Epilepsy and Intellectual Disabilities

 

Description:

This second edition of a successful book provides updated clinical and research knowledge, including information on the licensing of new antiepileptic drugs. All chapters are updated to reflect present accepted practice. New chapters highlighting the importance of the genetic aspects of epilepsy, nonpharmacological treatments, and the impact of epilepsy on families and carers have been added. Ongoing developments in the general population, which will more likely than not become relevant to the intellectually disabled population, are discussed. The impact of epilepsy on the person themselves and their carers is acknowledged, and person-centred treatment programs with a multifaceted team approach are proposed.  This book is aimed at physicians and residents in neurology and pediatrics, as well as other practitioners working with this population, such as neuropsychologists. Epilepsy and Intellectual Disabilities, Second Edition is recommended reading for all those caring for this important group of individuals.

 

 

Table of Contents:

 

Part I: Clinical Issues

Chapter 1: Introduction

Access to Care

Getting the Diagnosis Right

Treatment Issues

Psychosocial Issues

Delivering a Package of Care

Chapter 2: Epilepsy: A General Overview

Introduction

Definitions

Classification of Seizures

Generalised Seizures

Tonic-Clonic Seizures

Tonic Seizures

Clonic Seizures

Atonic Seizures

Absence Seizures

Myoclonic Jerks

Focal Epileptic Seizures

Classification of Epilepsy

Causes of Epilepsy

Genetic Epilepsy

Structural/Metabolic Epilepsy

Unknown Cause

Epidemiology

Incidence and Prevalence

Differential Diagnosis of Epilepsy

Syncope

Reflex Syncope

Orthostatic Syncope

Cardiac Syncope

Psychogenic Nonepileptic Seizures

Panic Disorder

Dissociative Seizures (“Pseudoseizures”)

Sleep Disorders

Sleep Disorders Misdiagnosed as Epilepsy

Epilepsy Misdiagnosed as Sleep Disorder

Investigation of Blackouts

Electrocardiogram (ECG)

Electroencephalography (EEG)

Common EEG Indications

Brain Imaging

Computed Tomography (CT)

Magnetic Resonance Imaging (MRI)

MRI Indications

Management

Living with Epilepsy

Sudden Unexpected Death in Epilepsy (SUDEP)

Driving

Photosensitivity

Neuropsychology

Special Client Groups

Intellectually Disabled

Neonates

Young Children

Teenagers

Elderly

Women

Conclusion

References

Chapter 3: Epidemiology of Epilepsy in Persons with Intellectual Disabilities

Introduction

Definitions and Variations

Learning Disability

Epilepsy

Overall Incidence and Prevalence of Epilepsy in the ID Population

A Note on Mortality

A Note on Concomitant Psychiatric Disorder

Some Syndromes of Developmental Disability Related to Epilepsy

Cerebral Palsy

Fragile X

Rett Syndrome

Disorders of Chromosome Region 15q11–q13

Tuberous Sclerosis

Down Syndrome

Some Epilepsy Syndromes Related to ID

Conclusions: Looking to the Future

References

Chapter 4: Diagnosis of Epilepsy in Persons with Intellectual Disabilities

Introduction

The Patient’s Medical History

Diagnostic Evaluation: Aims and Questions to Be Answered

Electroencephalography (EEG)

Neuroimaging

Summary/Conclusion

References

Chapter 5: The Differential Diagnosis of Epilepsy

Introduction

Classification of Nonepileptic Seizures and Events

Syncopes and Anoxic Seizures

Neurally Mediated Syncope

Reflex Asystolic Syncope: RAS

Vagovagal Syncope

Vasovagal Syncope

Breath-Holding Attacks

Hyperventilation Syncope

Orthostasis

Cardiovascular Syncope

Long QT Disorders

Psychological Disorders

Daydreams

Gratification and Stereotypies

Tantrums and Rage Reactions

Compulsive Valsalva

Out-of-Body Experiences

Eidetic Imagery

Panic/Anxiety

Psychogenic Nonepileptic Seizures (PNES)

Fabricated Illness

Derangements of the Sleep Process

Parasomnias

Non-REM-Related Parasomnias/Arousal parasomnias

REM Sleep Disorders

Sleep-Wake Transition Disorders

Head Banging and Body Rocking

Sleep Starts/Hypnic Jerks

The Narcolepsy-Cataplexy Syndrome

Paroxysmal Movement Disorders

Paroxysmal Dyskinesias

Paroxysmal Kinesigenic Dyskinesia (PKD)

Paroxysmal Nonkinesigenic Dyskinesia (PNKD)

Paroxysmal Exercise-Induced Dyskinesia (PED)

Episodic Ataxias

Familial Hemiplegic Migraine

Alternating Hemiplegia

Movement Disorders of Glut-1-Deficiency Syndrome

Migraine and Disorders Possibly Related to Migraine

Migraine with Visual Aura

Benign Paroxysmal Vertigo of Childhood

Cyclical Vomiting

Miscellaneous Neurologic Events

Tics

Myoclonus

Sandifer Syndrome

Cataplexy in Neurologic Disorders

Coffin-Lowry Syndrome

Conclusion

References

Part II: Treatment Issues

Chapter 6: Management of Acute Seizures in Persons with Intellectual Disabilities

Introduction

The First Seizure

Subsequent Seizures/Seizure Exacerbations in Established Epilepsy

Loss of Skills Related to Frequent Daytime Seizures

Nonconvulsive Status Epilepticus

Loss of Skills Related to Nocturnal Seizures

Electrical Status Epilepticus of Slow Wave Sleep

Treatment of (Convulsive) Status Epilepticus

Rectal Diazepam

Rectal Paraldehyde

Nasal (Intranasal) Midazolam

Buccal Midazolam

Emergency Treatment of Status Epilepticus in Hospital

Conclusion

References

Chapter 7: The Use of Antiepileptic Medication in Adults with Intellectual Disabilities: A Serio

Introduction

Evaluating the Impact of Seizures

When to Start Treatment

Choosing Medication

Managing Medication

Adverse Effects

Paradoxical Worsening of Seizures

Substituting and Adding Anticonvulsants

Drug Monitoring

Withdrawing Medication

Individual Medications

Specific Evidence for Antiepileptic Drugs in People with ID

Evaluating Outcome

Conclusion

Appendix 1

Carbamazepine

Clobazam

Clonazepam

Ethosuxamide

Gabapentin

Lamotrigine

Levetiracetam

Oxcarbazepine

Phenobarbital

Phenytoin

Pregabalin

Tiagabine

Topiramate

Valproate

Vigabatrin

Zonisamide

References

Chapter 8: Vagus Nerve Stimulation Therapy: An Intellectual Disabilities Perspective

Introduction

Background

The VNS Therapy System™

Mechanism of Action

Clinical Efficacy of VNS Therapy

VNS in Children

Intellectual Disability Population

VNS in Specific Learning-Disabled Persons

Landau-Kleffner Syndrome

Autism/Aspergers Syndrome

Lennox-Gastaut Syndrome

Ring Chromosome 20 Syndrome

Tuberous Sclerosis

Rett Syndrome

Adverse Effects and Safety

Surgically Related

Side Effects

Serious Adverse Events

VNS Therapy and Neurological Investigations

Electroencephalogram Changes and VNS

Functional Magnetic Resonance Imaging (fMRI) and VNS

SPECT and PET Brain Images and VNS Therapy Stimulation

Other Benefits of VNS Therapy

Conclusion

References

Chapter 9: Resective Surgery for Patients with Epilepsy and Intellectual Disabilities

Introduction

Should a Low IQ Be a Contraindication to Epilepsy Surgery?

Special Consideration for Presurgical Evaluation in People with LD

Neuropsychological Assessment

Seizure Recordings

Consent

Pathologies Associated with ID That May Benefit from Resective Surgery

Focal Cortical Dysplasia

Other Malformations of Cortical Development

Dysembryoplastic Neuroepithelial Tumor (DNT)

Tuberous Sclerosis

Lennox-Gastaut Syndrome

Hemispherectomy

Evaluating the Outcome of Resective Epilepsy Surgery in Patients with ID

Conclusion

References

Chapter 10: Nonpharmacological Management of Epilepsy in Adults with Intellectual Disabilities

Introduction

Psychosocial Challenges in Adults with Intellectual Disabilities

Adapting Psychological Therapies for Adults with Intellectual Disabilities

Establishing Patient Skills

Adaptations Addressing Cognitive and Emotional Skills

Communication Adaptations

Effectiveness of Psychological Treatments in Adults with Intellectual Disabilities

Psychosocial Challenges in Adults with Comorbid Epilepsy and Intellectual Disabilities

Methods

Identification of Studies

Article Selection and Data Extraction

Results

Psychopathology in Adults with E-ID

Problem Behaviors in Adults with E-ID

Contribution of Epilepsy Specific Factors to the Psychosocial Well-being of Adults with E-ID

Psychological Treatments in Adults with Epilepsy and Intellectual Disabilities

Methods

Identification of Studies

Article Selection

Results

Conclusions

References

Part III: Psychosocial Issues

Chapter 11: Psychopathology in People with Epilepsy and Intellectual Disabilities

Introduction

Psychopathology in Intellectual Disability

Psychopathology in Epilepsy in General Population

Developmental Issues

Personality

Anxiety Disorders

Mood Disorders

Psychotic Phenomena

Risk Factors for Developing Psychosis

Neuroimaging Studies

Psychiatric Symptomatology in TLE Patients

Forced Normalization

Medication

Psychopathology and Epilepsy in ID Population

Identification and Definition of ID

Identification of Epilepsy and Variables

Identification of Populations and Representativeness of Study Samples

Data Analysis

Length of Study

Rates of Psychopathology in People with ID and Epilepsy

Psychiatric Disorders in People with ID and Epilepsy

Personality Disorders

Autism

Behavioral Problems

The Nature of the Combination of Psychopathology and Epilepsy in People with ID

General Effects from the ID

Genetics-Specific Etiologies of the ID and Epilepsy

Angelman Syndrome

Down Syndrome (DS)

Fragile X

Landau-Kleffner Syndrome

Lennox-Gastaut Syndrome

Lesch-Nyhan Syndrome

Rett Syndrome

Tuberous Sclerosis (TS)

Velo-Cardio-Facial Syndrome

Miscellaneous Etiologies

The Effects of Seizures Themselves

The Psychosocial Environment of the Person

The Effect of the Treatment for the Seizures

Conclusion

References

Chapter 12: Associated Physical Problems of Epilepsy in Intellectual Disabilities

Introduction

Injuries: Overview

Burns

Drownings

Fractures

Head and Soft Tissue Injuries

Mortality and Sudden Unexpected Death for People with Epilepsy

Use of Nonpsychiatric Hospital Services

Conclusion

References

Chapter 13: Epilepsy and Cognition

Introduction

Attention and Concentration

Memory

Executive Functions

Academic Function

Other Cognitive Functions

Intractable Epilepsy Syndromes of Childhood

Infantile Spasms

Lennox-Gastaut Syndrome

Landau-Kleffner Syndrome

Severe Myoclonic Epilepsy in Infancy

Antiepileptic Drugs

Cognitive Deficits in New-Onset Epilepsy

Other Influences on Cognition

Conclusion

References

Chapter 14: Nursing and Community Aspects of Epilepsy in Intellectual Disabilities

Introduction

Health Care Provision for People with Intellectual Disabilities

The Epilepsy Specialist Nurse

Key Components of the Epilepsy Specialist Nurse

Capacity and Consent to Treatment

People with Intellectual Disabilities and Managing Risks in Epilepsy

Transition to Adult Services

Epilepsy and Women’s Health

Contraception

Preconception Care

Pregnancy

Menstruation and Catamenial Epilepsy

Conclusion

References

Chapter 15: Impact of Epilepsy and Intellectual Disabilities on Family Life

Introduction

Practical Issues: Impact on Family Life

Emotional Impact

Social Lives

Methods

Results

Main Theme 1: Missing Out/Exclusion

Subtheme 1: Illness-Related Factors

Subtheme 2: Accessibility

Subtheme 3: Stigma and Lack of Awareness

Subtheme 4: Safety Concerns or Embarrassment

Main Theme 2: Little Problem

Subtheme 5: “Not Particularly Social”

Subtheme 6: Visibility of Illness

Discussion of Qualitative Findings

Conclusions

References

Chapter 16: Epilogue: Death and Love in Epilepsy

Death

Love

Conclusion

References

Erratum

Index

 

An aparitie	2016
Autor	Prasher
Dimensiuni	15.49 x 2.13 x 23.5 cm
Editura	Springer
Format	Softcover
ISBN	9783319391427
Limba	Engleza
Nr pag	353