Epilepsy
Studies of Other Traits
Implications
PERSONALITY DISORDERS
The DSM Approach
Limitations and Future Directions
REFERENCES
CHAPTER 248. INTELLECTUAL DISABILITIES IN EPILEPSY
INTRODUCTION
CLASSIFICATION AND TERMINOLOGY OF INTELLECTUAL DISABILITY
Definition of Intellectual Disability
THE NATURE AND IMPACT OF EPILEPSY IN PEOPLE WITH INTELLECTUAL DISABILITY
Epidemiology
Etiologic Issues
The Impact of Epilepsy on Development and Learning
Mortality
THERAPEUTIC INTERVENTIONS
Recognition of the Need of Intervention
Choosing an Intervention
Quality Evidence
Learning from the Evidence
Special Interventions
THE CONTEXT OF CARE
Health Advocacy
Barriers and Safety
Quality of Care
Specialist Provision
Epilepsy Management
Communication Skills: Management by Proxy
The Family
Coordinating Multiagency Care Delivery
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 249. AUTISM AND EPILEPSY
INTRODUCTION
PREVALENCE
RISK MARKERS
Age
Intellectual Functioning
Sex
Underlying Etiologies
EPILEPSY FEATURES
EEG FINDINGS
Epileptiform EEGs
Future Risk for Epilepsy?
REGRESSION
NEUROBEHAVIORAL CORRELATES/AUTISM SEVERITY
INDIVIDUALS WITH ASD WHO DEVELOP EPILEPSY MAY BE A DISTINCT SUBSET
CONCLUSION
REFERENCES
CHAPTER 250. MOOD AND ANXIETY DISORDERS IN PEDIATRIC PATIENTS WITH EPILEPSY
INTRODUCTION
HISTORY OF DEPRESSION AND ANXIETY OVERLAP WITH EPILEPSY
ROLE OF THE HPA AXIS AND TEMPORAL LOBE IN ANXIETY, DEPRESSION, AND EPILEPSY
ANXIETY AND MOOD DISORDERS VERSUS SYMPTOMS
EPIDEMIOLOGY OF ANXIETY AND MOOD DISORDER IN PEDIATRIC PATIENTS WITH EPILEPSY
Internalizing Disorders Are More Common in Pediatric Epilepsy
Association of Anxiety and Mood Disorder Subtypes to Epilepsy Subtypes
Seizure Variables
Gender Variability
Age of Epilepsy Onset
Duration of Epilepsy
Timing of Symptom Presentation
Social Factors
TREATMENT
Nonpharmacologic Strategies
Pharmacologic Strategies
CONCLUSION
REFERENCES
CHAPTER 251. ATTENTION DEFICIT HYPERACTIVITY DISORDER AND EPILEPSY
INTRODUCTION
BACKGROUND OF ADHD
Definitions of ADHD
Dimensional Approach
THE PRESENCE OF ADHD IN EPILEPSY
Most Common Comorbidity in Pediatric Epilepsy
Gender Equivalence
Epilepsy Subtypes Associated with ADHD
Network Connectivity
Familial Overlap
Differential with Absence Epilepsy
Differentiation from Other Conditions
BIDIRECTIONALITY
Electrographic Abnormalities in ADHD without Epilepsy
ADHD SYMPTOMS RESULTING FROM ANTICONVULSANT MEDICINE
USE OF STIMULANT MEDICINE IN ADHD AND EPILEPSY
Risks of Stimulants in Epilepsy
FUTURE RESEARCH STUDIES
CONCLUSION
REFERENCES
CHAPTER 252. PSYCHIATRIC SYMPTOMS OF ANTISEIZURE MEDICATIONS
INTRODUCTION
ADVERSE PSYCHIATRIC EFFECTS OF SPECIFIC ASMs
First-Generation Drugs
Second-Generation ASMs
POSITIVE PSYCHOTROPIC EFFECTS OF ASMs
RISK FACTORS FOR PSYCHIATRIC ADVERSE EVENTS
MECHANISMS
FORCED NORMALIZATION
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 253. PSYCHIATRIC IATROGENIC EFFECTS OF EPILEPSY SURGERY
INTRODUCTION
DEPRESSION
PSYCHOSIS
PERSONALITY DISORDERS
Studies on Postoperative Stability of Personality Traits
PD as an Obstacle to Successful Postoperative Adaptation
Impact of PD on Seizure Outcome
Conclusion on PD in the context of ES
PNES AFTER EPILEPSY SURGERY
The Nature of PNES
Patients with PNES after Surgery
New-Onset PNES after Surgery
Conclusion on PNES and epilepsy surgery
INFLUENCE OF PSYCHIATRIC DISORDERS ON QOL
The Effects of Good Preoperative Coping Styles for Postoperative Improvement of QOL
Conclusion on Psychiatric Influence on QOL
CONCLUSIONS
REFERENCES
CHAPTER 254. THERAPEUTIC EFFECTS OF EPILEPSY SURGERY ON PRESURGICAL PSYCHIATRIC COMORBIDITIES
INTRODUCTION
ANXIETY AND DEPRESSION
DE NOVO CONDITIONS
SUICIDE AND EPILEPSY SURGERY
PSYCHOSIS
BIPOLAR AFFECTIVE DISORDERS
RISK FACTORS RELATED WITH EPILEPSY SURGERY
CHILDREN AND EPILEPSY SURGERY
LIMITATIONS OF THE SCIENTIFIC EVIDENCE IN THIS FIELD
CONCLUSIONS
REFERENCES
CHAPTER 255. DO PSYCHIATRIC COMORBID DISORDERS HAVE AN IMPACT ON POSTSURGICAL SEIZURE OUTCOME?
INTRODUCTION
PSYCHIATRIC DISEASE IS A RISK FACTOR FOR POOR OUTCOMES AFTER ATL
PSYCHIATRIC DISEASE IS NOT A RISK FACTOR OF POOR SEIZURE OUTCOMES AFTER ATL
CONCLUDING REMARKS: HOW CAN WE MAKE SENSE OF THESE DATA?
REFERENCES
CHAPTER 256. COGNITIVE ADVERSE EFFECTS OF ANTISEIZURE MEDICATIONS
INTRODUCTION
THE STUDY OF COGNITIVE SIDE EFFECT OF ASMs
Methodologic Concerns and Constraints
ANTISEIZURE MEDICATIONS
Phenobarbital
Phenytoin
Ethosuximide
Valproate
Carbamazepine
Lamotrigine
Gabapentin
Topiramate
Tiagabine
Oxcarbazepine
Levetiracetam
Zonisamide
Rufinamide
Lacosamide
Perampanel
Eslicarbazepine Acetate
Brivaracetam
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 257. PHARMACOLOGIC TREATMENT OF PSYCHIATRIC DISORDERS IN EPILEPSY: BASIC CONCEPTS
INTRODUCTION
DEPRESSION
Antidepressant Drugs in Epilepsy
Antiseizure Medications for Depression in Epilepsy
ANXIETY DISORDERS
PSYCHOSES
Antipsychotic Drugs
Treatment Issues in Patients with Epilepsy and Psychoses
Benzodiazepines in Epilepsy and Psychoses
The Use of Lithium in Epilepsy
CONCLUSIONS
REFERENCES
CHAPTER 258. PSYCHOTHERAPY IN EPILEPSY
INTRODUCTION
GENERAL OVERVIEW OF PSYCHOTHERAPIES
Classification of Psychological Interventions
THE UTILITY OF PSYCHOMETRIC MEASURES IN THE PSYCHOTHERAPEUTIC PROCESS
Measures of Mood and Affect Symptoms
Measures of Anxiety Symptoms
Quality of Life in Epilepsy (QOLIE-31) and (QOLIE-89)
PSYCHOTHERAPEUTIC TREATMENT TARGETS IN EPILEPSY
WHAT TYPES OF PSYCHOTHERAPY CAN BE USEFUL IN THE TREATMENT OF PWE
CONCLUSION
REFERENCES
CHAPTER 259. THE USE OF ELECTROSHOCK THERAPY AND TRANSCRANIAL MAGNETIC STIMULATION IN PATIENTS WITH EPILEPSY: SAFETY AND THERAPEUTIC CONSIDERATIONS
ELECTROCONVULSIVE THERAPY
Overview of ECT
ECT Special Treatment Parameters for Patients with Epilepsy
ECT Side Effects and Safety Considerations in Patients with Epilepsy
ECT Potential Indications in Patients with Epilepsy
TRANSCRANIAL MAGNETIC STIMULATION
Overview of TMS
rTMS Mechanism
rTMS Side Effects and Safety Considerations in Patients with Epilepsy
rTMS Dosing and Treatment Parameters
rTMS Potential Indications in Patients with Epilepsy
Psychogenic Nonepileptic Seizures and Other Promising Future Areas of Study
REFERENCES
CHAPTER 260. PSYCHIATRY AND RESIDENTIAL CARE IN EPILEPSY
OVERVIEW
HISTORY: A BRIEF OUTLINE OF THE RISE AND FALL OF CONFINEMENT
Development of Institutions
Colonies for People with Epilepsy: Their Role and Development
CURRENT RESIDENTIAL CENTERS
Residential Education for Children
Residential Assessment for Children and Adults
Long-Stay Provision and Rehabilitation for Adults
New Areas of Business
CURRENT TRENDS AND PURPOSES IN EPILEPSY INSTITUTIONS
Discharge of People with Epilepsy into the Community
Coassessment of Intellectual Disability (Learning Disability/Mental Handicap)
Outcome on Discharge from Special Schools, Centers, and Hospitals
CURRENT INTERNATIONAL SITUATION
CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 261. OVERVIEW: SOCIAL ISSUES IN EPILEPSY
INTRODUCTION
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 262. SOCIAL ASPECTS IN EPILEPSY: EPILEPSY STIGMA AND QUALITY OF LIFE
INTRODUCTION
EPILEPSY AS A SOCIAL LABEL
THEORIES OF STIGMA IN THE CONTEXT OF EPILEPSY
VIEWS ABOUT EPILEPSY AS A SOCIAL LABEL
Views of People with Epilepsy
Views of Other Groups
ROLE OF STIGMA IN QUALITY OF LIFE
MANAGING EPILEPSY STIGMA
Helping People with Epilepsy to Manage a Negative Social Label
Changing Negative Public Attitudes
SUMMARY AND CONCLUSIONS
DEDICATION
REFERENCES
CHAPTER 263. QUALITY OF LIFE IN CHILDREN WITH EPILEPSY
DEFINITION
ASSESSMENT AND MEASUREMENT ISSUES
Health Utility Approaches
Generic Measures
Disease-Specific Measures
BENEFIT OF MEASURING HRQOL IN CLINICAL PRACTICE
METHODOLOGIC ISSUES IN HRQOL MEASUREMENT
Clinically Meaningful Benchmarks
Clinical Cut-offs
Parent/Caregiver-Proxy Reporting
RISK AND RESILIENCE FACTORS
Medical Factors
Demographic Factors
Psychological and Neurocognitive Comorbidities
Family Factors
INTERVENTIONS TO IMPROVE HRQOL IN EPILEPSY
CONCLUSIONS AND FUTURE DIRECTIONS
REFERENCES
CHAPTER 264. QUALITY OF LIFE IN ADULTS WITH EPILEPSY
INTRODUCTION: OVERVIEW OF QUALITY OF LIFE IN ADULTS WITH EPILEPSY
MENTAL HEALTH AND COGNITION
Health Care Costs
Seizure Control
PSYCHOSOCIAL
Employment
Driving and Independence
Social Support
Marriage
DEVICE TREATMENT OF EPILEPSY
CONCLUSION
REFERENCES
CHAPTER 265. SELF/FAMILY MANAGEMENT IN PEDIATRIC EPILEPSY: OVERVIEW AND UTILITY IN ROUTINE PEDIATRIC EPILEPSY CARE
INTRODUCTION: SCOPE OF THE CHAPTER AND DEFINITION
ASSESSMENT: WHY IS IT IMPORTANT TO ASSESS PEDIATRIC EPILEPSY SELF/FAMILY MANAGEMENT?
INTERVENTION
Current Evidence-Based Recommendations for Psychological Treatments
TRANSITION
Developmental Considerations
INTEGRATING SELF AND FAMILY MANAGEMENT INTO THE CLINIC VISIT
CONCLUSION
REFERENCES
CHAPTER 266. SELF-MANAGEMENT PROGRAMS FOR ADULTS WITH EPILEPSY
INTRODUCTION
LITERATURE REVIEW
Assessment
SELF-MANAGEMENT PROGRAMS
WebEase
UPLIFT
HOBSCOTCH
PACES
TIME
SMART
MINDSET
PAUSE
Implementation of Self-Management Programs
BARRIERS TO IMPLEMENTATION
REFERENCES
CHAPTER 267. PSYCHOSOCIAL CARE NEEDS AND COMMUNITY RESOURCES FOR PEOPLE WITH EPILEPSY
INTRODUCTION
PSYCHOSOCIAL CARE
ASSESSMENT OF PSYCHOSOCIAL CARE NEEDS
PSYCHOSOCIAL CARE NEEDS ACROSS THE LIFESPAN
Children and Adolescents
Parents
Adults and Older Adults
STRATEGIES FOR MEETING PSYCHOSOCIAL CARE NEEDS
SOCIAL DETERMINANTS OF HEALTH
Risk Factors in People with Epilepsy
How SDH Can Influence Psychosocial Care Needs
RESOURCES TO ADDRESS PSYCHOSOCIAL CARE NEEDS
Resources in Health Care (Clinical) Setting
Resources in the Community Setting
Epilepsy Foundation—National and Local
Online Resources
Resources to Address SDH
CONCLUSION
REFERENCES
CHAPTER 268. THE RANGE OF NEEDS AND SERVICES IN VOCATIONAL REHABILITATION IN PEOPLE WITH EPILEPSY
INTRODUCTION
POSTSECONDARY SCHOOL VOCATIONAL ASSESSMENT
Vocational Interests/Work Values
Pattern of Abilities
Epilepsy-related Restrictions and Limitations
Behavioral Problems and Social Skills Deficits Associated with Epilepsy
SERVICES
Prevocational Intervention (Work Preparatory Courses, Social Rehabilitation)
Vocational Assessment and Its Components
Vocational Training Courses for Young Adults with Epilepsy
School-to-Work Transition
Subgroups of the Unemployed and Underemployed
Seizures and Unemployment
Neuropsychological Deficits and Employability
Interactions with Employers and Colleagues
Seizure Disclosure to Employers
Predictors of Long-term Employment Success
VOCATIONAL SERVICES
Programs for Assessment and Short-term Rehabilitation
Retraining Centers for Adults
Training and Placement Services
Postplacement Services
WORKPLACE ACCOMMODATIONS
Birgit’s Case
Harry’s Case
NATIONAL LEGISLATION AFFECTING JOB ACCESS
Germany
Americans with Disabilities Act
SHELTERED EMPLOYMENT VERSUS EMPLOYMENT OF PERSONS WITH EPILEPSY IN THE OPEN LABOR MARKET
NEW SERVICES
Models to Change Sheltered Employment
Models of Supported Employment Placement
Individualized Placement Programs
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENT
REFERENCES
CHAPTER 269. EPILEPSY AND TRANSITION OF CARE
WHAT IS TRANSITION AND HOW IS IT DIFFERENT FROM TRANSFER?
THE IMPORTANCE OF CARE TRANSITIONS
TYPES OF TRANSITION PROGRAMS FOR ADOLESCENTS AND YOUNG ADULTS
GUIDANCE
BEST PRACTICE AND QUALITY MEASURES
MEASURING OUTCOMES
LIFE TRANSITIONS IN ADOLESCENTS AND YOUNG ADULTS WITH EPILEPSY: THE IMPORTANCE OF EPILEPSY SELF-MANAGEMENT
FRAMEWORKS FOR EPILEPSY CARE DURING TRANSITION PROCESS
EPILEPSY SELF-MANAGEMENT TRANSITION SKILLS
Medication Management, Adherence, and Self-Monitoring
Staying Safe: Using Seizure Action Plans
Staying Safe: Driving and Transportation
Reproductive Health
General Health and Wellness
Emotional Health
Educational and Vocational Needs
Independent Living
TRANSITION RESOURCES
SUMMARY
REFERENCES
CHAPTER 270. ENHANCING SCHOOL FUNCTIONING AND THE SCHOOL-TO-WORK TRANSITION IN CHILDREN WITH EPILEPSY
SCHOOL PERFORMANCE OF YOUTH WITH EPILEPSY
ICF Model and Epilepsy
Body Structures and Functions
Activity and Participation
Personal Factors
Environmental Factors
SCHOOL-TO-WORK TRANSITION
ISSUES RELATED TO TRANSITION
The ICF Model as a Conceptual Framework for Transition Planning
Keys to Success: Early and Transdisciplinary Transition Planning
Transdisciplinary Assessment for Transition Planning
Evidence Based Practices and Predictors for Transition Planning
Special Consideration: Differentiating between Entitlement and Eligibility
Special Consideration: Understanding Pre-Employment Transition Services
Evaluation of Transition Outcomes
CONCLUSION
REFERENCES
CHAPTER 271. ISSUES IN HEALTH OUTCOMES ASSESSMENT IN EPILEPSY
INTRODUCTION
THE CONCEPT OF HEALTH-RELATED QUALITY OF LIFE IN EPILEPSY
SEIZURE FREQUENCY AND HEALTH-RELATED QUALITY OF LIFE
SURGERY AND HEALTH-RELATED QUALITY OF LIFE
MEDICATIONS AND HEALTH-RELATED QUALITY OF LIFE
PSYCHIATRIC COMORBIDITY AND HEALTH-RELATED QUALITY OF LIFE
OTHER COMORBIDITIES
SLEEP
EXERCISE
MIGRAINE
ISSUES SPECIFIC TO CHILDREN
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 272. LEGAL CONCERNS AND EFFECTIVE ADVOCACY STRATEGIES IN EPILEPSY
INTRODUCTION
DEFINING DISABILITY
EMPLOYMENT DISCRIMINATION
Qualified
Application and Interview Process
Reasonable Accommodation Process
What Kind of Documentation Should I Provide?
Family and Medical Leave Act
ADA/FMLA Interplay
Enforcing Employment Nondiscrimination Rights in Employment
TITLES II AND III OF THE ADA
Title II
Title III
Enforcing of Nondiscrimination Rights under Title II and III of the ADA
EDUCATION
IDEA and Section 504 of the Rehab Act
IDEA
Section 504
Title II and III of the ADA
Administration of Rescue Medications in Schools
DRIVING
OTHER CRITICAL AREAS OF ADVOCACY
EFFECTIVE ADVOCACY STRATEGIES
CONCLUSION
REFERENCES
SECTION 11 • Epilepsy Syndromes
CHAPTER 273. OVERVIEW: INTRODUCTION TO EPILEPSY SYNDROMES
REFERENCES
CHAPTER 274. INTRODUCTION TO THE CLASSIFICATION OF EPILEPSY
HISTORICAL PERSPECTIVES
DEFINITIONS OF EPILEPSY
CLASSIFICATIONS OF EPILEPSY
THE 2017 CLASSIFICATION
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 275. SELF-LIMITED (FAMILIAL) NEONATAL EPILEPSY
INTRODUCTION
HISTORICAL PERSPECTIVES: FROM THE EARLY DAYS TO GENE IDENTIFICATION
GENETIC MECHANISMS AND GENOTYPE–PHENOTYPE CORRELATIONS
Functional Studies and Genotype–Phenotype Correlations
EPIDEMIOLOGY
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
Interictal and Ictal EEG
Neuroimaging
TREATMENT
PROGNOSIS
DIFFERENTIAL DIAGNOSIS
SUMMARY
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 276. EARLY MYOCLONIC ENCEPHALOPATHY
INTRODUCTION
EPIDEMIOLOGY
ETIOLOGY
CLINICAL PRESENTATION/SEIZURE CHARACTERISTICS
EEG Features
Imaging
Other Laboratory Investigations
Developmental Course
Pathophysiologic Basis
DIFFERENTIAL DIAGNOSIS
TREATMENT
CONCLUSION
REFERENCES
CHAPTER 277. OHTAHARA SYNDROME
INTRODUCTION
HISTORICAL PERSPECTIVE
DEFINITIONS
EPIDEMIOLOGY
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
Electroencephalographic Findings
Neuroimaging and Other Laboratory Examinations
DIFFERENTIAL DIAGNOSIS
Ohtahara Syndrome and West Syndrome
Ohtahara Syndrome and Early Myoclonic Encephalopathy
TREATMENT AND OUTCOME
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 278. SELF-LIMITED (FAMILIAL) INFANTILE EPILEPSY
INTRODUCTION
HISTORICAL PERSPECTIVE
DEFINITION
EPIDEMIOLOGY
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
Self-Limited (Familial) Infantile Epilepsy
Self-Limited Familial Neonatal-Infantile Epilepsy
Self-Limited Infantile Seizures Associated With Mild Gastroenteritis
DIAGNOSTIC EVALUATION
ELECTROENCEPHALOGRAPHIC FINDINGS
NEUROIMAGING AND LABORATORY ASSESSMENT
DIFFERENTIAL DIAGNOSIS
TREATMENT AND OUTCOME
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 279. EPILEPSY OF INFANCY WITH MIGRATING FOCAL SEIZURES
INTRODUCTION
HISTORICAL PERSPECTIVES
DEFINITIONS
EPIDEMIOLOGY
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
Electroencephalographic Findings
Neuroimaging and Laboratory Examinations
Genetic Testing
DIFFERENTIAL DIAGNOSIS
TREATMENT AND OUTCOME
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 280. INFANTILE EPILEPTIC SPASMS SYNDROME
INTRODUCTION
EPIDEMIOLOGY
ETIOLOGY
Structural
Metabolic
Infectious and immune
Genetic
BASIC MECHANISMS
CLINICAL PRESENTATION
Seizures
Development
DIAGNOSTIC EVALUATION
DIFFERENTIAL DIAGNOSIS
TREATMENT AND OUTCOME
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 281. DRAVET SYNDROME
DEFINITION AND EPIDEMIOLOGY
CLINICAL AND EEG FEATURES
Clinical Presentation
Triggering Factors
Neurologic Signs
COGNITIVE AND BEHAVIORAL DEVELOPMENT
NEUROIMAGING AND NEUROPATHOLOGY
GENETICS
DIFFERENTIAL DIAGNOSIS
TREATMENT AND MANAGEMENT
Emergency Treatments and Protocols
Treatment Algorithm
Future Perspectives
LONG-TERM OUTCOME
CONCLUSIONS
REFERENCES
CHAPTER 282. MYOCLONIC EPILEPSIES IN INFANCY AND EARLY CHILDHOOD
INTRODUCTION
General Characteristics of Myoclonic Epilepsies
Definition of Epileptic Myoclonus
Clinical and EEG Features Common to the Myoclonic Seizures
DIFFERENTIAL DIAGNOSIS OF MYOCLONIC SEIZURES
ETIOLOGY OF THE MYOCLONIC EPILEPSIES
IDIOPATHIC MYOCLONIC EPILEPSY IN INFANCY
Historical Note and Nomenclature
Epidemiology
Genetics
Personal History
Clinical and EEG Manifestations
Treatment
Long-Term Outcome and Prognosis
IMEI WITH REFLEX SEIZURES
Diagnostic Criteria
Nosologic Place
EPILEPSY WITH MYOCLONIC-ATONIC SEIZURES
Nosologic Aspects
Etiology and Epidemiologic Data
Clinical and EEG Presentation
Course and Outcome
Treatment
REFERENCES
CHAPTER 283. HEMICONVULSION-HEMIPLEGIA-EPILEPSY SYNDROME
INTRODUCTION
HISTORICAL PERSPECTIVES AND DEFINITIONS
AGE AT ONSET
CLINICAL PRESENTATION AND DIAGNOSTIC EVALUATION
ETIOLOGY
PATHOPHYSIOLOGY
MANAGEMENT
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 284. SELF-LIMITED EPILEPSY WITH CENTROTEMPORAL SPIKES
INTRODUCTION
HISTORICAL PERSPECTIVES
DEFINITIONS
EPIDEMIOLOGY
GENETICS AND BASIC MECHANISMS
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
Electroencephalographic Findings
Neuroimaging and Other Laboratory Examinations
DIFFERENTIAL DIAGNOSIS
TREATMENT AND OUTCOME
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENT
REFERENCES
CHAPTER 285. CHILDHOOD OCCIPITAL VISUAL EPILEPSY AND SELF-LIMITED EPILEPSY WITH AUTONOMIC SEIZURES
INTRODUCTION
HISTORICAL PERSPECTIVES
Self-Limited Epilepsy with Autonomic Seizures
Childhood Occipital Visual Epilepsy
DEFINITIONS
SeLEAS
COVE
EPIDEMIOLOGY
SeLEAS
COVE
ETIOLOGY AND BASIC MECHANISMS
SeLEAS
COVE
CLINICAL PRESENTATION
SeLEAS
COVE
Core Clinical Features in SeLEAS
Frequent Features of Seizures
Less Frequent, but Not Rare, Symptoms
DIAGNOSTIC EVALUATION
Core Clinical Features in COVE
Neuroimaging and Other Laboratory Examinations in SeLEAS and COVE
Electroencephalographic Findings
Other Neurophysiologic Studies in SeLEAS and COVE
DIFFERENTIAL DIAGNOSIS IN SELEAS AND COVE
TREATMENT AND OUTCOME
SeLEAS
COVE
LONG-TERM PROGNOSIS IN SELEAS AND COVE
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENT
REFERENCES
CHAPTER 286. CHILDHOOD AND JUVENILE ABSENCE EPILEPSIES
INTRODUCTION
HISTORICAL PERSPECTIVES
EPIDEMIOLOGY
Childhood Absence Epilepsy
Juvenile Absence Epilepsy
ETIOLOGY
Genetic Factors
Childhood Absence Epilepsy
Juvenile Absence Epilepsy
Acquired Factors
CLINICAL PRESENTATION
Childhood Absence Epilepsy
Juvenile Absence Epilepsy
Cognitive and Psychiatric Comorbidity
DIAGNOSTIC EVALUATION
Electroencephalographic Findings
Neuroimaging
DIFFERENTIAL DIAGNOSIS
Within Generalized Genetic Epilepsies
From Focal Epilepsies
TREATMENT
SAFETY: PARTICIPATION IN SPORTS AND DRIVING
OUTCOME
Childhood Absence Epilepsy
Juvenile Absence Epilepsy
Social Prognosis of CAE/JAE
REFERENCES
CHAPTER 287. EPILEPSY WITH MYOCLONIC ABSENCES
INTRODUCTION
CLINICAL DATA
General Remarks
Myoclonic Absences
Seizures Other Than Myoclonic Absences
Neurologic and Neuropsychologic Examination
NEUROPHYSIOLOGIC DATA
Interictal EEG
Ictal EEG
Sleep EEG
EVOLUTION
DIAGNOSIS
TREATMENT
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 288. LENNOX–GASTAUT SYNDROME
INTRODUCTION
HISTORICAL PERSPECTIVE
DEFINITIONS
EPIDEMIOLOGY
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
Interictal EEG
Seizures
Clinical Variants
DIAGNOSTIC EVALUATION
DIFFERENTIAL DIAGNOSIS
Infantile Epileptic Spasms Syndrome (IESS)
Dravet Syndrome
Epilepsy with Myoclonic Atonic Seizures
Developmental and/or Epileptic Encephalopathy with Spike-Wave Activation in Sleep
Focal Motor Seizures
Metabolic Disorders
Drug-Related Exacerbation of Epilepsy Etiologies
Specific Genetic Etiologies
TREATMENT
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 289. ENCEPHALOPATHY RELATED TO STATUS EPILEPTICUS DURING SLOW SLEEP (ESES) INCLUDING LANDAU KLEFFNER SYNDROME
INTRODUCTION
EPIDEMIOLOGY
ETIOLOGY
Personal Antecedents
Genetics
CLINICAL AND NEUROPHYSIOLOGIC FEATURES
Epilepsy
Encephalopathy
EEG
Auditory Evoked Potentials
PHYSIOPATHOGICAL MECHANISMS
The Mechanism Generating SES
Role of Sleep in Cognition in the Developmental Age and Interference by Sleep-Related Epileptiform EEG Activities
DIFFERENTIAL DIAGNOSIS
TREATMENT
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 290. RASMUSSEN SYNDROME
INTRODUCTION
HISTORICAL PERSPECTIVE
EPIDEMIOLOGY
ETIOLOGY AND PATHOGENESIS OF RASMUSSEN ENCEPHALITIS
CLINICAL PRESENTATIONS
Typical Course of the Disease
Clinical Variants of Rasmussen Encephalitis
DIAGNOSIS
Electroencephalographic Findings
Structural Imaging
Functional Imaging
DIFFERENTIAL DIAGNOSIS
TREATMENT AND OUTCOME
Antiseizure Medication Therapy
Antiviral Therapy
Immune Therapy
Microglia-Activation–Mediated Neurodegeneration
Interferon-α
Steroids
Immunoglobulins
Plasmapheresis and Selective IgG Immunoadsorption
Immunosuppressive Therapy
Future Evolving Medical Therapies: Immunosuppressive or Immunomodulatory Treatment
Surgery
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 291. JUVENILE MYOCLONIC EPILEPSY
INTRODUCTION
HISTORICAL PERSPECTIVES
DEFINITIONS
EPIDEMIOLOGY
Prevalence
Sex Ratio
Age of Onset
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
Electroencephalographic Findings
Neuroimaging
Biochemical Studies
Genetic Studies
DIFFERENTIAL DIAGNOSIS
TREATMENT AND OUTCOME
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 292. GENERALIZED TONIC–CLONIC SEIZURES ALONE AND EPILEPSY WITH GENERALIZED TONIC–CLONIC SEIZURES ON AWAKENING
GENERALIZED TONIC–CLONIC SEIZURES ALONE
EPILEPSY WITH GTCS ON AWAKENING
Preamble
Historical Perspective
Definitions
Etiology and Basic Mechanisms
Clinical Presentation
Diagnostic Evaluation
Differential Diagnosis
Treatment and Outcome
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 293. MESIAL TEMPORAL LOBE EPILEPSY WITH HIPPOCAMPAL SCLEROSIS
INTRODUCTION
DEFINITIONS
HISTORICAL PERSPECTIVES AND PREVIOUS TERMS
EPIDEMIOLOGY
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
Evidence for Progression
Clinical Seizure Characteristics
Nonictal Manifestations of Temporal Lobe Epilepsy
DIAGNOSTIC EVALUATION
DIFFERENTIAL DIAGNOSIS
TREATMENT AND OUTCOME
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 294. FAMILIAL TEMPORAL LOBE EPILEPSIES
INTRODUCTION
HISTORICAL PERSPECTIVE
DEFINITIONS
Familial Mesial Temporal Lobe Epilepsy
Familial Temporal Lobe Epilepsy With Auditory Features
EPIDEMIOLOGY
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
Familial Mesial Temporal Lobe Epilepsy
Familial Temporal Lobe Epilepsy With Auditory Features
DIAGNOSTIC EVALUATION
Electroencephalographic Findings
Neuroimaging and Other Laboratory Examinations
DIFFERENTIAL DIAGNOSIS
TREATMENT AND OUTCOME
LONG-TERM PROGNOSIS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 295. FAMILIAL FRONTAL LOBE EPILEPSIES AND FAMILIAL FOCAL EPILEPSY WITH VARIABLE FOCI
INTRODUCTION
FAMILIAL FRONTAL LOBE EPILEPSIES
Historical Perspectives
Definitions
Epidemiology
Etiology and Basic Mechanisms
Clinical Presentation
Diagnostic Evaluation
Differential Diagnosis
Treatment and Outcome
Long-term Prognosis
Summary and Conclusions
FAMILIAL FOCAL EPILEPSY WITH VARIABLE FOCI
Historical Perspectives
Definitions
Epidemiology
Etiology and Basic Mechanisms
Clinical Presentation
Diagnostic Evaluation
Differential Diagnosis
Treatment and Outcome
Long-Term Prognosis
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 296. GELASTIC SEIZURES AND HYPOTHALAMIC HAMARTOMAS
INTRODUCTION
HISTORICAL PERSPECTIVES
DEFINITIONS
EPIDEMIOLOGY
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
EEG Findings
MRI
PET and SPECT Imaging
DIFFERENTIAL DIAGNOSIS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 297. PROGRESSIVE MYOCLONUS EPILEPSIES
THE PME SYNDROME AND ITS PHENOTYPIC LIMITS
GENETIC AND CLINICAL PHENOTYPIC FEATURES
Unverricht–Lundborg Disease
Lafora Disease
Neuronal Ceroid Lipofuscinoses
Myoclonic Epilepsy with Ragged Red Fibers
Action Myoclonus Renal Failure
Myoclonic Epilepsy and Ataxia Due to Potassium Channel Mutation
GOSR2 “North Sea” PME
Sialidosis
Dentatorubropallidoluysian Atrophy
KCTD7-Related PME
Gaucher Disease
Spinal Muscular Atrophy–Progressive Myoclonus Epilepsy
Neuroserpinopathy
RARE AND EMERGING CAUSES OF PME
TREATMENT STRATEGIES IN PME
Dietary Modification
Neuromodulatory Therapies
Immunomodulatory Therapies
Enzyme-Replacement Therapies
Gene Therapies
REFERENCES
CHAPTER 298. POSTTRAUMATIC SEIZURES
INTRODUCTION
HISTORICAL PERSPECTIVES
DEFINITIONS
EPIDEMIOLOGY
Traumatic Brain Injury
Epidemiologic Studies of Seizures After Traumatic Brain Injury
Characterization and Background of Impact Convulsions
Immediate and Early Seizures
Early Posttraumatic Seizures and Secondary Brain Injury
Late Seizures
Seizure Type of Late Seizures
Seizure Recurrence
Prevalence of Posttraumatic Epilepsy
Association of TBI and PTE With Cognitive and Psychiatric Comorbidities
Modalities of Traumatic Brain Injury and Posttraumatic Epilepsy
Posttraumatic Epilepsy Is Mechanistically Heterogeneous
Multiple Pathophysiologic Mechanisms May Contribute to Posttraumatic Epilepsy
RISK FACTORS FOR POSTTRAUMATIC EPILEPSY
Suggested Pathophysiologic Risk Factors for Posttraumatic Epilepsy
Possible Electrophysiologic Biomarkers for PTE
CLINICAL CONSIDERATIONS FOR SEIZURES AND EPILEPSY AFTER TBI
Clinical Presentation
Acute Seizures, Ictal–Interictal Continuum, and Secondary Brain Injury
DIAGNOSTIC EVALUATIONS
Electroencephalographic Findings
Neuroimaging and Other Laboratory Examinations
DIFFERENTIAL DIAGNOSIS
Nonepileptic Seizures After TBI
TREATMENT AND OUTCOMES
Management of Posttraumatic Seizures
TREATMENT OF POSTTRAUMATIC EPILEPSY
Efficacy of Surgical Therapy for Posttraumatic Epilepsy in Selected Cases
Failure of Clinical Trials in TBI
SUPPORTIVE THERAPY
LONG-TERM PROGNOSIS
REFERENCES
CHAPTER 299. ISOLATED SEIZURES
INTRODUCTION
HISTORICAL PERSPECTIVES
DEFINITIONS AND NOSOLOGIC PLACE
EPIDEMIOLOGY
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
RISK FOR RELAPSE
PROVOCATION OF ISOLATED SEIZURES
HOW EPILEPSY EVOLVES FROM A FIRST SEIZURE
DIAGNOSTIC EVALUATION
DIFFERENTIAL DIAGNOSIS
TREATMENT AND OUTCOME
LONG-TERM PROGNOSIS
CONCLUSION
REFERENCES
CHAPTER 300. GENETIC EPILEPSY WITH FEBRILE SEIZURES PLUS
INTRODUCTION
HISTORICAL PERSPECTIVES
DEFINITION AND EPIDEMIOLOGY OF GENETIC EPILEPSY WITH FEBRILE SEIZURES PLUS
ETIOLOGY AND BASIC MECHANISMS
CLINICAL PRESENTATION
Febrile Seizures
Febrile Seizures Plus
Febrile Seizures or Febrile Seizures Plus with Other Seizure Type
Epilepsy with Myoclonic-Atonic Seizures
Dravet Syndrome
Focal Epilepsies
DIAGNOSTIC EVALUATION
DIFFERENTIAL DIAGNOSIS
TREATMENT
LONG-TERM PROGNOSIS
Febrile Seizures
Febrile Seizures or Febrile Seizures Plus with Other Seizure Type
Doose Syndrome
GENETIC COUNSELING
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 301. REFLEX EPILEPSIES
DEFINITIONS
PHOTOSENSITIVITY
HOT WATER OR BATHING EPILEPSY
MUSICOGENIC EPILEPSY
THINKING (NOOGENIC) EPILEPSY
EPILEPSY WITH SOMATOSENSORY-STIMULATION–INDUCED SEIZURES
EPILEPSY WITH PROPRIOCEPTION-INDUCED SEIZURES
EATING EPILEPSY
READING EPILEPSY
SEXUAL/ORGASMIC EPILEPSY
EPILEPSY WITH PRAXIS-INDUCED REFLEX SEIZURES
SUMMARY
REFERENCES
CHAPTER 302. MALFORMATIONS OF CORTICAL DEVELOPMENT IN EPILEPSY
MALFORMATIONS RELATED TO ABNORMAL PROLIFERATION OF NEURONS AND GLIA
Megalencephaly, Hemimegalencephaly, Focal Cortical Dysplasia
MALFORMATIONS DUE TO ABNORMAL NEURONAL MIGRATION
Gray Matter Heterotopia
Periventricular Nodular Heterotopia
Lissencephaly and Subcortical Band Heterotopia (Agyria–Pachygyria-Band Spectrum)
Other Rare Genetic Causes of Lissencephaly or SBH
Tubulinopathies and Related Disorders
MALFORMATIONS RELATED TO ABNORMAL CORTICAL ORGANIZATION
Polymicrogyria
REFERENCES
CHAPTER 303. CHROMOSOMAL ABNORMALITIES IN EPILEPSY
INTRODUCTION
CYTOGENETIC AND MOLECULAR TECHNIQUES FOR DIAGNOSTICS
MAIN, RECURRENT, CHROMOSOMAL ABNORMALITIES, AND CNVS ASSOCIATED WITH EPILEPSY
Epilepsy in Syndromic Patients With Numeric Chromosomal Aberrations and Microdeletions
Other Recognizable and Rare Chromosomal Anomalies in Patients with Epilepsy
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 304. INHERITED METABOLIC DISORDERS AND EPILEPSY
INTRODUCTION
METABOLIC DISORDERS OF THE NEONATAL PERIOD
Aminoacidurias
Organic Acidurias
Dihydropyrimidine Dehydrogenase Deficiency (#274270)
Peroxisomal Diseases
Mitochondrial Disorders
Disorders of the Urea Cycle
Disorders of Carbohydrate Metabolism
Disorders of Vitamin Metabolism
METABOLIC DISORDERS OF EARLY INFANCY
Aminoacidurias
Lysosomal Disorders
Disorders of Vitamin Metabolism
Glucose Transporter Type 1 Deficiency Syndrome
Congenital Disorders of Glycosylation
Organic Acidurias
Defects of the Urea Cycle
Disorders of γ-Aminobutyric Acid Metabolism
Menkes Disease (#309400)
METABOLIC DISORDERS OF LATE INFANCY
Metachromatic Leukodystrophy
Mucopolysaccharidoses
Neuronal Ceroid Lipofuscinoses
METABOLIC DISORDERS OF CHILDHOOD AND ADOLESCENCE
Homocystinuria
Adrenoleukodystrophy
Lysosomal Disorders
Progressive Myoclonus Epilepsies
DIAGNOSTIC INVESTIGATION
TREATMENT
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 305. MITOCHONDRIAL DISEASES AND EPILEPSY
INTRODUCTION
CLINICAL DESCRIPTION
Mitochondrial Encephalomyopathies Associated With mtDNA Mutations
Mitochondrial Encephalomyopathies Associated With Nuclear Mutations
EPILEPTIC SEIZURES
Kearns–Sayre Syndrome
Myoclonus Epilepsy With Ragged-Red Fibers
Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Episodes
Other Mitochondrial Encephalomyopathies With Epilepsy Due to mtDNA Point Mutations
Mitochondrial Encephalomyopathies Associated With Nuclear Mutations
DIAGNOSTIC INVESTIGATION
Clinical Issues
Clinical Laboratory Tests
Special Laboratory Tests
TREATMENT
Symptom Management
Metabolic Therapy
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 306. SEIZURES IN NEONATAL HYPOXIC–ISCHEMIC ENCEPHALOPATHY
INTRODUCTION
DEFINITIONS
CLINICAL DIAGNOSIS OF HIE
Contributing Factors and Diagnostic Considerations
Criteria for Treatment With Therapeutic Hypothermia
PATHOPHYSIOLOGY OF HIE
Experimental Models
Evolution of Injury in Hypoxia–Ischemia
Mechanisms of Neuroprotection With Therapeutic Hypothermia
ACUTE SYMPTOMATIC SEIZURES IN HIE
Incidence of Seizures in Clinical HIE
Pathophysiology of Increased Seizure Susceptibility of the Neonatal Brain
Diagnosis of Seizures in Clinical HIE
Treatment of Neonatal Seizures Due to HIE
DEVELOPMENT OF EPILEPSY AFTER HIE
Epileptogenesis in the Developing Brain
Risk Factors for Epilepsy Following HIE
CONCLUSIONS
REFERENCES
CHAPTER 307. CENTRAL NERVOUS SYSTEM TUMORS AND SEIZURES: EPIDEMIOLOGY, DIAGNOSIS, AND MANAGEMENT
NEOPLASTIC DISEASES: INTRODUCTION
HISTORICAL PERSPECTIVES
EPIDEMIOLOGY
The Influence of Tumor Location and Growth Rate on Seizure Frequency
Biologic Factors
Epilepsy in Glioneuronal Tumors and Gliomas
Epilepsy in Meningiomas and Brain Metastases
CLINICAL PRESENTATION
Seizure Types in Tumor-Associated Epilepsies
Status Epilepticus in Patients With Brain Tumor
DIFFERENTIAL DIAGNOSIS
DIAGNOSTIC EVALUATION
Neuroimaging
Laboratory Investigations
Neurophysiologic Studies
The Role of Neuropsychological Evaluation
ANTISEIZURE MEDICATION THERAPY
Pharmacotherapeutic Aspects of Tumor-Associated Epilepsy
Potential Synergistic Antitumor Effects of ASM With Concurrent Chemotherapy or Radiation
Prophylactic ASM Use
Withdrawal of ASM Therapy in Brain Tumor Patients With Seizures
SURGICAL THERAPY
Lesionectomy Versus More Extensive Surgery
Electrocorticography in Tumor Surgery
RADIATION THERAPY AND CHEMOTHERAPY
Seizures as Prognostic Indicator in Gliomas
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 308. INFECTIOUS DISEASES AND SEIZURES OR EPILEPSY
PARASITIC INFECTIONS
Neurocysticercosis
Cerebral Malaria
Other Parasitic Diseases of the CNS
BACTERIAL INFECTIONS
Pyogenic Meningitis
Brain Abscess
Empyemas
Tuberculosis of the CNS
VIRAL INFECTIONS
Viral Encephalitis
Acquired Immunodeficiency Syndrome
REFERENCES
CHAPTER 309. ACUTE SYMPTOMATIC SEIZURES SECONDARY TO AUTOIMMUNE ENCEPHALITIS AND AUTOIMMUNE-ASSOCIATED EPILEPSIES
INTRODUCTION
DEFINITIONS
ACUTE SYMPTOMATIC SEIZURES SECONDARY TO AUTOIMMUNE ENCEPHALITIS
Clinical and Paraclinical Features of Seizures Secondary to Autoimmune Encephalitis
Specific Antibody Syndromes
AUTOIMMUNE-ASSOCIATED EPILEPSIES
Clinical and Paraclinical Features of Autoimmune Associated Epilepsies
Frequency of Autoantibody Positivity in Epilepsy Cohorts
Specific Antibodies in Autoimmune-Associated Epilepsy
Postencephalitic Epilepsy
DIAGNOSTIC APPROACH
Antibody Testing
Clinical and Paraclinical Investigations
Malignancy Screening
TREATMENT APPROACH AND OUTCOMES
General Treatment Approach
Outcomes
Predictive Outcome Scales
Clinical Trials
CONCLUSIONS
REFERENCES
CHAPTER 310. ELECTROLYTE, SPORADIC METABOLIC, AND ENDOCRINE DISORDERS IN EPILEPSY
INTRODUCTION
ELECTROLYTE DISORDERS
Sodium Electrolyte Disorders: Hyponatremia
Magnesium Electrolyte Disorders: Hypomagnesemia
RENAL FAILURE
Uremic Encephalopathy
Aluminum Encephalopathy Syndrome in Infancy and Childhood
Dialysis Disequilibrium Syndrome
Dialysis Encephalopathy Syndrome
ENDOCRINE DISORDERS
Hypothalamic–Pituitary Disorders
Thyroid Disorders
Parathyroid Disorders
Pancreas Disorders
Reproductive Endocrine Disorders
DISEASES OF THE GASTROINTESTINAL SYSTEM
Celiac Disease
Other Gastrointestinal Diseases and Epilepsy
Hepatic Disorders
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 311. THE RELATIONSHIP OF ALCOHOL AND SUBSTANCE MISUSE/ABUSE TO SEIZURES AND EPILEPSY
INTRODUCTION
ALCOHOL
Direct Alcohol Effects
Indirect Effects of Alcohol
Treatment of Alcohol Withdrawal Syndrome and Alcohol-Related Seizures
Alcohol Withdrawal Syndrome
Advice Concerning Drinking Alcohol in People With Epilepsy
SEDATIVE AND HYPNOTIC WITHDRAWAL SEIZURES
RECREATIONAL (ABUSED) DRUGS (CANNABINOIDS, COCAINE, PSYCHOSTIMULANTS)
Amphetamines
Cannabinoids
Cocaine
Dextromethorphan
Dissociative Anesthetics
Hallucinogens
Opioids
Summary of Illicit Substances
PRESCRIBED (LEGAL) STIMULANTS
Prescribed or Illicit Use of ASM
MANAGEMENT ISSUES
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 312. DISORDERS OF PREGNANCY IN EPILEPSY
INTRODUCTION
CARE IN CHILDHOOD AND ADOLESCENCE
CARE DURING CHILDBEARING YEARS
MANAGEMENT OF EPILEPSY DURING PREGNANCY
POSTPREGNANCY CONCERNS
ASM Dose Adjustments
Breastfeeding
Postpartum Depression
ECLAMPSIA
SEIZURE OCCURRENCE DURING PREGNANCY
SUMMARY
REFERENCES
CHAPTER 313. NEW-ONSET REFRACTORY STATUS EPILEPTICUS AND FEBRILE INFECTION-RELATED EPILEPSY SYNDROME
DEFINITION OF NORSE AND FIRES
HISTORY
EPIDEMIOLOGY OF NORSE AND FIRES
CLINICAL FEATURES OF NORSE AND FIRES
DIFFERENTIAL DIAGNOSIS AND MOST FREQUENTLY IDENTIFIED ETIOLOGIES
PATHOPHYSIOLOGY OF CRYPTOGENIC CASES
DIAGNOSTIC WORKUP OF NORSE AND FIRES
Laboratory
Electroencephalogram
Neuroimaging
TREATMENT OF NORSE AND FIRES
OUTCOME OF NORSE AND FIRES
CONCLUSION
REFERENCES
SECTION 12 • Disorders That Can Resemble Epilepsy
CHAPTER 314. OVERVIEW: DISORDERS THAT CAN RESEMBLE EPILEPSY
IMITATORS OF SEIZURES OF ORGANIC TYPE
Medical Disorders
Neurologic Disorders
Imitators of Seizures of Psychogenic Type
CONCLUDING REMARKS
REFERENCES
CHAPTER 315. SYNCOPE RESEMBLING SEIZURES
DEFINITIONS
INCIDENCE, PROGNOSIS, AND COST
CLINICAL DESCRIPTION
Classic Symptoms
Syncopal Convulsions/Syncopal Myoclonus
EEG Appearance
DIFFERENTIAL DIAGNOSIS
Disorders of Orthostatic Intolerance
Primary Cardiac Dysfunction
Metabolic Disorders
Psychiatric Disorders
Epilepsy and Other Neurologic Disorders
DIAGNOSTIC EVALUATION
History
Physical Examination
EKG/Cardiac Monitoring
Echocardiography
Tilt-Table Testing
EEG
Neuroimaging
Wearable Technology
TREATMENT
SUMMARY
REFERENCES
CHAPTER 316. METABOLIC AND ENDOCRINE DISORDERS RESEMBLING SEIZURES
INTRODUCTION
GENERAL COMMENTS REGARDING PATIENT HISTORY
SPECIFIC METABOLIC AND ENDOCRINE DISORDERS
Conditions That Can Mimic Seizures
Conditions That Can Cause or Mimic Seizures
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 317. NONEPILEPTIC NEUROLOGIC PAROXYSMAL DISORDERS AND EPISODIC SYMPTOMS IN INFANTS
INTRODUCTION
ENHANCED NORMAL PHENOMENA AND OTHER PAROXYSMAL EPISODES
Sporadic Myoclonic Jerks During Sleep or Physiologic Sleep Myoclonus
Localized Myoclonus during Wakefulness
Startle Responses
Bruxism
Nonepileptic Apnea
TRANSIENT OR BENIGN MOVEMENT DISORDERS
Benign Neonatal Sleep Myoclonus
Tonic Reflex Seizures of Early Infancy
Head Atonic Attacks in Infancy
Benign Myoclonus of Early Infancy or Fejerman Syndrome
Benign Paroxysmal Tonic Upward Gaze
Transient Paroxysmal Dystonia
Benign Paroxysmal Torticollis
Adverse Reactions to Exogenous Agents
HABIT-TYPE MOVEMENT AND SELF-GRATIFICATION EPISODES
Head Banging, Head Rolling, Rocking, and Other Stereotypic Movements
Masturbation-Like Episodes
SYMPTOMATIC ABNORMAL MOVEMENTS
Neonatal Posturing and Other Nonepileptic Episodes
Opsoclonus–Myoclonus Syndrome
Bobble-head Doll Syndrome
Encephalopathic Nonepileptic Myoclonus
OTHER NEUROLOGIC CONDITIONS WITH EPISODIC SYMPTOMS
Hyperekplexia
Cogan Oculomotor Apraxia
Benign Paroxysmal Vertigo
Spasmus Nutans
Alternating Hemiplegia of Childhood
Paroxysmal Dystonia and Choreoathetosis
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 318. MIGRAINE RESEMBLING SEIZURES
INTRODUCTION
CLASSIFICATION
Migraine
Aura
Mechanisms of Aura
Headache Phase
Postdrome or Postictal Phase
FORMAL INTERNATIONAL CLASSIFICATION OF HEADACHE DISORDERS-3 CLASSIFICATION
Migraine without Aura (Common Migraine)
Migraine With Aura (Classic Migraine)
MIGRAINE SUBTYPES
Migraine With Brainstem Aura (Formerly Basilar-Type Migraine)
Benign Paroxysmal Vertigo of Childhood (ICHD-3 1.6.2)
Aura without Headache (ICHD-3 1.2.1.2)
Migraine Aura–Triggered Seizure (ICHD-3 1.4.4)
EPIDEMIOLOGIC CONNECTIONS BETWEEN MIGRAINE AND EPILEPSY
INTERRELATIONSHIPS BETWEEN HEADACHE AND EPILEPSY
Headache as a Consequence of Seizures
Migraine–Epilepsy Syndromes
DIFFERENTIAL DIAGNOSIS AND CONCOMITANT DIAGNOSIS OF MIGRAINE AND EPILEPSY: CLINICAL AND ELECTROENCEPHALOGRAPHIC FEATURES
TREATMENT CONSIDERATIONS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 319. CEREBROVASCULAR DISORDERS RESEMBLING SEIZURES
INTRODUCTION
EPIDEMIOLOGY
TREATMENT
NOSOLOGY OF TRANSIENT ISCHEMIC ATTACKS
PREVALENCE AND INCIDENCE OF TRANSIENT ISCHEMIC ATTACKS
NATURAL HISTORY OF TRANSIENT ISCHEMIC ATTACKS
DIAGNOSTIC DIFFICULTY
TYPICAL TRANSIENT ISCHEMIC ATTACK SYMPTOMS
TYPICAL TIME COURSE OF TRANSIENT ISCHEMIC ATTACKS
ATYPICAL TRANSIENT ISCHEMIC ATTACK PRESENTATIONS
Limb-shaking Carotid Transient Ischemic Attacks
Unilateral Asterixis
Episodic Dyskinesia
Pure Sensory Spells
Speech Arrest
Visual Inversion
Visual Hallucinations
Brainstem Auditory Hallucinosis
Auditory Aprosodia
Transient Anosognosia
Akinetic Mutism
Drop Attacks
Moyamoya Disease
SUMMARY AND CONCLUSIONS
ADDITIONAL INFORMATION
REFERENCES
CHAPTER 320. SLEEP AND EPILEPSY: SEIZURE MIMICS AND SLEEP
EPILEPSY AND BIOLOGIC RHYTHMS
Circadian Rhythm
Ultradian Rhythm
Antiseizure Influence on Ultradian Rhythm and Sleepiness
Multidien Rhythm
SLEEP DISORDER MIMICS OF EPILEPSY
Sleep Disorders in Epilepsy
Nocturnal Frontal Lobe Epilepsy/Sleep-Related Hypermotor Epilepsy
Disorders of Central Hypersomnolence
Sleep-Related Movement Disorders
CONCLUSIONS
REFERENCES
CHAPTER 321. MYOCLONUS AND MYOCLONIC SYNDROMES
INTRODUCTION
CLINICAL DESCRIPTION
CLASSIFICATION
EPILEPTIC MYOCLONUS
Progressive Myoclonus Epilepsies
Dementias
Viral Encephalopathies
Metabolic Encephalopathies Including Endocrine Disorders
Autoimmune Disorders
Toxic Encephalopathies Including Drug Side Effects
Physical Encephalopathies Including Hypoxia
Focal Brain Damage
NONEPILEPTIC MYOCLONUS
Dystonic Myoclonus and Fragments of Other Involuntary Movement Disorders
Essential Myoclonus
Exaggerated Startle
Periodic Movements in Sleep
Segmental Myoclonus Including Spinal Myoclonus and Palatal Myoclonus
Asterixis
Functional (Psychogenic) Myoclonus
DIAGNOSTIC INVESTIGATION
TREATMENT
Epileptic Myoclonus
Essential Myoclonus
Exaggerated Startle
Periodic Movements in Sleep
Segmental Myoclonus
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 322. MOVEMENT DISORDERS RESEMBLING SEIZURES
INTRODUCTION
INFANTS
Myoclonus
Tremor and Oscillatory Movements
Dystonia
CHILDREN
Stereotypies and Tics
Paroxysmal Disorders
ADULTS
Functional Movement Disorders
Autoimmune Movement Disorders
Cortical Tremor
Staring Episodes in Lewy Body Dementia
Hemifacial Spasm
REFERENCES
CHAPTER 323. MOVEMENT DISORDERS: DYSKINESIAS
INTRODUCTION
PAROXYSMAL DYSKINESIAS—HISTORY
PAROXYSMAL KINESIGENIC DYSKINESIA
Clinical Features
Idiopathic Paroxysmal Dyskinesias
Symptomatic Paroxysmal Dyskinesias
PAROXYSMAL NONKINESIGENIC DYSKINESIA
Clinical Features
Idiopathic Nonkinesigenic Dyskinesias
Symptomatic Paroxysmal Nonkinesigenic Dyskinesia
PAROXYSMAL EXERTIONAL DYSKINESIA
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENT
REFERENCES
CHAPTER 324. SENSORY DISORDERS RESEMBLING SEIZURES
INTRODUCTION
DISORDERS OF OLFACTION
DISORDERS OF VISION
DISORDERS OF HEARING
DISORDERS OF THE VESTIBULAR SYSTEM
DISORDERS OF THE SOMATOSENSORY SYSTEM
DISORDERS OF THE AUTONOMIC (VISCERAL) SENSORY SYSTEM
PSYCHOGENIC SENSORY SYMPTOMS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 325. OTHER NEUROLOGIC EVENTS RESEMBLING EPILEPTIC SEIZURES
INTRODUCTION
TRANSIENT GLOBAL AMNESIA AND ITS DIFFERENTIATION FROM TRANSIENT EPILEPTIC AMNESIA
MOVEMENTS THAT MAY MIMIC SEIZURE ACTIVITY IN THE COMATOSE PATIENT
Decorticate and Decerebrate Posturing
Paroxysmal Sympathetic Hyperactivity Following Acquired Brain Injury
Involuntary Focal and Segmental Movements
DEMYELINATION AND PAROXYSMAL DYSKINESIA AS A POTENTIAL SEIZURE MIMIC
CONCLUSION
REFERENCES
CHAPTER 326. OVERVIEW: PSYCHIATRIC DISTURBANCES
INTRODUCTION
HISTORICAL PERSPECTIVE
CURRENT CHALLENGES
THE PROBLEM WITH SEIZURE MISDIAGNOSIS
WHAT CAN WE DO BETTER?
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 327. PSYCHOGENIC NONEPILEPTIC SEIZURES IN ADULTS
INTRODUCTION
NOMENCLATURE
EPIDEMIOLOGY OF PSYCHOGENIC NONEPILEPTIC SEIZURES
DIAGNOSIS OF PNES
ETIOLOGY
Stressors (Trauma, Abuse, and Stressful Life Events)
Acute and Persistent Stress
Dysfunctional Relationships and Attachment
Illness Beliefs
PSYCHIATRIC COMORBIDITY
Dissociative and Functional Disorders
Posttraumatic Stress Disorder
Personality Disorder
Depression and Anxiety
Factitious Disorder
Malingering
MEDICAL AND NEUROLOGIC COMORBIDITY
Epilepsy and Epilepsy Surgery
Traumatic Brain Injury
Cognitive Complaints
Chronic Pain
Migraine
Asthma
TREATMENT
SUMMARY AND CONCLUSION
REFERENCES
CHAPTER 328. PSYCHOGENIC NONEPILEPTIC SEIZURES IN PEDIATRIC PATIENTS
INTRODUCTION
RISK FACTORS
ASSESSMENT AND DIAGNOSIS
CLINICAL PNES CHARACTERISTICS AND COMORBIDITIES
TREATMENT
OUTCOME
SUMMARY
REFERENCES
CHAPTER 329. DISORDERS OF IMPULSE CONTROL IN EPILEPSY
INTRODUCTION
IMPULSIVE AGGRESSION IN EPILEPSY
TREATMENT OF AGGRESSION IN EPILEPSY
EPILEPSY AND OTHER DISORDERS OF IMPULSE CONTROL
CONCLUSION
REFERENCES
CHAPTER 330. DISSOCIATIVE DISORDERS
INTRODUCTION
THE CONCEPT OF DISSOCIATION: A HISTORICAL BACKGROUND
Origins of Dissociation
Division of Consciousness: Dissociation as Seen in Hysteria
Psychoanalytic Theories
Modern Theories
EPIDEMIOLOGY OF DISSOCIATIVE DISORDERS
PHENOMENOLOGY OF DISSOCIATION AND NOSOLOGIC CLASSIFICATION OF DISSOCIATIVE DISORDERS
Specific DSM-5 Dissociative Disorders
NEUROBIOLOGIC MECHANISMS OF DISSOCIATIVE DISORDERS
MEASURES OF DISSOCIATION
DIFFERENTIAL DIAGNOSIS
TREATMENT OF DISSOCIATIVE DISORDERS
Psychotherapy
Pharmacologic Treatment and Neuromodulation
CONCLUSIONS
REFERENCES
CHAPTER 331. PANIC DISORDER AND HYPERVENTILATION SYNDROME
INTRODUCTION
PANIC ATTACKS AND PANIC DISORDER
Epidemiologic Aspects
Clinical Manifestations
Localization of Ictal Fear
Differential Diagnosis
Diagnostic Evaluations
Treatment Strategies
HYPERVENTILATION SYNDROME
Historical Aspects
Clinical Manifestations
Physiopathologic Aspects
Differential Diagnosis
Treatment of HVS
HV-Induced Epileptic Seizures
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 332. OBSESSIVE-COMPULSIVE BEHAVIOR
INTRODUCTION
CLINICAL PRESENTATION
Obsessive-Compulsive Disorder
Obsessive-Compulsive–Related Disorders
The Neuroanatomy of Obsessive-Compulsive Behavior—Results of Neuroimaging Studies in Obsessive-Compulsive Disorder
Putative Neuroanatomic Model
DIFFERENTIAL DIAGNOSIS
INVESTIGATIONS
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 333. PSYCHOTIC SYMPTOMS MIMICKING EPILEPTIC SEIZURES
INTRODUCTION
PSYCHOTIC SYMPTOMS AS AN EXPRESSION OF EPILEPTIC SEIZURES
Ictal Psychotic Symptoms and Episodes
PSYCHOTIC SYMPTOMS AS AN EXPRESSION OF NONCONVULSIVE STATUS EPILEPTICUS
Psychiatric Manifestations of Absence Status Epilepticus
POSTICTAL PSYCHOTIC SYMPTOMS
FORCED NORMALIZATION OR ALTERNATIVE PSYCHOSIS
SUMMARY AND CONCLUSION
REFERENCES
SECTION 13 • Delivery of Health Care in People with Epilepsy
CHAPTER 334. OVERVIEW: DELIVERY OF HEALTH CARE AND SOCIOECONOMIC ISSUES IN PEOPLE WITH EPILEPSY
INTRODUCTION
LEVELS OF CARE
Primary Care
Secondary Care
Tertiary Care
Specialized Centers or Fourth-level Care
Stepped Model of Epilepsy Care
SOCIOECONOMIC CONSIDERATIONS
Government versus Private Bureaucracy
Gap in Epilepsy Care With Private Health Care
DEVELOPMENT OF EPILEPSY CARE
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENT
REFERENCES
CHAPTER 335. EPILEPSY IN AFRICA
EPIDEMIOLOGY
PREVALENCE AND BURDEN OF DISEASE
Risk Factors (Secondary Causes)
Health Care Services for People with Epilepsy in SSA
CONCLUSION
REFERENCES
CHAPTER 336. EPILEPSY IN ARGENTINA
INTRODUCTION
THE ARGENTINE HEALTH CARE SYSTEM
LEVELS OF MEDICAL CARE
NEUROLOGISTS AND CHILD NEUROLOGISTS
DATA ON EPILEPSY
ANTISEIZURE MEDICATIONS
PSYCHOSOCIAL ASPECTS
NEUROLOGY AND EPILEPSY TRAINING AND RESEARCH
SCIENTIFIC SOCIETIES
ADVOCACY AND PARENT ASSOCIATIONS
THE LAW ON EPILEPSY
NATIONAL PROGRAM
TELEMEDICINE IN EPILEPSY
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 337. EPILEPSY IN ASIA
INTRODUCTION
SOCIOECONOMIC BACKGROUND
EPIDEMIOLOGY
CAUSES
EPILEPSY CARE
Low Number of Neurologists in South and South East Asia
Antiseizure Medications
Neuroimaging, EEG, and Epilepsy Surgery
Treatment Gap
PSYCHO-CULTURAL ISSUES AND STIGMA
SOUTH EAST ASIA
Epidemiology
Aetiology
Status Epilepticus
Alternative Medicine
Compliance to Medication
Psychiatric Comorbidities
PAKISTAN, BANGLADESH, NEPAL, SRI LANKA
Pakistan
Bangladesh
Nepal
Sri Lanka
NORTH EAST ASIA OTHER THAN CHINA, JAPAN, AND SOUTH KOREA
North Korea
Taiwan
Hong Kong
Mongolia
THE PACIFIC ISLANDS
EPILEPSY ORGANIZATIONS
RESEARCH
REGIONAL NETWORKING
REFERENCES
CHAPTER 338. EPILEPSY IN BRAZIL
INTRODUCTION
GENERAL DATA ON THE HEALTH SYSTEM
EPILEPSY DATA
ANTISEIZURE MEDICATIONS
Clinicians and Neurologists
Drug Consumption and Treatment
THE SISTEMA ÚNICO DE SAúDE: A WORLD REFERENCE HEALTH SYSTEM
EPILEPSY IN BRAZIL
Types of Seizures and Epilepsy
Etiologies
Psychosocial Aspects
THE ROLE OF SOCIETIES
Brazilian Societies
Lay-People Associations and the National Demonstration Project on Epilepsy
HIGHLIGHTS OF BRAZILIAN SCIENTIFIC CONTRIBUTIONS TO EPILEPTOLOGY
Paulo Niemeyer Soares and the Transventricular Amygdalohippocampectomy
Esper Abrão Cavalheiro and the Pilocarpine Epilepsy Model
The Brazilian Program for Epilepsy Surgery
The Scientific Contribution of Brazilian Epilepsy Centers
Latin American Summer School on Epilepsy
International Summer School for Neuropathology and Epilepsy Surgery
Pediatric Epilepsy Training
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 339. EPILEPSY IN CANADA
HEALTH CARE IN CANADA
EPIDEMIOLOGY OF EPILEPSY IN CANADA
EPILEPSY RESOURCES
Antiseizure Medications and Devices
An Example of Organized Epilepsy Care: The Ontario Provincial Strategy
National Epilepsy Associations
CONCLUSIONS
REFERENCES
CHAPTER 340. EPILEPSY IN THE CARIBBEAN
INTRODUCTION
HEALTH STATISTICS OF THE ENGLISH-SPEAKING CARIBBEAN
EPILEPSY CARE IN THE CARIBBEAN: BEFORE THE JAMAICAN LEAGUE AGAINST EPILEPSY
EPILEPSY CARE IN THE CARIBBEAN: SINCE THE FORMATION OF THE JAMAICAN LEAGUE AGAINST EPILEPSY
ORGANIZATION OF HEALTH CARE SYSTEMS IN THE ENGLISH-SPEAKING CARIBBEAN
Jamaica
Barbados
Trinidad and Tobago
French Caribbean
THE CRITICAL IMPORTANCE OF RELATIONSHIPS IN CREATING CHANGE
ACHIEVEMENTS AND FAILURES
SUMMARY AND CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 341. EPILEPSY IN CHILE
INTRODUCTION
CHILEAN HEALTH SYSTEM
EPILEPSY IN CHILE AS “NONTRANSMISSIBLE CHRONIC DISEASE”
STAGES IN THE PROGRESS OF EPILEPSY MANAGEMENT IN THE MINISTRY OF HEALTH IN CHILE
IMPLEMENTATION OF THE EXPLICIT HEALTH GUARANTEE PLAN
EPILEPSY PROGRAM IN CHILE AND MINISTRY OF HEALTH: FOUNDATION OF THE EPILEPSY PROGRAM, OBJECTIVES, STRATEGIES, AND RESULTS
CHILEAN LEAGUE AGAINST EPILEPSY
Volunteering
Medication Banks
Boards of Directors
Present
Roles and Responsibilities
ANLICHE: National Association of Chilean Leagues Against Epilepsy
LICHE as PAHO/WHO Collaborating Center
CONCLUSIONS
REFERENCES
CHAPTER 342. EPILEPSY IN CHINA
INTRODUCTION
EPIDEMIOLOGY
Prevalence, Incidence, and Treatment Gap
Mortality and Sudden Unexpected Death in Epilepsy
Etiology
Prognosis
DIAGNOSIS AND TREATMENT
Preface
Diagnosis
ASM Treatments
Epilepsy Surgery and Presurgical Evaluation
Neuromodulation
Dietary Therapy
TCM and Epilepsy
PEDIATRIC EPILEPSY
EPILEPSY IN PUBLIC HEALTH ASPECTS
Stigma and Psychosocial Aspects
Public Health Projects for Epilepsy Control in China
“Going West” Project
Awareness, Publicities, and Education
Networking
EPILEPSY RESEARCH
CONCLUSION
REFERENCES
CHAPTER 343. EPILEPSY IN CUBA
THE CUBAN HEALTH SYSTEM
EPIDEMIOLOGY OF EPILEPSY IN CUBA
MANAGEMENT OF EPILEPSY AT PRIMARY HEALTH LEVEL
TRAINING OF HUMAN RESOURCES
STUDIES IN EXPERIMENTAL MODELS OF EPILEPSY
PSYCHOSOCIAL ASPECTS
COST OF EPILEPSY IN CUBA
A COMPREHENSIVE EPILEPSY PROGRAM FOR THE ASSESSMENT AND SURGICAL TREATMENT OF PHARMACORRESISTENT EPILEPSIES IN CUBA
Presurgical Evaluation in Pharmacoresistant Epilepsy of the Temporal and Extratemporal Lobe
Intraoperative Electrocorticographic Monitoring in Epilepsy Surgery: Relationship with the Neuropathologic Substrate
Surgical Treatment of Pharmacoresistant Epilepsies of the Temporal and Extratemporal Lobe: Electroclinical, Neuropsychological, Sensory, and Immunologic Longitudinal Follow-up
CONCLUSIONS
REFERENCES
CHAPTER 344. EPILEPSY IN THE CZECH REPUBLIC
INTRODUCTION
THE ORGANIZATION OF THE HEALTH CARE SYSTEM
EPILEPSY-SPECIFIC HEALTH CARE RESOURCES
ANTISEIZURE MEDICATION
NATIONAL EPILEPSY ORGANIZATION
EPILEPSY AWARENESS IN THE CZECH REPUBLIC
CONCLUSION
REFERENCES
CHAPTER 345. EPILEPSY IN GERMANY
INTRODUCTION
THE GERMAN SOCIAL WELFARE SYSTEM
Health Insurance
ORGANIZATION OF HEALTH SERVICES
EPILEPSY-SPECIFIC HEALTH CARE RESOURCES
Structure of Epilepsy-Specific Care in Germany
Cost of Epilepsy-Specific Care in Germany
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 346. EPILEPSY IN INDIA
TREATMENT GAP
National Epilepsy Program
Rural Medical Camps and Home-Based Care for Epilepsy
SPECIAL SYNDROMES
Pharmacogenetics
MANAGEMENT OF EPILEPSY
EPIDEMIOLOGY
NCC
Hot Water Epilepsy
Excess Mortality and SUDEP
SPECIAL ISSUES
Women with Epilepsy
Children
DISABILITY OF EPILEPSY
ECONOMIC BURDEN
MEDICOLEGAL
CONCLUSION
REFERENCES
CHAPTER 347. EPILEPSY IN IRAN
INTRODUCTION
HEALTH CARE IN IRAN
HISTORICAL BACKGROUND
EPIDEMIOLOGY
CAUSES OF EPILEPSY
PROVISION OF CARE FOR PEOPLE WITH EPILEPSY
DIAGNOSIS
PRESURGICAL EVALUATION
EPILEPSY SURGERY
SOCIAL SUPPORT
EPILEPSY RESEARCH
EFFECTS OF ECONOMIC SANCTIONS ON THE HEALTH CARE OF EPILEPTIC PATIENTS
CHALLENGES
CONCLUSION
REFERENCES
CHAPTER 348. EPILEPSY IN IRAQ
PREMODERN HISTORY
MODERN HISTORY
IRAQI HEALTH CARE
Education and Training
Health Services and Capacity
Cost of Care
Barriers to Services
CONCLUSION
REFERENCES
CHAPTER 349. EPILEPSY IN LATIN AMERICA
INTRODUCTION
MEDICAL CARE
DATA ON EPILEPSY
EPILEPSY CARE
Specialized Centers, Neurologists, and Epileptologists
Antiseizure Medications
Diagnostic Studies
Epilepsy Surgery
Ketogenic Diet
Vagus Nerve Stimulation
Traditional Medicine
THE TREATMENT GAP
PSYCHOSOCIAL ASPECTS AND STIGMA
EPILEPSY TRAINING IN PRIMARY HEALTH CARE
NEUROLOGY AND EPILEPSY TRAINING
RESEARCH IN EPILEPSY
SCIENTIFIC SOCIETIES
Advocacy and Parent Associations
The Laws on Epilepsy and National Programs
Telemedicine in Epilepsy
Plan of Action and Strategy for Epilepsy
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 350. EPIDEMIOLOGY OF EPILEPSY IN LATIN AMERICA
INTRODUCTION
PREVALENCE STUDIES
INCIDENCE STUDIES IN LATIN AMERICA
TREATMENT GAP
MORTALITY
CONCLUSION
REFERENCES
CHAPTER 351. EPILEPSY IN MEXICO
EPIDEMIOLOGY
CLASSIFICATION AND RISK FACTORS FOR EPILEPSY IN MEXICO
THERAPEUTIC EPILEPSY GUIDELINES PUBLISHED IN MEXICO
Guides of the National Center of Technological Excellence in Health (CENETEC)
Priority Epilepsy Program Guidelines
REPORTS ON EPILEPSY SURGERY IN MEXICO
Vagus Nerve Stimulation
Intracranial Neuromodulation
MEXICAN RESEARCH ARTICLES ON EPILEPSY
NEUROPSYCHIATRIC STUDIES OF EPILEPSY IN MEXICO
SOCIAL AND ECONOMIC IMPACT OF EPILEPSY IN MEXICO
EPILEPSY AT THE NATIONAL INSTITUTE OF NEUROLOGY AND NEUROSURGERY “MANUEL VELASCO SUáREZ” AND THE COMPREHENSIVE CARE CENTER 1 OF THE PRIORITY EPILEPSY PROGRAM IN MEXICO
EPILEPSY TRAINING IN MEXICO
Undergraduate Education in Epilepsy
Postgraduate Education in Mexico
CONCLUSIONS
REFERENCES
CHAPTER 352. EPILEPSY IN THE NETHERLANDS
EPIDEMIOLOGY
HEALTH CARE FACILITIES
HEALTH CARE PROVIDERS
Knowledge Transfer
Health Care Finances and Reimbursements
MORTALITY IN EPILEPSY
EPILEPSY DIAGNOSIS
SEIZURE DETECTION
EPILEPSY CLASSIFICATION AND DIAGNOSTIC FACILITIES
EPILEPSY TREATMENT
COLLABORATION IN CARE AND RESEARCH
REFERENCES
CHAPTER 353. EPILEPSY IN NIGERIA
GENERAL BACKGROUND OF NIGERIA
HEALTH CARE FACILITIES IN NIGERIA
HEALTH CARE HUMAN RESOURCES (MEDICAL DOCTORS)
EPIDEMIOLOGY OF EPILEPSY
Etiology
Antenatal Care, Birth Injury, Birth Asphyxia
Infectious Disease
Brain Injury and Stroke
TREATMENT OF EPILEPSY
Inadequate Manpower
Antiseizure Medications
Treatment Gap
Outcome
Quality of Life Measures
PSYCHIATRIC MORBIDITY IN EPILEPSY
CULTURAL CONTEXT OF EPILEPSY
INJURIES
HEALTH EDUCATION
REFERENCES
CHAPTER 354. EPILEPSY IN THE RUSSIAN FEDERATION
INTRODUCTION
HISTORY OF EPILEPTOLOGY IN RUSSIA
The Founders of Russian Epileptology
The Soviet Period
Epileptology in the Russian Federation
EPIDEMIOLOGY
ORGANIZATION OF CARE
EDUCATION
CONCLUSION
REFERENCES
CHAPTER 355. EPILEPSY IN SAUDI ARABIA
INTRODUCTION
EPIDEMIOLOGY OF EPILEPSY
CAUSES OF EPILEPSY
Epilepsy Management in the Kingdom of Saudi Arabia
Specialist Care
Developing Epilepsy Patients’ Medical Registers Program
Diagnostic Devices
Manpower for Epilepsy Management in KSA
Epilepsy Surgery Program in KSA
CLINICAL EPILEPSY RESEARCH IN THE KINGDOM OF SAUDI ARABIA
PUBLIC AWARENESS AND ATTITUDES
EPILEPSY HEALTH CARE SYSTEM IN KSA
CONCLUSIONS
REFERENCES
CHAPTER 356. EPILEPSY IN SCANDINAVIA
DEMOGRAPHY
CENTRAL REGISTERS FOR SURVEILLANCE AND RESEARCH
EPILEPSY CARE IN SWEDEN
Short History of Epilepsy Care in Sweden
Levels of Epilepsy Care in Sweden Today and Referral System
Specialized Epilepsy Care, Tertiary Centers
National Guidelines
Planned Improvements of Epilepsy Care
EPILEPSY CARE IN DENMARK
Organization of Health care in Denmark
Organization of Epilepsy Care in Denmark
Investigational Procedures
The Danish Epilepsy Hospital “Filadelfia”
EPILEPSY CARE IN NORWAY
Primary Health Care
Specialist Health Care
National Centre for Epilepsy
EpilepsiNETT
Norwegian Guidelines for Care and Treatment of Epilepsy
SIMILARITIES AND DIFFERENCES BETWEEN THE SCANDINAVIAN COUNTRIES
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 357. EPILEPSY IN SENEGAL
INTRODUCTION
OVERVIEW OF THE COUNTRY
GENERAL DATA ON THE HEALTH SYSTEM
Health Organization and General Data
Health Financing
Health Personnel
Neurologists
EPILEPSY IN SENEGAL
Epidemiology
The Etiologic Factors
Sociocultural Representation
Available Antiseizure Medications and Diagnostic Facilities in Senegal
The Role of the Senegalese League Against Epilepsy
SUMMARY AND CONCLUSION
ACKNOWLEDGMENT
REFERENCES
CHAPTER 358. EPILEPSY IN SOUTH AFRICA
INTRODUCTION, DEMOGRAPHICS, AND HEALTH CHALLENGES
Health Challenges
Social Support
History of the SA Health System
Present Day Access to Health Care
Epidemiology
ACUTE CARE
SPECIFIC CONDITIONS AND COMORBIDITIES
Neurocysticercosis
HIV and Epilepsy
Bone Health
Epileptic Spasms
Dravet Syndrome
Hemiconvulsion-Hemiplegia-Epilepsy Syndrome
EEG Utility
Psychogenic Nonepileptic Seizures
Social Stigma
Traditional and Faith Healers
Nongovernment Organizations for Epilepsy
TRAINING AND EDUCATION OPPORTUNITIES
NATIONAL BODIES
ILAE SA Chapter
Neuroscience Research in South Africa: Basic Science Activity
UNIQUE DIRECTIONS FOR SOUTH AFRICA
CONCLUSIONS
REFERENCES
CHAPTER 359. EPILEPSY IN SOUTH KOREA
TRADITIONAL ORIENTAL MEDICINE
ERA OF WESTERN MEDICINE
MEDICAL TREATMENT OF EPILEPSY
HEALTH CARE SYSTEM IN KOREA
EPILEPSY SURGERY
SIGNIFICANT ACHIEVEMENTS FOR THE EPILEPSY CARE IN KOREA
Driving Privileges
National Disability Enactment
New Name of Epilepsy
Prescription of SSRI and SSSNRI in Patients with Epilepsy
Life Insurance for Patients with Epilepsy
National Epilepsy Support Program
REFERENCES
CHAPTER 360. EPILEPSY IN TUNISIA
INTRODUCTION
GENERAL DATA ON THE HEALTH SYSTEM
Organization of the Health Care System in Tunisia
Health Care Professionals
Technical Resources for Epilepsy Diagnosis
Antiseizure Medications
HEALTH CARE FINANCING AND HEALTH INSURANCE
Health Care Financing
Health Insurance
EPIDEMIOLOGY OF EPILEPSY IN TUNISIA
EDUCATION ON EPILEPSY IN TUNISIA
RESEARCH IN EPILEPSY IN TUNISIA
THE ROLE OF SCIENTIFIC AND SOCIAL SOCIETIES
REFERENCES
CHAPTER 361. EPILEPSY IN TURKEY
BRIEF HISTORY OF THE TURKISH HEALTH CARE SYSTEM
SOCIAL SECURITY INSTITUTION
ORGANIZATION OF THE HEALTH CARE SERVICES IN TURKEY
Preventive Health Services
Therapeutic Health Services
Rehabilitation Services
MEDICAL CARE FOR PERSONS WITH EPILEPSY IN TURKEY
CONCLUSION
REFERENCES
CHAPTER 362. EPILEPSY IN THE UNITED KINGDOM
INTRODUCTION
MEDICAL DEVELOPMENTS
The Organisation of Paediatric Epilepsy Networks in the United Kingdom
Examples of Notable UK Epilepsy Studies
The Cochrane Collaboration
Genomics England, 100,000 Genome Project
Autoimmune Epilepsy
SURGICAL DEVELOPMENTS
Epilepsy Surgery in the United Kingdom
The Children’s Epilepsy Surgery Service (CESS)
GUIDELINES
NICE
SIGN
Entitlement to Drive
AUDITS
The National Sentinel Clinical Audit of Epilepsy-Related Death
Epilepsy12
National Audit of Seizure Management in Hospitals
Public Health England Mortality Audit
CHARITIES
Epilepsy Research UK
Epilepsy Action
SUDEP Action
Matthew’s Friends
CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
CHAPTER 363. EPILEPSY IN THE UNITED STATES OF AMERICA
HEALTH CARE PROVIDERS
EPILEPSY CARE
HEALTH INSURANCE
Public Health Insurance
Private Health Insurance
SUMMARY AND CONCLUSIONS
REFERENCES
CHAPTER 364. IMPLEMENTATION SCIENCE FOR EPILEPSY
GENERAL BACKGROUND
IMPLEMENTATION SCIENCE AND THE RESEARCH PIPELINE
IMPLEMENTATION SCIENCE HAS A ROLE DISTINCT FROM HEALTH SERVICES RESEARCH AND QUALITY IMPROVEMENT
IMPLEMENTATION SCIENCE FRAMEWORKS
HYBRID MODELS
EPILEPSY IS A LATE ADAPTER TO IMPLEMENTATION SCIENCE
IMPLEMENTATION SCIENCE EMERGENCE WITHIN EPILEPSY RESEARCH AND CLINICAL CARE
REFERENCES
CHAPTER 365. SOCIAL MEDIA TO ENHANCE HEALTH CARE DELIVERY AND EDUCATION IN EPILEPSY
BACKGROUND
PUBLIC AWARENESS CAMPAIGNS IN THE EARLY NAUGHTS (2000–2009) AND THE USE OF SOCIAL MEDIA
USE OF SOCIAL MEDIA IN EPILEPSY CARE AND EDUCATION
Presence of Epilepsy Community and Groups on Social Media
Social Networking as Method for Peer-Support in Epilepsy
Community Education
Patient Care and Physician Engagement
Reaching Underserved Groups
Professional Networking
DANGERS OF SOCIAL MEDIA
Does Stigmatization of Epilepsy Exist in Social Media?
When GIFs and Social Media Posts Attack
Poor-Quality Information
Professionalism
Ethical Concerns with Patient Privacy, Data Security, and the Online Patient–Clinician Relationship
ISSUES WITH ONLINE HEALTH EDUCATION MATERIALS
SUMMARY
REFERENCES
Index
An aparitie | 25 noi 2023 |
Autor | Jerome Engel, Jr., Solomon L. Moshe |
Dimensiuni | 213 x 276 mm |
Editura | LWW |
Format | Hardcover |
ISBN | 9781975105525 |
Limba | Engleza |
Nr pag | 3998 |
Versiune digitala | DA |
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