Epilepsy
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Epilepsy
NIH - Medical Encyclopedia Epilepsy
"Some seizures are idiopathic, which means the cause can not be identified. Such seizures usually being between age 5 and 20, but can occur at any age. People with this condition have no other neurological problems, but often have a family history of seizures or epilepsy. Disorders affecting the blood vessels, such as stroke and TIA, are the most common cause of seizures after age 60. Degenerative disorders such as senile dementia Alzheimer type can also lead to seizures.
Some of the more common causes of seizures include:
Developmental problems, genetic conditions present at birth, or injuries near birth (seizures usually begin in infancy or early childhood)
Metabolic abnormalities may affect people of any age and may be a result of:
o Diabetes complications o Electrolyte imbalances o Kidney failure, uremia (toxic accumulation of wastes) o Nutritional deficiencies o Phenylketonuria (PKU) -- can cause seizures in infants o Other metabolic diseases, such as inborn error of metabolism o Use of cocaine, amphetamines, alcohol, or certain other recreational drugs o Withdrawal from alcohol o Withdrawal from drugs, particularly barbiturates and benzodiazepines
Brain injury o Most common in young adults o Seizures usually begin within 2 years after the injury o Early seizures (within 2 weeks of injury) do not necessarily mean that chronic (ongoing) seizures (epilepsy) will develop
Tumors and brain lesions (such as hematomas) o May affect any age but are more common after age 30 o Partial (focal) seizures most common to start with o May lead to generalized tonic-clonic seizures
Infections o May affect people of all ages o May be a reversible cause of seizures o Brain infections like meningitis and encephalitis can produce seizures o Brain abscess o Acute severe infections of any part of the body o Chronic infections (such as neurosyphilis) o Complications of AIDS or other immune disorders.
Seizure disorders affect about 0.5% of the population. Approximately 1.5-5.0% of the population may have a seizure in their lifetime. Epilepsy can affect people of any age."
Highlighted Article
Refractory Epilepsy: Clinical Overview (Epilepsia 2007)
"The incidence of refractory epilepsy remains high despite the influx of many new antiepileptic drugs (AEDs) over the past 10 years. Epidemiological data indicate that 20–40% of the patients with newly diagnosed epilepsy will become refractory to treatment. Factors that may be used to predict whether or not a patient will respond favorably to AED therapy include the type of epilepsy, underlying syndrome, etiology, and the patient's history of seizure frequency, density, and clustering. Environmental factors, such as trauma and prior drug exposure, and genetic factors that predetermine the rate of absorption, metabolism, and uptake of a drug by target tissue may also uniquely impact an individual and influence their response to AED therapy."
Featured Internet Site
NIH - Medical Encyclopedia Seizures
"What to expect at your health care provider's office: The doctor will perform a physical examination and ask questions to help understand the cause of the seizures, such as: • Did it occur or start on one side of the body? • Was there movement of the muscles and if so, what was the pattern? • Are there any risk factors (such as recent head injury)? • Was consciousness maintained during the seizure? • How long did the seizure last? • What are the frequency of the seizures? • Was there any warning (aura) of the seizures? • Were there any other symptoms present (visual changes, abnormal smells)? The following diagnostic tests may be performed: • CT scan of the head or MRI of the head • EEG • Lumbar puncture • Blood tests"
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Epilepsy
General Information
NEWS:
NIH - Intractable epilepsy tied to nutritional deficits "The nutrient levels in young children with poorly controlled seizure disorders is often below the recommended levels, researchers report. Growth problems have been reported in children with epilepsy and poor nutrition may be a factor, especially in children with intractable epilepsy. To further investigate, Dr. Stella L. Volpe, at the University of Pennsylvania in Philadelphia, and colleagues conducted a nutritional analysis comparing 43 children with intractable epilepsy with 1,718 healthy children between 1 and 8 years of age. The subjects were part of the National Health and Nutritional Examination Survey (NHANES) between 2001 and 2002. Intractable epilepsy was defined as one or more seizures every month, despite treatment with at least three antiepileptic drugs. The average age of the children was 4.7 years. … The team found that 30 percent of the children with seizures had lower-than-recommended intakes of vitamins D, E and K, folate, calcium, linoleic acid and alpha-linoleic acid. The younger children had lower levels of micronutrients than the older children."
ARTICLES:
Advances in Pediatric Epilepsy
JOURNAL ARTICLES:
10-Year Research Update Review: Psychiatric Problems in Children With Epilepsy. (J Am Acad Child Adolesc Psychiatry. 2007)
A study of idiopathic generalised epilepsy in an Irish population. (Seizure. 2007) "CONCLUSIONS: More women than men were diagnosed with generalised epilepsy. Tonic clonic seizures were the most common seizure type reported. EGTCSA was the most frequent syndrome seen. Gender differences were evident for JAE and JME as previously reported and for EGTCSA, which was not reported to date, and reached statistical significance for EGTCA and JME."
Age-Dependent Seizure Semiology in Temporal Lobe Epilepsy. (Epilepsia. 2007)
[An epidemiological, clinical and developmental study of 37 patients with early-onset benign occipital epilepsy of childhood.] (Rev Neurol. 2007) "CONCLUSIONS. Early-onset benign occipital epilepsy of childhood is relatively frequent at the paediatric age, especially in the pre-school years. Although its semiological sequence is quite characteristic, the fact that it lacks clinical and neurological specificity makes diagnostic suspicion more difficult. Its prognosis is especially favourable; however, since their progress may develop in an atypical manner, a rigorous developmental control of these patients would be of the highest priority."
Analysis of status epilepticus related presumed encephalitis in children. (Eur J Paediatr Neurol. 2007) "CONCLUSIONS: Our data indicated that children of SE related presumed encephalitis had a high mortality and morbidity. Outcome was related to multifocal or generalized abnormalities of the initial EEG and presence of RSE."
Autism Spectrum Disorders in Children with Seizures in the First Year of Life-A Population-Based Study (Epilepsia 2007) "Conclusion: These results suggest that the estimated prevalence of ASD is higher in children with history of seizure in the first year of life than it is in the general population. There are indications that support the view that children with ASD and history of seizure in the first year of life have higher prevalence of congenital brain abnormalities and are more often female, than other children with ASD."
Benign epilepsy of childhood with rolandic spikes: typical and atypical variants. (Pediatr Neurol. 2007)
Can patients with epilepsy predict their seizures? (NEUROLOGY 2007) "Conclusions: A significant subgroup of our adult patients with epilepsy were able to self-predict their seizures, which may yield novel therapeutic opportunities."
Children with seizures exhibit preferences for foods compatible with the ketogenic diet. (Epilepsy Behav. 2007) "Children with seizures exhibited significantly higher preferences for fat versus carbohydrate foods compared with controls, and parents demonstrated low accuracy."
Clinical characteristics and outcome of patients diagnosed with psychogenic nonepileptic seizures: A 5-year review. (Epilepsy Behav. 2007)
Cognitive decline in temporal lobe epilepsy due to unilateral hippocampal sclerosis. (Epilepsy Behav. 2007)
[Cognitive repercussion of early-onset epilepsies.] (Rev Neurol. 2007)
[Comorbidity in children with epilepsy. I: behaviour problems, ADHD and intelligence] (Ugeskr Laeger. 2007) "Behaviour problems seem to occur before the children have seizures, i.e. the behaviour problem seems to exist before the onset of epileptic seizures. There was no sound evidence for the prevalence of comorbidity in the form of ADHD. Children with epilepsy seem to have normal IQ."
Early epileptic seizures after stroke are associated with increased risk of new-onset dementia (Journal of Neurology, Neurosurgery, and Psychiatry 2007)
Early seizures: causal events or predisposition to adult epilepsy? (Lancet Neurol. 2007) "Accumulating evidence suggests that early seizures may be associated with, or cause, brain damage; or alternatively, they may be the first expression of a genetic or lesional predisposition to epilepsy. The course of early seizures ranges from transient to life-long, depending on epilepsy syndrome, causes, and treatment. The main factors that determine late or persisting epilepsy after the occurrence of early seizures are protracted seizures, tonic seizures, and involvement of mesial temporal structures."
Effects of polydipsia-hyponatremia on seizures in patients with epilepsy. (Psychiatry Clin Neurosci. 2007)
Epilepsy. (Curr Opin Neurol. 2007)
Epilepsy and risk of suicide: a population-based case-control study. (Lancet Neurol. 2007) "INTERPRETATION: Individuals with epilepsy have a higher risk of suicide, even if coexisting psychiatric disease, demographic differences, and socioeconomic factors are taken into account. Our study identifies people with newly diagnosed epilepsy as a vulnerable group that require special attention."
Epilepsy in children in navarre, Spain: epileptic seizure types and epileptic syndromes. (J Child Neurol. 2007)
Epilepsy and women’s health issues: Unmet needs—Survey results from women with epilepsy (Epilepsy & Behavior 2007) "Across the responders, the greatest concerns related to AED therapy were weight gain (63%) and bone health (64%). Among women less than 35 years old, 69% were concerned about pregnancy. Women with epilepsy who access online health information are not adequately educated by their physicians about the impact of epilepsy and AED therapy."
Estrogens and epilepsy: why are we so excited? (Neuroscientist. 2007)
Evaluation of a first seizure. (Am Fam Physician. 2007) "Seizures are categorized based on presentation and etiology. A generalized seizure involves all areas of the brain (both hemispheres), whereas a partial (focal) seizure involves only one area of the brain. A first seizure is twice as likely to be a generalized seizure as a partial seizure. Most generalized seizures occur when the patient is awake, but one in four occurs during sleep.3 Partial seizures can be further classified as simple (i.e., no loss of consciousness) or complex (i.e., loss of consciousness). Symptomatic seizures are those that have a recognizable cause (e.g., head injury, brain tumor), and idiopathic seizures are those for which no abnormality is found. Acute symptomatic seizures are caused by a recent or current event, whereas remote symptomatic seizures are caused by a chronic abnormality such as an old stroke."
Helicobacter pylori infection in epileptic patients (Seizure 2007) "These results suggest a probable association between the acute H. pylori infection and epilepsy, especially with poor prognosis."
Identification and treatment of acute repetitive seizures in children and adults. (Curr Treat Options Neurol. 2007)
[Incidence of epilepsy in 0-15 year-olds.] (An Pediatr (Barc). 2007)
Incidence of Status Epilepticus in Southern Europe: A Population Study in the Health District of Ferrara, Italy. (Eur Neurol. 2007)
In-hospital mortality of generalized convulsive status epilepticus (NEUROLOGY 2007) "Conclusion: Overall in-hospital mortality from generalized convulsive status epilepticus is low, but remarkably increases in those treated with mechanical ventilation. Other predictors of mortality include older age, female sex, hypoxic–ischemic brain injury, and higher comorbidity index."
Irreversible brain injury following status epilepticus. (Epilepsy Behav. 2007)
Management of epilepsy in children with autism (Current Paediatrics 2007)
Manganese and epilepsy: A systematic review of the literature (Brain Research Reviews 2007)
Memory and phonological awareness in children with Benign Rolandic Epilepsy compared to a matched control group. (Epilepsy Res. 2007)
Memory consolidation and accelerated forgetting in children with idiopathic generalized epilepsy (Epilepsy & Behavior 2007) "Overall, poor initial learning efficiency led to retrieval difficulties, specifically at the longer delay, and was more common in the IGE group. These results, although preliminary, have implications for education planning in childhood IGE."
Mortality in epilepsy. (Epilepsy Behav. 2007) "Mortality is frequently secondary to acute symptomatic disorders. Poor compliance with treatment in patients with epilepsy accounts for a small proportion of deaths from SE. The incidence of suicide is increased, particularly for individuals with epilepsy and comorbid psychiatric conditions. Late mortality figures in patients undergoing epilepsy surgery vary and are likely to reflect differences in case selection."
Neonatal status epilepticus vs recurrent neonatal seizures: clinical findings and outcome. (Neurology. 2007)
Neuropsychological Deficits in Childhood Epilepsy Syndromes. (Neuropsychol Rev. 2007)
Neurosyphilis presenting with status epilepticus. (Epileptic Disord. 2007)
No deterioration in epilepsy and motor function in children with medically intractable epilepsy ineligible for surgery. (Dev Med Child Neurol. 2007) " We conclude that during a 2-year follow-up period, in children with medically intractable epilepsy who do not have surgical intervention, seizure severity does not deteriorate, motor impairments do not increase, motor development does not deflect negatively, and activities of daily living and restrictions do not worsen."
Nocturnal Frontal Lobe Epilepsy: There Is Bad, Good, and Very Good News! (Epilepsy Currents 2007)
Nonconvulsive Status Epilepticus in the Elderly: A Case-Control Study. (Epilepsia. 2007) "Conclusions: NCSE is a serious cause of altered mental status in the elderly. Although its direct role in brain damage is controversial, elderly patients with NCSE have higher morbidity and worst prognosis than those with altered mental status without NCSE."
Olfactory dysfunction in temporal lobe epilepsy: A case of ictus-related parosmia. (pilepsy Behav. 2007)
Outcomes of newly diagnosed idiopathic generalized epilepsy syndromes in a non-pediatric setting. (Acta Neurol Scand. 2007) " Conclusions - Idiopathic generalized epilepsy syndromes constituted 13% of cases in a largely adult cohort of newly diagnosed epilepsy, most of whom achieved remission usually with a single antiepileptic drug. History of febrile seizures was associated with a poorer outcome."
Practice Parameter: Evaluating an apparent unprovoked first seizure in adults (an evidence-based review) (NEUROLOGY 2007)
Prevalence and Clinical Features of Epilepsy in Argentina (Neuroepidemiology 2007)
Prognosis of children with partial epilepsy (NEUROLOGY 2007)
Psychiatric events in epilepsy. (Seizure. 2007) "Our results suggest that people with epilepsy if unselected are not at higher risk for psychiatric disorders than the general population."
Quality of life outcomes of immediate or delayed treatment of early epilepsy and single seizures (NEUROLOGY 2007) "Conclusions: In treatment uncertain patients, there is a clear trade-off between adverse effects of seizures and adverse effects of taking antiepileptic drugs, i.e., neither policy examined in our study was associated with overall quality of life gains or losses longer term."
Refractory Epilepsy: Clinical Overview (Epilepsia 2007) "The incidence of refractory epilepsy remains high despite the influx of many new antiepileptic drugs (AEDs) over the past 10 years. Epidemiological data indicate that 20–40% of the patients with newly diagnosed epilepsy will become refractory to treatment. Factors that may be used to predict whether or not a patient will respond favorably to AED therapy include the type of epilepsy, underlying syndrome, etiology, and the patient's history of seizure frequency, density, and clustering. Environmental factors, such as trauma and prior drug exposure, and genetic factors that predetermine the rate of absorption, metabolism, and uptake of a drug by target tissue may also uniquely impact an individual and influence their response to AED therapy."
Seizure disorders (Current Opinion in Neurology 2007)
Seizure impact on the school attendance in children with epilepsy (Seizure 2007) "Seizures have a significant impact on school attendance, and as a result may increase the academic difficulties faced by children with epilepsy. This effect may be especially pronounced in children with symptomatic epilepsy and medically intractable seizures."
Seizure occurrence: Precipitants and prediction. (Neurology. 2007) "CONCLUSION: Lack of sleep and higher self-reported stress and anxiety levels were associated with seizure occurrence. In a model that included self-prediction, less sleep, and self-prediction had significant effects, whereas stress and anxiety did not. The psychological and biologic mechanisms which link stress and anxiety to self-prediction of seizures requires further exploration. Ultimately, seizure prediction based on precipitants, premonitory features, and self-prediction may provide a foundation for preemptive treatment."
Semantic memory impairment in temporal lobe epilepsy associated with hippocampal sclerosis. (Epilepsy Behav. 2007)
Sexual dysfunction in epileptic men. (Urol J. 2007)
Status Epilepticus in Children with Epilepsy: Dutch Study of Epilepsy in Childhood (Epilepsia 2007)
Status epilepticus: An independent outcome predictor after cerebral anoxia (NEUROLOGY 2007)
Subacute postictal aggression in patients with epilepsy. (Epilepsy Behav. 2007) "Epilepsy of prolonged duration and brain dysfunction involving a broad area including the temporal and frontal lobes may be associated with the occurrence of subacute postictal aggression."
Sudden unexpected death in epilepsy patients: Risk factors (Seizure 2007) "A number of strong risk factors for SUDEP: young age, early onset of seizures, the presence of generalized tonic clonic seizures, male sex and being in bed. Weak risk factors for SUDEP: prone position, one or more subtherapeutic bloodlevels, being in the bedroom, a strucural brain lesion and sleeping."
The development of intellectual abilities in pediatric temporal lobe epilepsy. (Epilepsia. 2007) "Conclusion: These data suggest a critical period during the first year of life for the subsequent development of intellectual abilities and highlight the importance of early treatment in this population."
The Epidemiology of Convulsive Status Epilepticus in Children: A Critical Review. (Epilepsia. 2007) "Age is a main determinant of the epidemiology of CSE and, even within the pediatric population there are substantial differences between older and younger children in terms of incidence, etiology, and frequency of prior neurological abnormalities or prior seizures. Overall, incidence is highest during the first year of life, febrile CSE is the single most common cause, around 40% of children will have previous neurological abnormalities and less than 15% will have a prior history of epilepsy. Outcome is mainly a function of etiology. However, the causative role of CSE itself on mesial temporal sclerosis and subsequent epilepsy or the influence of age, duration, or treatment on outcome of CSE remains largely unknown."
The frequency, complications and aetiology of ADHD in new onset paediatric epilepsy. (Brain. 2007) "Overall, ADHD is a prevalent comorbidity of new onset idiopathic epilepsy associated with a diversity of salient educational, cognitive, behavioural and social complications that antedate epilepsy onset in a significant proportion of cases, and appear related to neurodevelopmental abnormalities in brain structure."
The impact of seizures and adverse effects on global health ratings. (Epilepsy Behav. 2007)
Vitamin B6 related epilepsy during childhood. (Chang Gung Med J. 2007)
Who is at risk for prolonged seizures? (J Child Neurol. 2007)
Women and epilepsy: review and practical recommendations. (Expert Rev Neurother. 2007)
Women with epilepsy: Hormonal issues from menarche through menopause. (Epilepsy Behav. 2007)
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