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Neurological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Even with a good eyewitness account, distinguishing epilepsy from other causes of altered consciousness can be very difficult. Establishing whether attacks are due to epileptic seizures is more important than establishing quite what kind of epilepsy the patient has, although this can be helpful in prognosis and guiding management (Table 13.3). Epilepsy is diagnosed when more than one epileptic seizure has occurred.
Natural Product Compounds from Plants in Neurodegenerative Diseases
Published in Namrita Lall, Medicinal Plants for Cosmetics, Health and Diseases, 2022
Priya Darshani, Md TanjimAlam, Prem P. Tripathi, V.S. Pragadheesh
Epilepsy is characterized by the manifestation of epileptic seizures and linked social, psychological and cognitive complications. It involves the occurrence of two unprovoked seizures, a single unprovoked seizure with a high risk of relapse and consequent appearance of an epileptic syndrome caused by abnormal coordinated neuronal cell firing (Devinsky et al., 2018). Though the causes of epilepsy are relatively unknown, genetic mutations, brain strokes, traumatic injury, inflammatory and auto-immune diseases are linked with epileptic development in many patients (Vossler et al., 2018).
Critical care, neurology and analgesia
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
The recognition and diagnosis of epileptic seizures is almost entirely dependent on the history. The examination will often be normal, and the results of any investigations can only be interpreted with reference to the history. A detailed description is required of events occurring before, during and after a suspected epileptic seizure. The accurate account of any eyewitness is essential and will be the only history available when young children present with seizures. Video-recordings of suspected seizures may be very helpful and should be encouraged whenever there is any continuing doubt or confusion from the history. If the diagnosis remains uncertain, then it is appropriate to await further episodes, because a delay in making a diagnosis of epilepsy is, in most children, unlikely to be harmful.
Efficacy and safety of perampanel for the treatment of epilepsy in adolescents: a meta-analysis
Published in International Journal of Neuroscience, 2023
Ting Wang, Limin Li, Fei Sun, Yonghua Yang, Xiaohong Liu
Epilepsy is a chronic disease characterized by acute abnormal discharge of brain neurons, which results in transient brain dysfunction. The clinical manifestations of epileptic seizures are complex and diverse due to the different initial sites and transmission modes of abnormal discharges, including paroxysmal motor, sensory, autonomic, conscious, and mental disorders [1, 2]. Reportedly, 32–55 per 10,000 children in developed countries and 36–440 per 10,000 children in undeveloped countries suffer from epilepsy [3]. Anti-seizure drugs(ASDs) function mainly through the influence of central neurons and improve the excitation threshold of normal brain tissue to eliminate or reduce the seizure. The most commonly used ASDs for pediatric patients are carbamazepine (CBZ), valproate (VPA), oxcarbazepine (OXC) and lamotrigine (LVFX) as monotherapy or adjunctive therapy. Nearly half of patients obtain seizure control after receiving their first AED [4]. However, seizures in some patients remain uncontrolled with the most commonly used ASDs, thus, further antiepileptic medications or combination regimens are prescribed. To achieve effective seizure control, improved tolerability, and minimal drug interaction potential, new ASDs have been developed within the past two decades.
Treatment response in newly diagnosed epilepsy: a syndromic approach
Published in Neurological Research, 2022
Ali A. Asadi-Pooya, Mohsen Farazdaghi
The prevalence of epilepsy is about 7 per 1,000 people worldwide, with 61 per 100,000 persons developing the condition every year [1]. However, epilepsy is not a single diagnostic entity; various brain disorders may cause epileptic seizures. To satisfactorily diagnose and manage ‘epilepsy’ a healthcare professional (HCP) should do more than establishing that recurrent epileptic seizures have happened or are highly likely to happen after the first episode. It is of great significance to make an attempt to diagnose the specific epilepsy syndrome [2]. Any HCP, who is dealing with patients with epilepsy (PWE), should at least be able to differentiate three general categories of epileptic syndromes from one another: idiopathic (genetic) generalized epilepsies (IGEs), structural-metabolic-genetic generalized epilepsies [formerly, symptomatic generalized epilepsies (SGEs)], and focal epilepsies [3]. This syndromic diagnosis establishes the foundation for the treating HCP to decide on an appropriate treatment strategy and also to explain the prognosis for the patient and their caregivers [2].
Epilepsy in prolonged disorders of consciousness: a systematic review
Published in Brain Injury, 2021
Nicolas Lejeune, Nathan Zasler, Rita Formisano, Anna Estraneo, Olivier Bodart, Wendy L. Magee, Aurore Thibaut
Following a severe acquired brain injury (ABI), some patients in coma will evolve to prolonged “disorder of consciousness” (DoC) (i.e., a DoC lasting ≥ 28 days) (1,2). Prolonged DoC encompasses (1) the Unresponsive Wakefulness Syndrome (UWS) (3), also known as Vegetative State (VS), in which patients show only reflexive movements without any behavioral evidence of consciousness; and (2) the Minimally Conscious State (MCS), in which patients show clear, reproducible but inconsistent behavioral signs of consciousness (4). Recovery of consciousness is defined by the presence of functional communication and/or functional use of objects (5). These patients are highly vulnerable and at high risk of medical complications (as much as 0.40 medical event per week per patient) (6–9). Among those medical complications, epileptic seizures are suspected to impact prognosis and require pharmacological treatment potentially influencing recovery of consciousness (10).