Jerome Engel
Seizures and Epilepsy
Jerome Engel
Seizures and Epilepsy
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According to the World Health Organization, epilepsy accounts for 1% of the global burden of disease, equivalent to breast cancer in women and lung cancer in men. Among primary disorders of the brain, it is equivalent to depression, dementia, and substance abuse. Singly authored by Jerome Engel, Jr, this must-read from 1989 reasserts itself as a modern classic comprehensive textbook covering a broad range of both basic and clinical epileptology.
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According to the World Health Organization, epilepsy accounts for 1% of the global burden of disease, equivalent to breast cancer in women and lung cancer in men. Among primary disorders of the brain, it is equivalent to depression, dementia, and substance abuse. Singly authored by Jerome Engel, Jr, this must-read from 1989 reasserts itself as a modern classic comprehensive textbook covering a broad range of both basic and clinical epileptology.
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Hinweis: Dieser Artikel kann nur an eine deutsche Lieferadresse ausgeliefert werden.
Produktdetails
- Produktdetails
- Verlag: Hurst & Co.
- 2nd edition
- Seitenzahl: 732
- Erscheinungstermin: 31. Dezember 2012
- Englisch
- Abmessung: 261mm x 189mm x 43mm
- Gewicht: 1895g
- ISBN-13: 9780195328547
- ISBN-10: 019532854X
- Artikelnr.: 35938422
- Verlag: Hurst & Co.
- 2nd edition
- Seitenzahl: 732
- Erscheinungstermin: 31. Dezember 2012
- Englisch
- Abmessung: 261mm x 189mm x 43mm
- Gewicht: 1895g
- ISBN-13: 9780195328547
- ISBN-10: 019532854X
- Artikelnr.: 35938422
Jerome Engel, Jr., MD, PhD, is Director of the Seizure Disorder Center, and The Jonathan Sinay Distinguished Professor of Neurology, Neurobiology, and Psychiatry and Biobehavioral Sciences at UCLA. He is past president of the American Clinical Neurophysiology Society, the American Epilepsy Society, and the International League against Epilepsy, and is past co-chair of the Global Campaign against Epilepsy. His bibliography lists over 1,000 publications and over 30 books, and he is principal investigator on three research grants from the National Institute of Neurological Disorders and Stroke. He has received numerous awards and honors, including a Fulbright Scholarship, a Guggenheim Fellowship, and a Javits Award.
PART I: INTRODUCTION
Chapter 1
TERMINOLOGY AND CLASSIFICATIONS
TERMINOLOGY
Epileptic Seizures
Definition
Discussion
Epilepsy Disorders
Definition
Discussion
Epileptic and Epilepsy
Definition
Discussion
Ictal, Postictal, and Interictal
Definitions
Discussion
Epileptogenesis and Epileptogenicity
Definition
Discussion
Epileptic Spike Focus, Epileptic Lesion, and Epileptogenic Zone or Region
Definition
Discussion
Control, Cure, and Drug Resistance
Definition
Discussion
Antiepileptogenesis, Prevention, and Disease Modification
Definition
Discussion
Nonepileptic Seizures
Definition
Discussion
CLASSIFICATIONS
Older Classifications of Epileptic Seizure
International Classification of Epileptic Seizures
Other Seizure Classifications
Older Classifications of the Epilepsies
The 1970 International Classification
The WHO Classifications
The 1985 and 1989 International Classifications
Recent Efforts to Revise the International Classifications
Practical Considerations
SUMMARY AND CONCLUSIONS
Chapter 2
PERSPECTIVES
EPILEPSY THEN-HISTORICAL PERSPECTIVE
Medical History
Ancient and Medieval Periods
The Modern Era
Epilepsy and Religion
Epilepsy and Genius
EPILEPSY NOW-EPIDEMIOLOGICAL PERSPECTIVE
Definitions of Incidence and Prevalence
Methodological Considerations
Estimations of Incidence and Prevalence
Global Burden of Disease
SUMMARY AND CONCLUSIONS
PART II: PATHOPHYSIOLOGY
Chapter 3
MECHANISMS OF NEURONAL EXCITATION AND SYNCHRONIZATION
THE NEURON
The Excitable Membrane and Its Microenvironment
Voltage gated Channels
Membrane Physiology
Intracellular Processes
Structure-Function Relationship of Neuronal Elements
Interneuronal Connections
Chemical Synapses
Electrotonic Synapses
Nonsynaptic Communication
Glial Influences
NEURONAL NETWORKS
Intrinsic Organization of Ammon's Horn
Intrinsic Organization of the Neocortex
Subcortical and Interhemispheric Connections
PHYLOGENY AND ONTOGENY
Species Differences
Cortical Development
Maturational Effects on Excitability
SYSTEMIC INFLUENCES
NEURONAL BASIS OF EEG ACTIVITY
METHODOLOGICAL DEVELOPMENTS
SUMMARY AND CONCLUSIONS
Chapter 4
BASIC MECHANISMS OF SEIZURES AND EPILEPSY
EXPERIMENTAL MODELS OF SEIZURES AND EPILEPSY
Acute Models
In Vivo Models of Focal Seizures
In Vivo Models of Generalized Seizures
In Vitro Studies of Acute Seizures
Chronic Models
In Vivo Models of Epilepsy with Focal Seizures
Lesion and insult models
Models in the developing brain
Secondary epileptogenesis
In Vivo Models of Epilepsy with Generalized Seizures
In Vitro Studies of Chronic Epilepsy
STUDIES OF HUMAN EPILEPSY
Electrophysiological Investigations
Investigations Using Brain Imaging Techniques
Microanatomical Investigations
Biochemical and Molecular Investigations
MOLECULAR GENETIC INVESTIGATIONS
Gene Discovery
Acquired Genetic Disturbances
POSSIBLE MECHANISMS OF HUMAN EPILEPTIC PHENOMENA
Epileptogenesis
Interictal State
Ictogenesis
Ictus
Ictal Termination
Postictal Period
Possible Consequences of Epileptic Seizures
SUMMARY AND CONCLUSIONS
Chapter 5
CAUSES OF HUMAN EPILEPSY
NONSPECIFIC PREDISPOSING FACTORS
Genetic Factors
Environmental Factors
Dynamic Aspects of Threshold
SPECIFIC EPILEPTOGENIC DISTURBANCES
Genetic Causes of Epilepsy Disorders
Genetic Epilepsies
Genetic Disorders Associated with Epilepsy
Acquired Causes of Epilepsy Disorders
Anoxia and Trauma
Cerebrovascular Disorders
Brain Tumors
Infections Diseases
Inflammation and Immune-Mediated Disorders
Malformations of Cortical Development
Toxic and Metabolic Disturbances
Hippocampal Sclerosis
PRECIPITATING FACTORS
Nonspecific Precipitating Factors
Specific Precipitating Factors
SUMMARY AND CONCLUSIONS
PART III: PHENOMENOLOGY
Chapter 6
EPILEPTIC SEIZURES
NEUROBIOLOGICAL CONSIDERATIONS FOR THE DIAGNOSIS OF EPILEPTIC
SEIZURE TYPES
Anatomic Substrates
Pathophysiological Mechanisms
Pharmacological Considerations
TYPES OF EPILEPTIC SEIZURES
Definitions
FOCAL SEIZURES
Neocortical Seizures
Mechanisms
Phenomenology
Motor Signs
Sensory Symptoms
EEG
Clinical Considerations
Limbic Seizures
Mechanisms
Phenomenology
Limbic Sensory Symptoms
Autonomic Symptoms and Signs
Psychic Symptoms
Automatisms
EEG
Clinical Considerations
Focal Seizures Evolving Into Secondarily Generalized Seizures
Mechanisms
Phenomenology
Clinical Considerations
GENERALIZED SEIZURES
Tonic-Clonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Typical Absence Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Atypical Absence Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Myoclonic Absences
Eyelid Myoclonia
Myoclonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Myoclonic Atonic Seizures
Myoclonic Tonic Seizures
Clonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Tonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Atonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
UNCLASSIFIED SEIZURES
Epileptic Spasms
Reflex Seizures
Neonatal Seizures
MYOCLONUS
SUMMARY AND CONCLUSIONS
Chapter 7
EPILEPSY SYNDROMES
NEONATAL PERIOD
Benign Familial Neonatal Epilepsy (BFNE)
Early Myoclonic Epilepsy (EME)
Ohtahara Syndrome (OS)
INFANCY
Epilepsy of Infancy with Migrating Focal Seizures (MPSI)
West Syndrome (WS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Myoclonic Epilepsy in Infancy (MEI)
Benign Infantile Epilepsy (BIE) and Benign Familial Infantile Epilepsy (BFIE)
Dravet Syndrome (DS)
Myoclonic Encephalopathy in Non-progressive Disorders
CHILDHOOD
Febrile Seizures Plus (FS+)
Panayiotopoulos Syndrome (PS)
Epilepsy with Myoclonic-Atonic Seizures (EMAS)
Benign Epilepsy with Centrotemporal Spikes (BECTS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Autosomal-Dominant Nocturnal Frontal Lobe Epilepsy (ADNFLE)
Late Childhood Occipital Epilepsy (Gastaut Type)
Epilepsy with Myoclonic Absences (EMA)
Lennox-Gastaut Syndrome (LGS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Epileptic Encephalopathy with Continuous Spike and Wave During Sleep (CSWS)
Landau-Kleffner Syndrome (LKS)
Childhood Absence Epilepsy (CAE)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
ADOLESCENCE-ADULT
Juvenile Absence Epilepsy (JAE)
Juvenile Myoclonic Epilepsy (JME)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Epilepsy with Generalized Tonic-Clonic Seizures Alone
Progressive Myoclonus Epilepsies (PME)
Autosomal-Dominant Epilepsy with Auditory Features (ADEAF)
Other Familial Temporal Lobe Epilepsies
LESS SPECIFIC AGE RELATIONSHIP
Familial Focal Epilepsy with Variable Foci
Reflex Epilepsies
DISTINCTIVE CONSTELLATIONS
Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (MTLE with HS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Rasmussen Syndrome (RS)
Gelastic Seizures with Hypothalamic Hamartoma
Hemiconvulsion-Hemiplegia Epilepsy (HHE)
CONDITIONS WITH EPILEPTIC SEIZURES THAT ARE TRADITIONALLY NOT DIAGNOSED AS A FORM OF EPILEPSY PER SE
Benign Neonatal Seizures (BNS)
Febrile Seizures (FS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Reactive Seizures
Neonatal Seizures Due to Structural and Metabolic Disorders
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
MYOCLONIC SYNDROMES
SUMMARY AND CONCLUSIONS
Chapter 8
EPILEPTOGENESIS
THE DEVELOPMENT OF EPILEPSY
Phenomenology
Character of the Lesion
Location of the Lesion
Genetic Factors
Practical Considerations
Prophylaxis for Early Seizures
Prophylaxis for Chronic Epilepsy
THE PROGRESSIVE NATURE OF EPILEPSY
Secondary Epileptogenesis
Clinical Evidence for Progression
Practical Considerations
EPILEPTIC SEIZURES AND BRAIN DEVELOPMENT
Epileptic Susceptibility of the Immature Brain
Evolution of Epileptic Syndromes
Migration of the Interictal EEG Spike
Practical Considerations
SUMMARY AND CONCLUSIONS
Chapter 9
PERIICTAL PHENOMENA
ICTAL INITIATION
Mechanisms
Clinical Considerations
Reflex Seizures
Genetic Reflex Epilepsies
Reflex Epilepsies Due to Structural Lesions
Simple vs. Complex Reflex Epilepsies
Reflex Myoclonus
Abortive Stimuli
SLEEP-WAKE CYCLES AND CHRONOBIOLOGY
METABOLIC AND TOXIC INFLUENCES
PSYCHOLOGICAL STRESS
POSTICTAL SYMPTOMS
Mechanisms
Clinical Considerations
Specific Postictal Cerebral Dysfunction
Nonspecific Postictal Cerebral Dysfunction
Noncerebral Postictal Dysfunction
MORTALITY
Comorbidity
Sudden unexpected death
Drowning
SUMMARY AND CONCLUSIONS
Chapter 10
STATUS EPILEPTICUS
GENERALIZED CONVULSIVE STATUS EPILEPTICUS
Clinical Description
Tonic-Clonic Status Epilepticus
Other Forms of Generalized Convulsive Status Epilepticus
Incidence
Etiology
Treatment
Lorazepam
Diazepam
Fosphenytoin
Phenobarbital
Paraldehyde
Other drugs
General Anesthesia
EEG Monitoring, Ventilation, and Follow-Up
Prognosis
ABSENCE STATUS EPILEPTICUS
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
EPILEPSIA PARTIALIS CONTINUA
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
FOCAL DYSCOGNITIVE (COMPLEX PARTIAL) STATUS EPILEPTICUS
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
SUBTLE STATUS EPILEPTICUS
FEBRILE STATUS EPILEPTICUS
NEONATAL STATUS EPILEPTICUS
EPILEPTIC BRAIN DAMAGE
SUMMARY AND CONCLUSIONS
Chapter 11
CHRONIC BEHAVIORAL DISTURBANCES
EPIDEMIOLOGY OF PSYCHIATRIC COMORBIDITY IN EPILEPSY
PHENOMENOLOGY OF BEHAVIORAL DISTURBANCES IN EPILEPSY
Ictal and Peri-ictal Behavior
Psychosocial Adaptation
Neurological, Intellectual, and Cognitive Function
Personality
Mood and Affect
Anxiety
Attention Deficit Hyperactivity Disorder (ADHD)
Psychosis
Classification of Neuropsychiatric Disorders in Epilepsy
MECHANISMS OF INTERICTAL BEHAVIORAL DISTURBANCES IN EPILEPSY
Psychosocial Factors-The Predicament
Neuropathological Factors
Effects of Treatment
Epilepsy-Induced Neurobiological Factors
SUMMARY AND CONCLUSIONS
PART IV: MANAGEMENT
Chapter 12
DIAGNOSTIC EVALUATION
HISTORY
Seizure History
Aura or Prodrome
Clinical Seizures
Postictal Period
Precipitating Factors and Pattern
Frequency
Age of Onset
Progression of Symptoms
ANTISEIZURE DRUG HISTORY
Past Medical History
Family History
Psychosocial History
PHYSICAL EXAMINATION
General Physical Examination
Neurological Examination
Epileptic Seizure Observation
LABORATORY EXAMINATION
Clinical Laboratory Tests
Electroencephalography
When to Use EEG
Special EEG Approaches
Additional Electrodes
Physiological Activation Procedures
Pharmacological Activation Procedures
Video-EEG Monitoring (VEM)
Computer-Enhanced EEG
Evoked Potentials
Magnetoencephalography
Transcranial Magnetic Stimulation (TMS)
Structural Neuroimaging
Magnetic Resonance Imaging (MRI)
X-Ray Computed Tomography (CT)
Radiographs
Functional Neuroimaging
Positron Emission Tomography (PET)
Single Photon Emission Computed Tomography (SPECT)
Functional Magnetic Resonance Imaging (fMRI)
Magnetic Resonance Spectroscopy (MRS)
Rectilinear Radionuclide Brain Scanning
PSYCHOLOGICAL EVALUATION
BIOMARKERS
SUMMARY AND CONCLUSIONS
Chapter 13
DIFFERENTIAL DIAGNOSIS
DIFFERENTIAL DIAGNOSIS OF NONEPILEPTIC PAROXYSMAL EVENTS
Systemic Disturbances
Syncope
Breath Holding
Hyperventilation
Toxic and Metabolic Disturbances
Abdominal Epilepsy
Neurologic Disturbances
Cerebrovascular Disorders
Sleep Disorders
Motor Disorders
Sensory Disorders
Psychogenic Disturbances
Psychogenic Nonepileptic Seizures (PNES)
Intermittent Explosive Disorders
Dissociative States
Daydreaming
Psychoses and Other Nonpsychotic Psychiatric Conditions
DIFFERENTIAL DIAGNOSIS OF REACTIVE (ACUTE SYMPTOMATIC, PROVOKED) EPILEPTIC SEIZURES
Alcohol Withdrawal Seizures
Recurrent Reactive Seizures
DIFFERENTIAL DIAGNOSIS OF CHRONIC EPILEPSY
THE USE OF THE EEG IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY
Avoiding an Inappropriate Diagnosis of Epilepsy
EEG Contributions to a Positive Diagnosis of Epilepsy
EEG Contributions to Diagnosis of the Type of Epilepsy
THE USE OF FUNCTIONAL IMAGING IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY
SUMMARY AND CONCLUSIONS
Chapter 14
GENERAL PRINCIPLES OF TREATMENT
PHARMACOLOGICAL TREATMENT
Pharmacological Principles
Absorption
Protein Binding
Distribution
Elimination
Half-Life
Zero-Order Kinetics
Pharmacodynamic Actions
Dose Planning
Approach to Monotherapy and Polytherapy
Clinical Factors Influencing Drug Efficacy
Adverse Side Effects
Dose-Dependent Adverse Side Effects
Hypersensitive and Chronic Adverse Side Effects
Drug Monitoring
Choosing the Appropriate Drug
Discontinuation of Medication
Special Considerations
Age
Pregnancy
Comorbidity
Surgery
Psychiatric Conditions
Alcohol and Sedative Drug Withdrawal
MEDICALLY REFRACTORY SEIZURES
ALTERNATIVE THERAPY
PSYCHOSOCIAL CONSIDERATIONS
THE USE OF EEG IN ASSESSING TREATMENT
MANAGEMENT AFTER A SINGLE SEIZURE
EMERGENCY TREATMENT
SUMMARY AND CONCLUSIONS
Chapter 15
ANTISEIZURE DRUGS
STANDARD OLDER DRUGS
Phenobarbital (PB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Phenytoin (PHT)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Primidone (PRM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ethosuximide (ESM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Benzodiazepines
Diazepam (DZP)
Clonazepam (CLN)
Lorazepam (LZP)
Clobazam (CLB)
Carbamazepine (CBZ)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Valproic Acid (VPA)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
NEWER DRUGS
Eslicarbazepine Acetate (ESL)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ezogabine (EZG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Felbamate (FBM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Gabapentin (GBP)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lacosamide (LCM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lamotrigine (LTG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Leviteracetam (LEV)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Oxcarbazepine (OXC)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Pregabalin (PGN)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Rufinamide (RUF)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Tiagabine (TGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Topiramate (TPM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Vigabatrin (VGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Zonisamide (ZON)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
SPECIAL AND RARELY USED DRUGS
Acetazolamide
ACTH and Adrenocorticosteroids
Barbiturates
Methylphenobarbital
Metharbital
Benzodiazepines
Clorazepate
Midazolam
Nitrazepam
Bromides
Hydantoins
Fosphenytoin
Mephenytoin
Ethotoin
Oxazolidinediones
Trimethadione
Paramethadione
Paraldehyde
Phenacemide
Piracetam
Progabide
Propofol
Stiripentol
Succinimides
Methsuximide
Phensuximide
Sulthiame
NEW DRUG DEVELOPMENT
Identification of New Compounds
Preclinical Evluation
Clincial Evaluation
DRUGS UNDER INVESTIGATION
Drugs in Phase III Trials
Brivaracetam
Ganaxolone
Perampanel
Drugs in Preclincal Development
2-Deoxy-D-Glucose
Huperzine A
ICA105665
T2000
Tonabersat
Valproic Acid Derivatives
YKP3089
VX-765
SUMMARY AND CONCLUSIONS
Chapter 15
ANTISEIZURE DRUGS
STANDARD OLDER DRUGS
Phenobarbital (PB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Phenytoin (PHT)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Primidone (PRM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ethosuximide (ESM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Benzodiazepines
Diazepam (DZP)
Clonazepam (CLN)
Lorazepam (LZP)
Clobazam (CLB)
Carbamazepine (CBZ)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Valproic Acid (VPA)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
NEWER DRUGS
Eslicarbazepine Acetate (ESL)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ezogabine (EZG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Felbamate (FBM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Gabapentin (GBP)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lacosamide (LCM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lamotrigine (LTG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Leviteracetam (LEV)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Oxcarbazepine (OXC)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Pregabalin (PGN)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Rufinamide (RUF)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Tiagabine (TGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Topiramate (TPM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Vigabatrin (VGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Zonisamide (ZON)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
SPECIAL AND RARELY USED DRUGS
Acetazolamide
ACTH and Adrenocorticosteroids
Barbiturates
Methylphenobarbital
Metharbital
Benzodiazepines
Clorazepate
Midazolam
Nitrazepam
Bromides
Hydantoins
Fosphenytoin
Mephenytoin
Ethotoin
Oxazolidinediones
Trimethadione
Paramethadione
Paraldehyde
Phenacemide
Piracetam
Progabide
Propofol
Stiripentol
Succinimides
Methsuximide
Phensuximide
Sulthiame
NEW DRUG DEVELOPMENT
Identification of New Compounds
Preclinical Evluation
Clincial Evaluation
DRUGS UNDER INVESTIGATION
Drugs in Phase III Trials
Brivaracetam
Ganaxolone
Perampanel
Drugs in Preclincal Development
2-Deoxy-D-Glucose
Huperzine A
ICA105665
T2000
Tonabersat
Valproic Acid Derivatives
YKP3089
VX-765
SUMMARY AND CONCLUSIONS
Chapter 16
NONPHARMACOLOGICAL THERAPY OF SEIZURES
SURGICAL THERAPY
Historical Perspectives
Surgical Therapy Continues to Be Underutilized
Misconceptions about Surgical Candidates
Arguments for Early Surgical Intervention
Surgically Remediable Epilepsy Syndromes
Therapeutic Surgical Procedures
Standardized Resections
Tailored Resections
Disconnection Surgery
Ablative Surgery
Stimulation
Surgical Protocols
Strategy
Candidate Selection
Phase I
Phase II
Phase III
Outcome
Outcome with Respect to Seizures
Quality of Life
Cognitive, Psychiatric, and Social Outcomes
Surgical Complications
Development of New Centers
VAGUS NERVE STIMULATION (VNS)
HORMONE THERAPY
IMMUNE THERAPY
COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)
Diet
Ketogenic Diet
Dietary Supplements
Amino Acits
Vitamins
Minerals
Food Sensitivity
Traditional and Folk Medicine
Behavioral Therapies
Treatment of the Reflex Epilepsies
Abortive Sensory Stimulation
EEG Biofeedback
Psychological Treatments
Physical Interventions
Nonallopathic Medical Systems
SUMMARY AND CONCLUSIONS
Chapter 17
SOCIAL MANAGEMENT
STIGMA
QUALITY OF LIFE
ACTIVITIES OF DAILY LIVING
Driving
Practical Criteria for Restrictions on Driving
Driver's License Regulations
Participation in Sports
Alcohol and Drugs
Specific Hazards
FAMILY
The Child with Epilepsy
The Parent with Epilepsy
SCHOOL
EMPLOYMENT
LEGAL RIGHTS
INSURANCE
FINANCIAL AID
RESOURCES
HEALTH CARE DISPARITIES
SUMMARY AND CONCLUSIONS
Chapter 1
TERMINOLOGY AND CLASSIFICATIONS
TERMINOLOGY
Epileptic Seizures
Definition
Discussion
Epilepsy Disorders
Definition
Discussion
Epileptic and Epilepsy
Definition
Discussion
Ictal, Postictal, and Interictal
Definitions
Discussion
Epileptogenesis and Epileptogenicity
Definition
Discussion
Epileptic Spike Focus, Epileptic Lesion, and Epileptogenic Zone or Region
Definition
Discussion
Control, Cure, and Drug Resistance
Definition
Discussion
Antiepileptogenesis, Prevention, and Disease Modification
Definition
Discussion
Nonepileptic Seizures
Definition
Discussion
CLASSIFICATIONS
Older Classifications of Epileptic Seizure
International Classification of Epileptic Seizures
Other Seizure Classifications
Older Classifications of the Epilepsies
The 1970 International Classification
The WHO Classifications
The 1985 and 1989 International Classifications
Recent Efforts to Revise the International Classifications
Practical Considerations
SUMMARY AND CONCLUSIONS
Chapter 2
PERSPECTIVES
EPILEPSY THEN-HISTORICAL PERSPECTIVE
Medical History
Ancient and Medieval Periods
The Modern Era
Epilepsy and Religion
Epilepsy and Genius
EPILEPSY NOW-EPIDEMIOLOGICAL PERSPECTIVE
Definitions of Incidence and Prevalence
Methodological Considerations
Estimations of Incidence and Prevalence
Global Burden of Disease
SUMMARY AND CONCLUSIONS
PART II: PATHOPHYSIOLOGY
Chapter 3
MECHANISMS OF NEURONAL EXCITATION AND SYNCHRONIZATION
THE NEURON
The Excitable Membrane and Its Microenvironment
Voltage gated Channels
Membrane Physiology
Intracellular Processes
Structure-Function Relationship of Neuronal Elements
Interneuronal Connections
Chemical Synapses
Electrotonic Synapses
Nonsynaptic Communication
Glial Influences
NEURONAL NETWORKS
Intrinsic Organization of Ammon's Horn
Intrinsic Organization of the Neocortex
Subcortical and Interhemispheric Connections
PHYLOGENY AND ONTOGENY
Species Differences
Cortical Development
Maturational Effects on Excitability
SYSTEMIC INFLUENCES
NEURONAL BASIS OF EEG ACTIVITY
METHODOLOGICAL DEVELOPMENTS
SUMMARY AND CONCLUSIONS
Chapter 4
BASIC MECHANISMS OF SEIZURES AND EPILEPSY
EXPERIMENTAL MODELS OF SEIZURES AND EPILEPSY
Acute Models
In Vivo Models of Focal Seizures
In Vivo Models of Generalized Seizures
In Vitro Studies of Acute Seizures
Chronic Models
In Vivo Models of Epilepsy with Focal Seizures
Lesion and insult models
Models in the developing brain
Secondary epileptogenesis
In Vivo Models of Epilepsy with Generalized Seizures
In Vitro Studies of Chronic Epilepsy
STUDIES OF HUMAN EPILEPSY
Electrophysiological Investigations
Investigations Using Brain Imaging Techniques
Microanatomical Investigations
Biochemical and Molecular Investigations
MOLECULAR GENETIC INVESTIGATIONS
Gene Discovery
Acquired Genetic Disturbances
POSSIBLE MECHANISMS OF HUMAN EPILEPTIC PHENOMENA
Epileptogenesis
Interictal State
Ictogenesis
Ictus
Ictal Termination
Postictal Period
Possible Consequences of Epileptic Seizures
SUMMARY AND CONCLUSIONS
Chapter 5
CAUSES OF HUMAN EPILEPSY
NONSPECIFIC PREDISPOSING FACTORS
Genetic Factors
Environmental Factors
Dynamic Aspects of Threshold
SPECIFIC EPILEPTOGENIC DISTURBANCES
Genetic Causes of Epilepsy Disorders
Genetic Epilepsies
Genetic Disorders Associated with Epilepsy
Acquired Causes of Epilepsy Disorders
Anoxia and Trauma
Cerebrovascular Disorders
Brain Tumors
Infections Diseases
Inflammation and Immune-Mediated Disorders
Malformations of Cortical Development
Toxic and Metabolic Disturbances
Hippocampal Sclerosis
PRECIPITATING FACTORS
Nonspecific Precipitating Factors
Specific Precipitating Factors
SUMMARY AND CONCLUSIONS
PART III: PHENOMENOLOGY
Chapter 6
EPILEPTIC SEIZURES
NEUROBIOLOGICAL CONSIDERATIONS FOR THE DIAGNOSIS OF EPILEPTIC
SEIZURE TYPES
Anatomic Substrates
Pathophysiological Mechanisms
Pharmacological Considerations
TYPES OF EPILEPTIC SEIZURES
Definitions
FOCAL SEIZURES
Neocortical Seizures
Mechanisms
Phenomenology
Motor Signs
Sensory Symptoms
EEG
Clinical Considerations
Limbic Seizures
Mechanisms
Phenomenology
Limbic Sensory Symptoms
Autonomic Symptoms and Signs
Psychic Symptoms
Automatisms
EEG
Clinical Considerations
Focal Seizures Evolving Into Secondarily Generalized Seizures
Mechanisms
Phenomenology
Clinical Considerations
GENERALIZED SEIZURES
Tonic-Clonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Typical Absence Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Atypical Absence Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Myoclonic Absences
Eyelid Myoclonia
Myoclonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Myoclonic Atonic Seizures
Myoclonic Tonic Seizures
Clonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Tonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Atonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
UNCLASSIFIED SEIZURES
Epileptic Spasms
Reflex Seizures
Neonatal Seizures
MYOCLONUS
SUMMARY AND CONCLUSIONS
Chapter 7
EPILEPSY SYNDROMES
NEONATAL PERIOD
Benign Familial Neonatal Epilepsy (BFNE)
Early Myoclonic Epilepsy (EME)
Ohtahara Syndrome (OS)
INFANCY
Epilepsy of Infancy with Migrating Focal Seizures (MPSI)
West Syndrome (WS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Myoclonic Epilepsy in Infancy (MEI)
Benign Infantile Epilepsy (BIE) and Benign Familial Infantile Epilepsy (BFIE)
Dravet Syndrome (DS)
Myoclonic Encephalopathy in Non-progressive Disorders
CHILDHOOD
Febrile Seizures Plus (FS+)
Panayiotopoulos Syndrome (PS)
Epilepsy with Myoclonic-Atonic Seizures (EMAS)
Benign Epilepsy with Centrotemporal Spikes (BECTS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Autosomal-Dominant Nocturnal Frontal Lobe Epilepsy (ADNFLE)
Late Childhood Occipital Epilepsy (Gastaut Type)
Epilepsy with Myoclonic Absences (EMA)
Lennox-Gastaut Syndrome (LGS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Epileptic Encephalopathy with Continuous Spike and Wave During Sleep (CSWS)
Landau-Kleffner Syndrome (LKS)
Childhood Absence Epilepsy (CAE)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
ADOLESCENCE-ADULT
Juvenile Absence Epilepsy (JAE)
Juvenile Myoclonic Epilepsy (JME)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Epilepsy with Generalized Tonic-Clonic Seizures Alone
Progressive Myoclonus Epilepsies (PME)
Autosomal-Dominant Epilepsy with Auditory Features (ADEAF)
Other Familial Temporal Lobe Epilepsies
LESS SPECIFIC AGE RELATIONSHIP
Familial Focal Epilepsy with Variable Foci
Reflex Epilepsies
DISTINCTIVE CONSTELLATIONS
Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (MTLE with HS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Rasmussen Syndrome (RS)
Gelastic Seizures with Hypothalamic Hamartoma
Hemiconvulsion-Hemiplegia Epilepsy (HHE)
CONDITIONS WITH EPILEPTIC SEIZURES THAT ARE TRADITIONALLY NOT DIAGNOSED AS A FORM OF EPILEPSY PER SE
Benign Neonatal Seizures (BNS)
Febrile Seizures (FS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Reactive Seizures
Neonatal Seizures Due to Structural and Metabolic Disorders
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
MYOCLONIC SYNDROMES
SUMMARY AND CONCLUSIONS
Chapter 8
EPILEPTOGENESIS
THE DEVELOPMENT OF EPILEPSY
Phenomenology
Character of the Lesion
Location of the Lesion
Genetic Factors
Practical Considerations
Prophylaxis for Early Seizures
Prophylaxis for Chronic Epilepsy
THE PROGRESSIVE NATURE OF EPILEPSY
Secondary Epileptogenesis
Clinical Evidence for Progression
Practical Considerations
EPILEPTIC SEIZURES AND BRAIN DEVELOPMENT
Epileptic Susceptibility of the Immature Brain
Evolution of Epileptic Syndromes
Migration of the Interictal EEG Spike
Practical Considerations
SUMMARY AND CONCLUSIONS
Chapter 9
PERIICTAL PHENOMENA
ICTAL INITIATION
Mechanisms
Clinical Considerations
Reflex Seizures
Genetic Reflex Epilepsies
Reflex Epilepsies Due to Structural Lesions
Simple vs. Complex Reflex Epilepsies
Reflex Myoclonus
Abortive Stimuli
SLEEP-WAKE CYCLES AND CHRONOBIOLOGY
METABOLIC AND TOXIC INFLUENCES
PSYCHOLOGICAL STRESS
POSTICTAL SYMPTOMS
Mechanisms
Clinical Considerations
Specific Postictal Cerebral Dysfunction
Nonspecific Postictal Cerebral Dysfunction
Noncerebral Postictal Dysfunction
MORTALITY
Comorbidity
Sudden unexpected death
Drowning
SUMMARY AND CONCLUSIONS
Chapter 10
STATUS EPILEPTICUS
GENERALIZED CONVULSIVE STATUS EPILEPTICUS
Clinical Description
Tonic-Clonic Status Epilepticus
Other Forms of Generalized Convulsive Status Epilepticus
Incidence
Etiology
Treatment
Lorazepam
Diazepam
Fosphenytoin
Phenobarbital
Paraldehyde
Other drugs
General Anesthesia
EEG Monitoring, Ventilation, and Follow-Up
Prognosis
ABSENCE STATUS EPILEPTICUS
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
EPILEPSIA PARTIALIS CONTINUA
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
FOCAL DYSCOGNITIVE (COMPLEX PARTIAL) STATUS EPILEPTICUS
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
SUBTLE STATUS EPILEPTICUS
FEBRILE STATUS EPILEPTICUS
NEONATAL STATUS EPILEPTICUS
EPILEPTIC BRAIN DAMAGE
SUMMARY AND CONCLUSIONS
Chapter 11
CHRONIC BEHAVIORAL DISTURBANCES
EPIDEMIOLOGY OF PSYCHIATRIC COMORBIDITY IN EPILEPSY
PHENOMENOLOGY OF BEHAVIORAL DISTURBANCES IN EPILEPSY
Ictal and Peri-ictal Behavior
Psychosocial Adaptation
Neurological, Intellectual, and Cognitive Function
Personality
Mood and Affect
Anxiety
Attention Deficit Hyperactivity Disorder (ADHD)
Psychosis
Classification of Neuropsychiatric Disorders in Epilepsy
MECHANISMS OF INTERICTAL BEHAVIORAL DISTURBANCES IN EPILEPSY
Psychosocial Factors-The Predicament
Neuropathological Factors
Effects of Treatment
Epilepsy-Induced Neurobiological Factors
SUMMARY AND CONCLUSIONS
PART IV: MANAGEMENT
Chapter 12
DIAGNOSTIC EVALUATION
HISTORY
Seizure History
Aura or Prodrome
Clinical Seizures
Postictal Period
Precipitating Factors and Pattern
Frequency
Age of Onset
Progression of Symptoms
ANTISEIZURE DRUG HISTORY
Past Medical History
Family History
Psychosocial History
PHYSICAL EXAMINATION
General Physical Examination
Neurological Examination
Epileptic Seizure Observation
LABORATORY EXAMINATION
Clinical Laboratory Tests
Electroencephalography
When to Use EEG
Special EEG Approaches
Additional Electrodes
Physiological Activation Procedures
Pharmacological Activation Procedures
Video-EEG Monitoring (VEM)
Computer-Enhanced EEG
Evoked Potentials
Magnetoencephalography
Transcranial Magnetic Stimulation (TMS)
Structural Neuroimaging
Magnetic Resonance Imaging (MRI)
X-Ray Computed Tomography (CT)
Radiographs
Functional Neuroimaging
Positron Emission Tomography (PET)
Single Photon Emission Computed Tomography (SPECT)
Functional Magnetic Resonance Imaging (fMRI)
Magnetic Resonance Spectroscopy (MRS)
Rectilinear Radionuclide Brain Scanning
PSYCHOLOGICAL EVALUATION
BIOMARKERS
SUMMARY AND CONCLUSIONS
Chapter 13
DIFFERENTIAL DIAGNOSIS
DIFFERENTIAL DIAGNOSIS OF NONEPILEPTIC PAROXYSMAL EVENTS
Systemic Disturbances
Syncope
Breath Holding
Hyperventilation
Toxic and Metabolic Disturbances
Abdominal Epilepsy
Neurologic Disturbances
Cerebrovascular Disorders
Sleep Disorders
Motor Disorders
Sensory Disorders
Psychogenic Disturbances
Psychogenic Nonepileptic Seizures (PNES)
Intermittent Explosive Disorders
Dissociative States
Daydreaming
Psychoses and Other Nonpsychotic Psychiatric Conditions
DIFFERENTIAL DIAGNOSIS OF REACTIVE (ACUTE SYMPTOMATIC, PROVOKED) EPILEPTIC SEIZURES
Alcohol Withdrawal Seizures
Recurrent Reactive Seizures
DIFFERENTIAL DIAGNOSIS OF CHRONIC EPILEPSY
THE USE OF THE EEG IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY
Avoiding an Inappropriate Diagnosis of Epilepsy
EEG Contributions to a Positive Diagnosis of Epilepsy
EEG Contributions to Diagnosis of the Type of Epilepsy
THE USE OF FUNCTIONAL IMAGING IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY
SUMMARY AND CONCLUSIONS
Chapter 14
GENERAL PRINCIPLES OF TREATMENT
PHARMACOLOGICAL TREATMENT
Pharmacological Principles
Absorption
Protein Binding
Distribution
Elimination
Half-Life
Zero-Order Kinetics
Pharmacodynamic Actions
Dose Planning
Approach to Monotherapy and Polytherapy
Clinical Factors Influencing Drug Efficacy
Adverse Side Effects
Dose-Dependent Adverse Side Effects
Hypersensitive and Chronic Adverse Side Effects
Drug Monitoring
Choosing the Appropriate Drug
Discontinuation of Medication
Special Considerations
Age
Pregnancy
Comorbidity
Surgery
Psychiatric Conditions
Alcohol and Sedative Drug Withdrawal
MEDICALLY REFRACTORY SEIZURES
ALTERNATIVE THERAPY
PSYCHOSOCIAL CONSIDERATIONS
THE USE OF EEG IN ASSESSING TREATMENT
MANAGEMENT AFTER A SINGLE SEIZURE
EMERGENCY TREATMENT
SUMMARY AND CONCLUSIONS
Chapter 15
ANTISEIZURE DRUGS
STANDARD OLDER DRUGS
Phenobarbital (PB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Phenytoin (PHT)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Primidone (PRM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ethosuximide (ESM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Benzodiazepines
Diazepam (DZP)
Clonazepam (CLN)
Lorazepam (LZP)
Clobazam (CLB)
Carbamazepine (CBZ)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Valproic Acid (VPA)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
NEWER DRUGS
Eslicarbazepine Acetate (ESL)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ezogabine (EZG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Felbamate (FBM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Gabapentin (GBP)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lacosamide (LCM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lamotrigine (LTG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Leviteracetam (LEV)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Oxcarbazepine (OXC)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Pregabalin (PGN)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Rufinamide (RUF)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Tiagabine (TGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Topiramate (TPM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Vigabatrin (VGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Zonisamide (ZON)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
SPECIAL AND RARELY USED DRUGS
Acetazolamide
ACTH and Adrenocorticosteroids
Barbiturates
Methylphenobarbital
Metharbital
Benzodiazepines
Clorazepate
Midazolam
Nitrazepam
Bromides
Hydantoins
Fosphenytoin
Mephenytoin
Ethotoin
Oxazolidinediones
Trimethadione
Paramethadione
Paraldehyde
Phenacemide
Piracetam
Progabide
Propofol
Stiripentol
Succinimides
Methsuximide
Phensuximide
Sulthiame
NEW DRUG DEVELOPMENT
Identification of New Compounds
Preclinical Evluation
Clincial Evaluation
DRUGS UNDER INVESTIGATION
Drugs in Phase III Trials
Brivaracetam
Ganaxolone
Perampanel
Drugs in Preclincal Development
2-Deoxy-D-Glucose
Huperzine A
ICA105665
T2000
Tonabersat
Valproic Acid Derivatives
YKP3089
VX-765
SUMMARY AND CONCLUSIONS
Chapter 15
ANTISEIZURE DRUGS
STANDARD OLDER DRUGS
Phenobarbital (PB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Phenytoin (PHT)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Primidone (PRM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ethosuximide (ESM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Benzodiazepines
Diazepam (DZP)
Clonazepam (CLN)
Lorazepam (LZP)
Clobazam (CLB)
Carbamazepine (CBZ)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Valproic Acid (VPA)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
NEWER DRUGS
Eslicarbazepine Acetate (ESL)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ezogabine (EZG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Felbamate (FBM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Gabapentin (GBP)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lacosamide (LCM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lamotrigine (LTG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Leviteracetam (LEV)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Oxcarbazepine (OXC)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Pregabalin (PGN)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Rufinamide (RUF)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Tiagabine (TGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Topiramate (TPM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Vigabatrin (VGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Zonisamide (ZON)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
SPECIAL AND RARELY USED DRUGS
Acetazolamide
ACTH and Adrenocorticosteroids
Barbiturates
Methylphenobarbital
Metharbital
Benzodiazepines
Clorazepate
Midazolam
Nitrazepam
Bromides
Hydantoins
Fosphenytoin
Mephenytoin
Ethotoin
Oxazolidinediones
Trimethadione
Paramethadione
Paraldehyde
Phenacemide
Piracetam
Progabide
Propofol
Stiripentol
Succinimides
Methsuximide
Phensuximide
Sulthiame
NEW DRUG DEVELOPMENT
Identification of New Compounds
Preclinical Evluation
Clincial Evaluation
DRUGS UNDER INVESTIGATION
Drugs in Phase III Trials
Brivaracetam
Ganaxolone
Perampanel
Drugs in Preclincal Development
2-Deoxy-D-Glucose
Huperzine A
ICA105665
T2000
Tonabersat
Valproic Acid Derivatives
YKP3089
VX-765
SUMMARY AND CONCLUSIONS
Chapter 16
NONPHARMACOLOGICAL THERAPY OF SEIZURES
SURGICAL THERAPY
Historical Perspectives
Surgical Therapy Continues to Be Underutilized
Misconceptions about Surgical Candidates
Arguments for Early Surgical Intervention
Surgically Remediable Epilepsy Syndromes
Therapeutic Surgical Procedures
Standardized Resections
Tailored Resections
Disconnection Surgery
Ablative Surgery
Stimulation
Surgical Protocols
Strategy
Candidate Selection
Phase I
Phase II
Phase III
Outcome
Outcome with Respect to Seizures
Quality of Life
Cognitive, Psychiatric, and Social Outcomes
Surgical Complications
Development of New Centers
VAGUS NERVE STIMULATION (VNS)
HORMONE THERAPY
IMMUNE THERAPY
COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)
Diet
Ketogenic Diet
Dietary Supplements
Amino Acits
Vitamins
Minerals
Food Sensitivity
Traditional and Folk Medicine
Behavioral Therapies
Treatment of the Reflex Epilepsies
Abortive Sensory Stimulation
EEG Biofeedback
Psychological Treatments
Physical Interventions
Nonallopathic Medical Systems
SUMMARY AND CONCLUSIONS
Chapter 17
SOCIAL MANAGEMENT
STIGMA
QUALITY OF LIFE
ACTIVITIES OF DAILY LIVING
Driving
Practical Criteria for Restrictions on Driving
Driver's License Regulations
Participation in Sports
Alcohol and Drugs
Specific Hazards
FAMILY
The Child with Epilepsy
The Parent with Epilepsy
SCHOOL
EMPLOYMENT
LEGAL RIGHTS
INSURANCE
FINANCIAL AID
RESOURCES
HEALTH CARE DISPARITIES
SUMMARY AND CONCLUSIONS
PART I: INTRODUCTION
Chapter 1
TERMINOLOGY AND CLASSIFICATIONS
TERMINOLOGY
Epileptic Seizures
Definition
Discussion
Epilepsy Disorders
Definition
Discussion
Epileptic and Epilepsy
Definition
Discussion
Ictal, Postictal, and Interictal
Definitions
Discussion
Epileptogenesis and Epileptogenicity
Definition
Discussion
Epileptic Spike Focus, Epileptic Lesion, and Epileptogenic Zone or Region
Definition
Discussion
Control, Cure, and Drug Resistance
Definition
Discussion
Antiepileptogenesis, Prevention, and Disease Modification
Definition
Discussion
Nonepileptic Seizures
Definition
Discussion
CLASSIFICATIONS
Older Classifications of Epileptic Seizure
International Classification of Epileptic Seizures
Other Seizure Classifications
Older Classifications of the Epilepsies
The 1970 International Classification
The WHO Classifications
The 1985 and 1989 International Classifications
Recent Efforts to Revise the International Classifications
Practical Considerations
SUMMARY AND CONCLUSIONS
Chapter 2
PERSPECTIVES
EPILEPSY THEN-HISTORICAL PERSPECTIVE
Medical History
Ancient and Medieval Periods
The Modern Era
Epilepsy and Religion
Epilepsy and Genius
EPILEPSY NOW-EPIDEMIOLOGICAL PERSPECTIVE
Definitions of Incidence and Prevalence
Methodological Considerations
Estimations of Incidence and Prevalence
Global Burden of Disease
SUMMARY AND CONCLUSIONS
PART II: PATHOPHYSIOLOGY
Chapter 3
MECHANISMS OF NEURONAL EXCITATION AND SYNCHRONIZATION
THE NEURON
The Excitable Membrane and Its Microenvironment
Voltage gated Channels
Membrane Physiology
Intracellular Processes
Structure-Function Relationship of Neuronal Elements
Interneuronal Connections
Chemical Synapses
Electrotonic Synapses
Nonsynaptic Communication
Glial Influences
NEURONAL NETWORKS
Intrinsic Organization of Ammon's Horn
Intrinsic Organization of the Neocortex
Subcortical and Interhemispheric Connections
PHYLOGENY AND ONTOGENY
Species Differences
Cortical Development
Maturational Effects on Excitability
SYSTEMIC INFLUENCES
NEURONAL BASIS OF EEG ACTIVITY
METHODOLOGICAL DEVELOPMENTS
SUMMARY AND CONCLUSIONS
Chapter 4
BASIC MECHANISMS OF SEIZURES AND EPILEPSY
EXPERIMENTAL MODELS OF SEIZURES AND EPILEPSY
Acute Models
In Vivo Models of Focal Seizures
In Vivo Models of Generalized Seizures
In Vitro Studies of Acute Seizures
Chronic Models
In Vivo Models of Epilepsy with Focal Seizures
Lesion and insult models
Models in the developing brain
Secondary epileptogenesis
In Vivo Models of Epilepsy with Generalized Seizures
In Vitro Studies of Chronic Epilepsy
STUDIES OF HUMAN EPILEPSY
Electrophysiological Investigations
Investigations Using Brain Imaging Techniques
Microanatomical Investigations
Biochemical and Molecular Investigations
MOLECULAR GENETIC INVESTIGATIONS
Gene Discovery
Acquired Genetic Disturbances
POSSIBLE MECHANISMS OF HUMAN EPILEPTIC PHENOMENA
Epileptogenesis
Interictal State
Ictogenesis
Ictus
Ictal Termination
Postictal Period
Possible Consequences of Epileptic Seizures
SUMMARY AND CONCLUSIONS
Chapter 5
CAUSES OF HUMAN EPILEPSY
NONSPECIFIC PREDISPOSING FACTORS
Genetic Factors
Environmental Factors
Dynamic Aspects of Threshold
SPECIFIC EPILEPTOGENIC DISTURBANCES
Genetic Causes of Epilepsy Disorders
Genetic Epilepsies
Genetic Disorders Associated with Epilepsy
Acquired Causes of Epilepsy Disorders
Anoxia and Trauma
Cerebrovascular Disorders
Brain Tumors
Infections Diseases
Inflammation and Immune-Mediated Disorders
Malformations of Cortical Development
Toxic and Metabolic Disturbances
Hippocampal Sclerosis
PRECIPITATING FACTORS
Nonspecific Precipitating Factors
Specific Precipitating Factors
SUMMARY AND CONCLUSIONS
PART III: PHENOMENOLOGY
Chapter 6
EPILEPTIC SEIZURES
NEUROBIOLOGICAL CONSIDERATIONS FOR THE DIAGNOSIS OF EPILEPTIC
SEIZURE TYPES
Anatomic Substrates
Pathophysiological Mechanisms
Pharmacological Considerations
TYPES OF EPILEPTIC SEIZURES
Definitions
FOCAL SEIZURES
Neocortical Seizures
Mechanisms
Phenomenology
Motor Signs
Sensory Symptoms
EEG
Clinical Considerations
Limbic Seizures
Mechanisms
Phenomenology
Limbic Sensory Symptoms
Autonomic Symptoms and Signs
Psychic Symptoms
Automatisms
EEG
Clinical Considerations
Focal Seizures Evolving Into Secondarily Generalized Seizures
Mechanisms
Phenomenology
Clinical Considerations
GENERALIZED SEIZURES
Tonic-Clonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Typical Absence Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Atypical Absence Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Myoclonic Absences
Eyelid Myoclonia
Myoclonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Myoclonic Atonic Seizures
Myoclonic Tonic Seizures
Clonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Tonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Atonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
UNCLASSIFIED SEIZURES
Epileptic Spasms
Reflex Seizures
Neonatal Seizures
MYOCLONUS
SUMMARY AND CONCLUSIONS
Chapter 7
EPILEPSY SYNDROMES
NEONATAL PERIOD
Benign Familial Neonatal Epilepsy (BFNE)
Early Myoclonic Epilepsy (EME)
Ohtahara Syndrome (OS)
INFANCY
Epilepsy of Infancy with Migrating Focal Seizures (MPSI)
West Syndrome (WS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Myoclonic Epilepsy in Infancy (MEI)
Benign Infantile Epilepsy (BIE) and Benign Familial Infantile Epilepsy (BFIE)
Dravet Syndrome (DS)
Myoclonic Encephalopathy in Non-progressive Disorders
CHILDHOOD
Febrile Seizures Plus (FS+)
Panayiotopoulos Syndrome (PS)
Epilepsy with Myoclonic-Atonic Seizures (EMAS)
Benign Epilepsy with Centrotemporal Spikes (BECTS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Autosomal-Dominant Nocturnal Frontal Lobe Epilepsy (ADNFLE)
Late Childhood Occipital Epilepsy (Gastaut Type)
Epilepsy with Myoclonic Absences (EMA)
Lennox-Gastaut Syndrome (LGS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Epileptic Encephalopathy with Continuous Spike and Wave During Sleep (CSWS)
Landau-Kleffner Syndrome (LKS)
Childhood Absence Epilepsy (CAE)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
ADOLESCENCE-ADULT
Juvenile Absence Epilepsy (JAE)
Juvenile Myoclonic Epilepsy (JME)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Epilepsy with Generalized Tonic-Clonic Seizures Alone
Progressive Myoclonus Epilepsies (PME)
Autosomal-Dominant Epilepsy with Auditory Features (ADEAF)
Other Familial Temporal Lobe Epilepsies
LESS SPECIFIC AGE RELATIONSHIP
Familial Focal Epilepsy with Variable Foci
Reflex Epilepsies
DISTINCTIVE CONSTELLATIONS
Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (MTLE with HS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Rasmussen Syndrome (RS)
Gelastic Seizures with Hypothalamic Hamartoma
Hemiconvulsion-Hemiplegia Epilepsy (HHE)
CONDITIONS WITH EPILEPTIC SEIZURES THAT ARE TRADITIONALLY NOT DIAGNOSED AS A FORM OF EPILEPSY PER SE
Benign Neonatal Seizures (BNS)
Febrile Seizures (FS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Reactive Seizures
Neonatal Seizures Due to Structural and Metabolic Disorders
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
MYOCLONIC SYNDROMES
SUMMARY AND CONCLUSIONS
Chapter 8
EPILEPTOGENESIS
THE DEVELOPMENT OF EPILEPSY
Phenomenology
Character of the Lesion
Location of the Lesion
Genetic Factors
Practical Considerations
Prophylaxis for Early Seizures
Prophylaxis for Chronic Epilepsy
THE PROGRESSIVE NATURE OF EPILEPSY
Secondary Epileptogenesis
Clinical Evidence for Progression
Practical Considerations
EPILEPTIC SEIZURES AND BRAIN DEVELOPMENT
Epileptic Susceptibility of the Immature Brain
Evolution of Epileptic Syndromes
Migration of the Interictal EEG Spike
Practical Considerations
SUMMARY AND CONCLUSIONS
Chapter 9
PERIICTAL PHENOMENA
ICTAL INITIATION
Mechanisms
Clinical Considerations
Reflex Seizures
Genetic Reflex Epilepsies
Reflex Epilepsies Due to Structural Lesions
Simple vs. Complex Reflex Epilepsies
Reflex Myoclonus
Abortive Stimuli
SLEEP-WAKE CYCLES AND CHRONOBIOLOGY
METABOLIC AND TOXIC INFLUENCES
PSYCHOLOGICAL STRESS
POSTICTAL SYMPTOMS
Mechanisms
Clinical Considerations
Specific Postictal Cerebral Dysfunction
Nonspecific Postictal Cerebral Dysfunction
Noncerebral Postictal Dysfunction
MORTALITY
Comorbidity
Sudden unexpected death
Drowning
SUMMARY AND CONCLUSIONS
Chapter 10
STATUS EPILEPTICUS
GENERALIZED CONVULSIVE STATUS EPILEPTICUS
Clinical Description
Tonic-Clonic Status Epilepticus
Other Forms of Generalized Convulsive Status Epilepticus
Incidence
Etiology
Treatment
Lorazepam
Diazepam
Fosphenytoin
Phenobarbital
Paraldehyde
Other drugs
General Anesthesia
EEG Monitoring, Ventilation, and Follow-Up
Prognosis
ABSENCE STATUS EPILEPTICUS
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
EPILEPSIA PARTIALIS CONTINUA
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
FOCAL DYSCOGNITIVE (COMPLEX PARTIAL) STATUS EPILEPTICUS
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
SUBTLE STATUS EPILEPTICUS
FEBRILE STATUS EPILEPTICUS
NEONATAL STATUS EPILEPTICUS
EPILEPTIC BRAIN DAMAGE
SUMMARY AND CONCLUSIONS
Chapter 11
CHRONIC BEHAVIORAL DISTURBANCES
EPIDEMIOLOGY OF PSYCHIATRIC COMORBIDITY IN EPILEPSY
PHENOMENOLOGY OF BEHAVIORAL DISTURBANCES IN EPILEPSY
Ictal and Peri-ictal Behavior
Psychosocial Adaptation
Neurological, Intellectual, and Cognitive Function
Personality
Mood and Affect
Anxiety
Attention Deficit Hyperactivity Disorder (ADHD)
Psychosis
Classification of Neuropsychiatric Disorders in Epilepsy
MECHANISMS OF INTERICTAL BEHAVIORAL DISTURBANCES IN EPILEPSY
Psychosocial Factors-The Predicament
Neuropathological Factors
Effects of Treatment
Epilepsy-Induced Neurobiological Factors
SUMMARY AND CONCLUSIONS
PART IV: MANAGEMENT
Chapter 12
DIAGNOSTIC EVALUATION
HISTORY
Seizure History
Aura or Prodrome
Clinical Seizures
Postictal Period
Precipitating Factors and Pattern
Frequency
Age of Onset
Progression of Symptoms
ANTISEIZURE DRUG HISTORY
Past Medical History
Family History
Psychosocial History
PHYSICAL EXAMINATION
General Physical Examination
Neurological Examination
Epileptic Seizure Observation
LABORATORY EXAMINATION
Clinical Laboratory Tests
Electroencephalography
When to Use EEG
Special EEG Approaches
Additional Electrodes
Physiological Activation Procedures
Pharmacological Activation Procedures
Video-EEG Monitoring (VEM)
Computer-Enhanced EEG
Evoked Potentials
Magnetoencephalography
Transcranial Magnetic Stimulation (TMS)
Structural Neuroimaging
Magnetic Resonance Imaging (MRI)
X-Ray Computed Tomography (CT)
Radiographs
Functional Neuroimaging
Positron Emission Tomography (PET)
Single Photon Emission Computed Tomography (SPECT)
Functional Magnetic Resonance Imaging (fMRI)
Magnetic Resonance Spectroscopy (MRS)
Rectilinear Radionuclide Brain Scanning
PSYCHOLOGICAL EVALUATION
BIOMARKERS
SUMMARY AND CONCLUSIONS
Chapter 13
DIFFERENTIAL DIAGNOSIS
DIFFERENTIAL DIAGNOSIS OF NONEPILEPTIC PAROXYSMAL EVENTS
Systemic Disturbances
Syncope
Breath Holding
Hyperventilation
Toxic and Metabolic Disturbances
Abdominal Epilepsy
Neurologic Disturbances
Cerebrovascular Disorders
Sleep Disorders
Motor Disorders
Sensory Disorders
Psychogenic Disturbances
Psychogenic Nonepileptic Seizures (PNES)
Intermittent Explosive Disorders
Dissociative States
Daydreaming
Psychoses and Other Nonpsychotic Psychiatric Conditions
DIFFERENTIAL DIAGNOSIS OF REACTIVE (ACUTE SYMPTOMATIC, PROVOKED) EPILEPTIC SEIZURES
Alcohol Withdrawal Seizures
Recurrent Reactive Seizures
DIFFERENTIAL DIAGNOSIS OF CHRONIC EPILEPSY
THE USE OF THE EEG IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY
Avoiding an Inappropriate Diagnosis of Epilepsy
EEG Contributions to a Positive Diagnosis of Epilepsy
EEG Contributions to Diagnosis of the Type of Epilepsy
THE USE OF FUNCTIONAL IMAGING IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY
SUMMARY AND CONCLUSIONS
Chapter 14
GENERAL PRINCIPLES OF TREATMENT
PHARMACOLOGICAL TREATMENT
Pharmacological Principles
Absorption
Protein Binding
Distribution
Elimination
Half-Life
Zero-Order Kinetics
Pharmacodynamic Actions
Dose Planning
Approach to Monotherapy and Polytherapy
Clinical Factors Influencing Drug Efficacy
Adverse Side Effects
Dose-Dependent Adverse Side Effects
Hypersensitive and Chronic Adverse Side Effects
Drug Monitoring
Choosing the Appropriate Drug
Discontinuation of Medication
Special Considerations
Age
Pregnancy
Comorbidity
Surgery
Psychiatric Conditions
Alcohol and Sedative Drug Withdrawal
MEDICALLY REFRACTORY SEIZURES
ALTERNATIVE THERAPY
PSYCHOSOCIAL CONSIDERATIONS
THE USE OF EEG IN ASSESSING TREATMENT
MANAGEMENT AFTER A SINGLE SEIZURE
EMERGENCY TREATMENT
SUMMARY AND CONCLUSIONS
Chapter 15
ANTISEIZURE DRUGS
STANDARD OLDER DRUGS
Phenobarbital (PB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Phenytoin (PHT)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Primidone (PRM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ethosuximide (ESM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Benzodiazepines
Diazepam (DZP)
Clonazepam (CLN)
Lorazepam (LZP)
Clobazam (CLB)
Carbamazepine (CBZ)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Valproic Acid (VPA)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
NEWER DRUGS
Eslicarbazepine Acetate (ESL)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ezogabine (EZG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Felbamate (FBM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Gabapentin (GBP)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lacosamide (LCM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lamotrigine (LTG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Leviteracetam (LEV)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Oxcarbazepine (OXC)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Pregabalin (PGN)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Rufinamide (RUF)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Tiagabine (TGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Topiramate (TPM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Vigabatrin (VGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Zonisamide (ZON)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
SPECIAL AND RARELY USED DRUGS
Acetazolamide
ACTH and Adrenocorticosteroids
Barbiturates
Methylphenobarbital
Metharbital
Benzodiazepines
Clorazepate
Midazolam
Nitrazepam
Bromides
Hydantoins
Fosphenytoin
Mephenytoin
Ethotoin
Oxazolidinediones
Trimethadione
Paramethadione
Paraldehyde
Phenacemide
Piracetam
Progabide
Propofol
Stiripentol
Succinimides
Methsuximide
Phensuximide
Sulthiame
NEW DRUG DEVELOPMENT
Identification of New Compounds
Preclinical Evluation
Clincial Evaluation
DRUGS UNDER INVESTIGATION
Drugs in Phase III Trials
Brivaracetam
Ganaxolone
Perampanel
Drugs in Preclincal Development
2-Deoxy-D-Glucose
Huperzine A
ICA105665
T2000
Tonabersat
Valproic Acid Derivatives
YKP3089
VX-765
SUMMARY AND CONCLUSIONS
Chapter 15
ANTISEIZURE DRUGS
STANDARD OLDER DRUGS
Phenobarbital (PB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Phenytoin (PHT)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Primidone (PRM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ethosuximide (ESM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Benzodiazepines
Diazepam (DZP)
Clonazepam (CLN)
Lorazepam (LZP)
Clobazam (CLB)
Carbamazepine (CBZ)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Valproic Acid (VPA)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
NEWER DRUGS
Eslicarbazepine Acetate (ESL)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ezogabine (EZG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Felbamate (FBM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Gabapentin (GBP)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lacosamide (LCM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lamotrigine (LTG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Leviteracetam (LEV)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Oxcarbazepine (OXC)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Pregabalin (PGN)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Rufinamide (RUF)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Tiagabine (TGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Topiramate (TPM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Vigabatrin (VGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Zonisamide (ZON)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
SPECIAL AND RARELY USED DRUGS
Acetazolamide
ACTH and Adrenocorticosteroids
Barbiturates
Methylphenobarbital
Metharbital
Benzodiazepines
Clorazepate
Midazolam
Nitrazepam
Bromides
Hydantoins
Fosphenytoin
Mephenytoin
Ethotoin
Oxazolidinediones
Trimethadione
Paramethadione
Paraldehyde
Phenacemide
Piracetam
Progabide
Propofol
Stiripentol
Succinimides
Methsuximide
Phensuximide
Sulthiame
NEW DRUG DEVELOPMENT
Identification of New Compounds
Preclinical Evluation
Clincial Evaluation
DRUGS UNDER INVESTIGATION
Drugs in Phase III Trials
Brivaracetam
Ganaxolone
Perampanel
Drugs in Preclincal Development
2-Deoxy-D-Glucose
Huperzine A
ICA105665
T2000
Tonabersat
Valproic Acid Derivatives
YKP3089
VX-765
SUMMARY AND CONCLUSIONS
Chapter 16
NONPHARMACOLOGICAL THERAPY OF SEIZURES
SURGICAL THERAPY
Historical Perspectives
Surgical Therapy Continues to Be Underutilized
Misconceptions about Surgical Candidates
Arguments for Early Surgical Intervention
Surgically Remediable Epilepsy Syndromes
Therapeutic Surgical Procedures
Standardized Resections
Tailored Resections
Disconnection Surgery
Ablative Surgery
Stimulation
Surgical Protocols
Strategy
Candidate Selection
Phase I
Phase II
Phase III
Outcome
Outcome with Respect to Seizures
Quality of Life
Cognitive, Psychiatric, and Social Outcomes
Surgical Complications
Development of New Centers
VAGUS NERVE STIMULATION (VNS)
HORMONE THERAPY
IMMUNE THERAPY
COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)
Diet
Ketogenic Diet
Dietary Supplements
Amino Acits
Vitamins
Minerals
Food Sensitivity
Traditional and Folk Medicine
Behavioral Therapies
Treatment of the Reflex Epilepsies
Abortive Sensory Stimulation
EEG Biofeedback
Psychological Treatments
Physical Interventions
Nonallopathic Medical Systems
SUMMARY AND CONCLUSIONS
Chapter 17
SOCIAL MANAGEMENT
STIGMA
QUALITY OF LIFE
ACTIVITIES OF DAILY LIVING
Driving
Practical Criteria for Restrictions on Driving
Driver's License Regulations
Participation in Sports
Alcohol and Drugs
Specific Hazards
FAMILY
The Child with Epilepsy
The Parent with Epilepsy
SCHOOL
EMPLOYMENT
LEGAL RIGHTS
INSURANCE
FINANCIAL AID
RESOURCES
HEALTH CARE DISPARITIES
SUMMARY AND CONCLUSIONS
Chapter 1
TERMINOLOGY AND CLASSIFICATIONS
TERMINOLOGY
Epileptic Seizures
Definition
Discussion
Epilepsy Disorders
Definition
Discussion
Epileptic and Epilepsy
Definition
Discussion
Ictal, Postictal, and Interictal
Definitions
Discussion
Epileptogenesis and Epileptogenicity
Definition
Discussion
Epileptic Spike Focus, Epileptic Lesion, and Epileptogenic Zone or Region
Definition
Discussion
Control, Cure, and Drug Resistance
Definition
Discussion
Antiepileptogenesis, Prevention, and Disease Modification
Definition
Discussion
Nonepileptic Seizures
Definition
Discussion
CLASSIFICATIONS
Older Classifications of Epileptic Seizure
International Classification of Epileptic Seizures
Other Seizure Classifications
Older Classifications of the Epilepsies
The 1970 International Classification
The WHO Classifications
The 1985 and 1989 International Classifications
Recent Efforts to Revise the International Classifications
Practical Considerations
SUMMARY AND CONCLUSIONS
Chapter 2
PERSPECTIVES
EPILEPSY THEN-HISTORICAL PERSPECTIVE
Medical History
Ancient and Medieval Periods
The Modern Era
Epilepsy and Religion
Epilepsy and Genius
EPILEPSY NOW-EPIDEMIOLOGICAL PERSPECTIVE
Definitions of Incidence and Prevalence
Methodological Considerations
Estimations of Incidence and Prevalence
Global Burden of Disease
SUMMARY AND CONCLUSIONS
PART II: PATHOPHYSIOLOGY
Chapter 3
MECHANISMS OF NEURONAL EXCITATION AND SYNCHRONIZATION
THE NEURON
The Excitable Membrane and Its Microenvironment
Voltage gated Channels
Membrane Physiology
Intracellular Processes
Structure-Function Relationship of Neuronal Elements
Interneuronal Connections
Chemical Synapses
Electrotonic Synapses
Nonsynaptic Communication
Glial Influences
NEURONAL NETWORKS
Intrinsic Organization of Ammon's Horn
Intrinsic Organization of the Neocortex
Subcortical and Interhemispheric Connections
PHYLOGENY AND ONTOGENY
Species Differences
Cortical Development
Maturational Effects on Excitability
SYSTEMIC INFLUENCES
NEURONAL BASIS OF EEG ACTIVITY
METHODOLOGICAL DEVELOPMENTS
SUMMARY AND CONCLUSIONS
Chapter 4
BASIC MECHANISMS OF SEIZURES AND EPILEPSY
EXPERIMENTAL MODELS OF SEIZURES AND EPILEPSY
Acute Models
In Vivo Models of Focal Seizures
In Vivo Models of Generalized Seizures
In Vitro Studies of Acute Seizures
Chronic Models
In Vivo Models of Epilepsy with Focal Seizures
Lesion and insult models
Models in the developing brain
Secondary epileptogenesis
In Vivo Models of Epilepsy with Generalized Seizures
In Vitro Studies of Chronic Epilepsy
STUDIES OF HUMAN EPILEPSY
Electrophysiological Investigations
Investigations Using Brain Imaging Techniques
Microanatomical Investigations
Biochemical and Molecular Investigations
MOLECULAR GENETIC INVESTIGATIONS
Gene Discovery
Acquired Genetic Disturbances
POSSIBLE MECHANISMS OF HUMAN EPILEPTIC PHENOMENA
Epileptogenesis
Interictal State
Ictogenesis
Ictus
Ictal Termination
Postictal Period
Possible Consequences of Epileptic Seizures
SUMMARY AND CONCLUSIONS
Chapter 5
CAUSES OF HUMAN EPILEPSY
NONSPECIFIC PREDISPOSING FACTORS
Genetic Factors
Environmental Factors
Dynamic Aspects of Threshold
SPECIFIC EPILEPTOGENIC DISTURBANCES
Genetic Causes of Epilepsy Disorders
Genetic Epilepsies
Genetic Disorders Associated with Epilepsy
Acquired Causes of Epilepsy Disorders
Anoxia and Trauma
Cerebrovascular Disorders
Brain Tumors
Infections Diseases
Inflammation and Immune-Mediated Disorders
Malformations of Cortical Development
Toxic and Metabolic Disturbances
Hippocampal Sclerosis
PRECIPITATING FACTORS
Nonspecific Precipitating Factors
Specific Precipitating Factors
SUMMARY AND CONCLUSIONS
PART III: PHENOMENOLOGY
Chapter 6
EPILEPTIC SEIZURES
NEUROBIOLOGICAL CONSIDERATIONS FOR THE DIAGNOSIS OF EPILEPTIC
SEIZURE TYPES
Anatomic Substrates
Pathophysiological Mechanisms
Pharmacological Considerations
TYPES OF EPILEPTIC SEIZURES
Definitions
FOCAL SEIZURES
Neocortical Seizures
Mechanisms
Phenomenology
Motor Signs
Sensory Symptoms
EEG
Clinical Considerations
Limbic Seizures
Mechanisms
Phenomenology
Limbic Sensory Symptoms
Autonomic Symptoms and Signs
Psychic Symptoms
Automatisms
EEG
Clinical Considerations
Focal Seizures Evolving Into Secondarily Generalized Seizures
Mechanisms
Phenomenology
Clinical Considerations
GENERALIZED SEIZURES
Tonic-Clonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Typical Absence Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Atypical Absence Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Myoclonic Absences
Eyelid Myoclonia
Myoclonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Myoclonic Atonic Seizures
Myoclonic Tonic Seizures
Clonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Tonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
Atonic Seizures
Mechanisms
Phenomenology
EEG
Clinical Considerations
UNCLASSIFIED SEIZURES
Epileptic Spasms
Reflex Seizures
Neonatal Seizures
MYOCLONUS
SUMMARY AND CONCLUSIONS
Chapter 7
EPILEPSY SYNDROMES
NEONATAL PERIOD
Benign Familial Neonatal Epilepsy (BFNE)
Early Myoclonic Epilepsy (EME)
Ohtahara Syndrome (OS)
INFANCY
Epilepsy of Infancy with Migrating Focal Seizures (MPSI)
West Syndrome (WS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Myoclonic Epilepsy in Infancy (MEI)
Benign Infantile Epilepsy (BIE) and Benign Familial Infantile Epilepsy (BFIE)
Dravet Syndrome (DS)
Myoclonic Encephalopathy in Non-progressive Disorders
CHILDHOOD
Febrile Seizures Plus (FS+)
Panayiotopoulos Syndrome (PS)
Epilepsy with Myoclonic-Atonic Seizures (EMAS)
Benign Epilepsy with Centrotemporal Spikes (BECTS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Autosomal-Dominant Nocturnal Frontal Lobe Epilepsy (ADNFLE)
Late Childhood Occipital Epilepsy (Gastaut Type)
Epilepsy with Myoclonic Absences (EMA)
Lennox-Gastaut Syndrome (LGS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Epileptic Encephalopathy with Continuous Spike and Wave During Sleep (CSWS)
Landau-Kleffner Syndrome (LKS)
Childhood Absence Epilepsy (CAE)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
ADOLESCENCE-ADULT
Juvenile Absence Epilepsy (JAE)
Juvenile Myoclonic Epilepsy (JME)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Epilepsy with Generalized Tonic-Clonic Seizures Alone
Progressive Myoclonus Epilepsies (PME)
Autosomal-Dominant Epilepsy with Auditory Features (ADEAF)
Other Familial Temporal Lobe Epilepsies
LESS SPECIFIC AGE RELATIONSHIP
Familial Focal Epilepsy with Variable Foci
Reflex Epilepsies
DISTINCTIVE CONSTELLATIONS
Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (MTLE with HS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Rasmussen Syndrome (RS)
Gelastic Seizures with Hypothalamic Hamartoma
Hemiconvulsion-Hemiplegia Epilepsy (HHE)
CONDITIONS WITH EPILEPTIC SEIZURES THAT ARE TRADITIONALLY NOT DIAGNOSED AS A FORM OF EPILEPSY PER SE
Benign Neonatal Seizures (BNS)
Febrile Seizures (FS)
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
Reactive Seizures
Neonatal Seizures Due to Structural and Metabolic Disorders
Clinical Description
Epidemiology
Etiology
Differential Diagnosis
Treatment
Prognosis
MYOCLONIC SYNDROMES
SUMMARY AND CONCLUSIONS
Chapter 8
EPILEPTOGENESIS
THE DEVELOPMENT OF EPILEPSY
Phenomenology
Character of the Lesion
Location of the Lesion
Genetic Factors
Practical Considerations
Prophylaxis for Early Seizures
Prophylaxis for Chronic Epilepsy
THE PROGRESSIVE NATURE OF EPILEPSY
Secondary Epileptogenesis
Clinical Evidence for Progression
Practical Considerations
EPILEPTIC SEIZURES AND BRAIN DEVELOPMENT
Epileptic Susceptibility of the Immature Brain
Evolution of Epileptic Syndromes
Migration of the Interictal EEG Spike
Practical Considerations
SUMMARY AND CONCLUSIONS
Chapter 9
PERIICTAL PHENOMENA
ICTAL INITIATION
Mechanisms
Clinical Considerations
Reflex Seizures
Genetic Reflex Epilepsies
Reflex Epilepsies Due to Structural Lesions
Simple vs. Complex Reflex Epilepsies
Reflex Myoclonus
Abortive Stimuli
SLEEP-WAKE CYCLES AND CHRONOBIOLOGY
METABOLIC AND TOXIC INFLUENCES
PSYCHOLOGICAL STRESS
POSTICTAL SYMPTOMS
Mechanisms
Clinical Considerations
Specific Postictal Cerebral Dysfunction
Nonspecific Postictal Cerebral Dysfunction
Noncerebral Postictal Dysfunction
MORTALITY
Comorbidity
Sudden unexpected death
Drowning
SUMMARY AND CONCLUSIONS
Chapter 10
STATUS EPILEPTICUS
GENERALIZED CONVULSIVE STATUS EPILEPTICUS
Clinical Description
Tonic-Clonic Status Epilepticus
Other Forms of Generalized Convulsive Status Epilepticus
Incidence
Etiology
Treatment
Lorazepam
Diazepam
Fosphenytoin
Phenobarbital
Paraldehyde
Other drugs
General Anesthesia
EEG Monitoring, Ventilation, and Follow-Up
Prognosis
ABSENCE STATUS EPILEPTICUS
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
EPILEPSIA PARTIALIS CONTINUA
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
FOCAL DYSCOGNITIVE (COMPLEX PARTIAL) STATUS EPILEPTICUS
Clinical Description
Incidence
Etiology
Differential Diagnosis
Treatment
Prognosis
SUBTLE STATUS EPILEPTICUS
FEBRILE STATUS EPILEPTICUS
NEONATAL STATUS EPILEPTICUS
EPILEPTIC BRAIN DAMAGE
SUMMARY AND CONCLUSIONS
Chapter 11
CHRONIC BEHAVIORAL DISTURBANCES
EPIDEMIOLOGY OF PSYCHIATRIC COMORBIDITY IN EPILEPSY
PHENOMENOLOGY OF BEHAVIORAL DISTURBANCES IN EPILEPSY
Ictal and Peri-ictal Behavior
Psychosocial Adaptation
Neurological, Intellectual, and Cognitive Function
Personality
Mood and Affect
Anxiety
Attention Deficit Hyperactivity Disorder (ADHD)
Psychosis
Classification of Neuropsychiatric Disorders in Epilepsy
MECHANISMS OF INTERICTAL BEHAVIORAL DISTURBANCES IN EPILEPSY
Psychosocial Factors-The Predicament
Neuropathological Factors
Effects of Treatment
Epilepsy-Induced Neurobiological Factors
SUMMARY AND CONCLUSIONS
PART IV: MANAGEMENT
Chapter 12
DIAGNOSTIC EVALUATION
HISTORY
Seizure History
Aura or Prodrome
Clinical Seizures
Postictal Period
Precipitating Factors and Pattern
Frequency
Age of Onset
Progression of Symptoms
ANTISEIZURE DRUG HISTORY
Past Medical History
Family History
Psychosocial History
PHYSICAL EXAMINATION
General Physical Examination
Neurological Examination
Epileptic Seizure Observation
LABORATORY EXAMINATION
Clinical Laboratory Tests
Electroencephalography
When to Use EEG
Special EEG Approaches
Additional Electrodes
Physiological Activation Procedures
Pharmacological Activation Procedures
Video-EEG Monitoring (VEM)
Computer-Enhanced EEG
Evoked Potentials
Magnetoencephalography
Transcranial Magnetic Stimulation (TMS)
Structural Neuroimaging
Magnetic Resonance Imaging (MRI)
X-Ray Computed Tomography (CT)
Radiographs
Functional Neuroimaging
Positron Emission Tomography (PET)
Single Photon Emission Computed Tomography (SPECT)
Functional Magnetic Resonance Imaging (fMRI)
Magnetic Resonance Spectroscopy (MRS)
Rectilinear Radionuclide Brain Scanning
PSYCHOLOGICAL EVALUATION
BIOMARKERS
SUMMARY AND CONCLUSIONS
Chapter 13
DIFFERENTIAL DIAGNOSIS
DIFFERENTIAL DIAGNOSIS OF NONEPILEPTIC PAROXYSMAL EVENTS
Systemic Disturbances
Syncope
Breath Holding
Hyperventilation
Toxic and Metabolic Disturbances
Abdominal Epilepsy
Neurologic Disturbances
Cerebrovascular Disorders
Sleep Disorders
Motor Disorders
Sensory Disorders
Psychogenic Disturbances
Psychogenic Nonepileptic Seizures (PNES)
Intermittent Explosive Disorders
Dissociative States
Daydreaming
Psychoses and Other Nonpsychotic Psychiatric Conditions
DIFFERENTIAL DIAGNOSIS OF REACTIVE (ACUTE SYMPTOMATIC, PROVOKED) EPILEPTIC SEIZURES
Alcohol Withdrawal Seizures
Recurrent Reactive Seizures
DIFFERENTIAL DIAGNOSIS OF CHRONIC EPILEPSY
THE USE OF THE EEG IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY
Avoiding an Inappropriate Diagnosis of Epilepsy
EEG Contributions to a Positive Diagnosis of Epilepsy
EEG Contributions to Diagnosis of the Type of Epilepsy
THE USE OF FUNCTIONAL IMAGING IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY
SUMMARY AND CONCLUSIONS
Chapter 14
GENERAL PRINCIPLES OF TREATMENT
PHARMACOLOGICAL TREATMENT
Pharmacological Principles
Absorption
Protein Binding
Distribution
Elimination
Half-Life
Zero-Order Kinetics
Pharmacodynamic Actions
Dose Planning
Approach to Monotherapy and Polytherapy
Clinical Factors Influencing Drug Efficacy
Adverse Side Effects
Dose-Dependent Adverse Side Effects
Hypersensitive and Chronic Adverse Side Effects
Drug Monitoring
Choosing the Appropriate Drug
Discontinuation of Medication
Special Considerations
Age
Pregnancy
Comorbidity
Surgery
Psychiatric Conditions
Alcohol and Sedative Drug Withdrawal
MEDICALLY REFRACTORY SEIZURES
ALTERNATIVE THERAPY
PSYCHOSOCIAL CONSIDERATIONS
THE USE OF EEG IN ASSESSING TREATMENT
MANAGEMENT AFTER A SINGLE SEIZURE
EMERGENCY TREATMENT
SUMMARY AND CONCLUSIONS
Chapter 15
ANTISEIZURE DRUGS
STANDARD OLDER DRUGS
Phenobarbital (PB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Phenytoin (PHT)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Primidone (PRM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ethosuximide (ESM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Benzodiazepines
Diazepam (DZP)
Clonazepam (CLN)
Lorazepam (LZP)
Clobazam (CLB)
Carbamazepine (CBZ)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Valproic Acid (VPA)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
NEWER DRUGS
Eslicarbazepine Acetate (ESL)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ezogabine (EZG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Felbamate (FBM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Gabapentin (GBP)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lacosamide (LCM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lamotrigine (LTG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Leviteracetam (LEV)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Oxcarbazepine (OXC)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Pregabalin (PGN)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Rufinamide (RUF)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Tiagabine (TGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Topiramate (TPM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Vigabatrin (VGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Zonisamide (ZON)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
SPECIAL AND RARELY USED DRUGS
Acetazolamide
ACTH and Adrenocorticosteroids
Barbiturates
Methylphenobarbital
Metharbital
Benzodiazepines
Clorazepate
Midazolam
Nitrazepam
Bromides
Hydantoins
Fosphenytoin
Mephenytoin
Ethotoin
Oxazolidinediones
Trimethadione
Paramethadione
Paraldehyde
Phenacemide
Piracetam
Progabide
Propofol
Stiripentol
Succinimides
Methsuximide
Phensuximide
Sulthiame
NEW DRUG DEVELOPMENT
Identification of New Compounds
Preclinical Evluation
Clincial Evaluation
DRUGS UNDER INVESTIGATION
Drugs in Phase III Trials
Brivaracetam
Ganaxolone
Perampanel
Drugs in Preclincal Development
2-Deoxy-D-Glucose
Huperzine A
ICA105665
T2000
Tonabersat
Valproic Acid Derivatives
YKP3089
VX-765
SUMMARY AND CONCLUSIONS
Chapter 15
ANTISEIZURE DRUGS
STANDARD OLDER DRUGS
Phenobarbital (PB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Phenytoin (PHT)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Primidone (PRM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ethosuximide (ESM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Benzodiazepines
Diazepam (DZP)
Clonazepam (CLN)
Lorazepam (LZP)
Clobazam (CLB)
Carbamazepine (CBZ)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Valproic Acid (VPA)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
NEWER DRUGS
Eslicarbazepine Acetate (ESL)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Ezogabine (EZG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Felbamate (FBM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Gabapentin (GBP)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lacosamide (LCM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Lamotrigine (LTG)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Leviteracetam (LEV)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Oxcarbazepine (OXC)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Pregabalin (PGN)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Rufinamide (RUF)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Tiagabine (TGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Topiramate (TPM)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Vigabatrin (VGB)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
Zonisamide (ZON)
Mechanisms of Action
Pharmacokinetics
Toxicity
Drug Interactions
Indications
Administration
SPECIAL AND RARELY USED DRUGS
Acetazolamide
ACTH and Adrenocorticosteroids
Barbiturates
Methylphenobarbital
Metharbital
Benzodiazepines
Clorazepate
Midazolam
Nitrazepam
Bromides
Hydantoins
Fosphenytoin
Mephenytoin
Ethotoin
Oxazolidinediones
Trimethadione
Paramethadione
Paraldehyde
Phenacemide
Piracetam
Progabide
Propofol
Stiripentol
Succinimides
Methsuximide
Phensuximide
Sulthiame
NEW DRUG DEVELOPMENT
Identification of New Compounds
Preclinical Evluation
Clincial Evaluation
DRUGS UNDER INVESTIGATION
Drugs in Phase III Trials
Brivaracetam
Ganaxolone
Perampanel
Drugs in Preclincal Development
2-Deoxy-D-Glucose
Huperzine A
ICA105665
T2000
Tonabersat
Valproic Acid Derivatives
YKP3089
VX-765
SUMMARY AND CONCLUSIONS
Chapter 16
NONPHARMACOLOGICAL THERAPY OF SEIZURES
SURGICAL THERAPY
Historical Perspectives
Surgical Therapy Continues to Be Underutilized
Misconceptions about Surgical Candidates
Arguments for Early Surgical Intervention
Surgically Remediable Epilepsy Syndromes
Therapeutic Surgical Procedures
Standardized Resections
Tailored Resections
Disconnection Surgery
Ablative Surgery
Stimulation
Surgical Protocols
Strategy
Candidate Selection
Phase I
Phase II
Phase III
Outcome
Outcome with Respect to Seizures
Quality of Life
Cognitive, Psychiatric, and Social Outcomes
Surgical Complications
Development of New Centers
VAGUS NERVE STIMULATION (VNS)
HORMONE THERAPY
IMMUNE THERAPY
COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)
Diet
Ketogenic Diet
Dietary Supplements
Amino Acits
Vitamins
Minerals
Food Sensitivity
Traditional and Folk Medicine
Behavioral Therapies
Treatment of the Reflex Epilepsies
Abortive Sensory Stimulation
EEG Biofeedback
Psychological Treatments
Physical Interventions
Nonallopathic Medical Systems
SUMMARY AND CONCLUSIONS
Chapter 17
SOCIAL MANAGEMENT
STIGMA
QUALITY OF LIFE
ACTIVITIES OF DAILY LIVING
Driving
Practical Criteria for Restrictions on Driving
Driver's License Regulations
Participation in Sports
Alcohol and Drugs
Specific Hazards
FAMILY
The Child with Epilepsy
The Parent with Epilepsy
SCHOOL
EMPLOYMENT
LEGAL RIGHTS
INSURANCE
FINANCIAL AID
RESOURCES
HEALTH CARE DISPARITIES
SUMMARY AND CONCLUSIONS