Frequently Asked Questions

Total Page:16

File Type:pdf, Size:1020Kb

Frequently Asked Questions EPILEPSY AND SEIZURES – GENERAL Frequently Asked Questions What is epilepsy? Seizures are divided into two main categories: Epilepsy is a common neurological disease Generalized seizures characterized by the tendency to have recurrent • Involve both hemispheres of the brain seizures. It is sometimes called a seizure disorder. • Two common types are absence seizures (petit A person has epilepsy if they: mal seizures) and tonic-clonic seizures (grand mal seizures) • Have had at least two unprovoked seizures, or • Have had one seizure and are very likely to Focal seizures (partial seizures) have another, or • Only involve one part of the brain • Are diagnosed with an epilepsy syndrome • Include focal impaired awareness seizures (complex partial seizures) and focal aware seizures (simple partial seizures). What is a seizure? People with epilepsy may experience more than one A seizure is a sudden burst of electrical activity in the type of seizure. For more information about seizure brain that causes a temporary disturbance in the way types, see our Seizure Types Spark sheet. brain cells communicate with each other. The kind of seizure a person has depends on which part and how much of the brain is affected by the electrical FACT: About 1 in 100 Canadians have epilepsy. disturbance that produces the seizure. A seizure may take many different forms, including a blank stare, Why do people have seizures? uncontrolled movements, altered awareness, odd sensations, or convulsions. Seizures are typically brief There are many potential reasons why someone could and can last anywhere from a few seconds to a few have a seizure. Some seizures are a symptom of an minutes. acute condition, such as an illness or a recent head injury. Some people will have an isolated seizure for no apparent reason and never have another one. FACT: It is estimated that 1 out of 10 people will have When someone has epilepsy, they have an underlying a seizure in their lifetime, but most people who have a brain condition that makes them more likely to have single seizure do not have epilepsy. recurrent seizures. There are a wide range of causes of epilepsy. 1 / 6 Frequently Asked Questions continued Do people get a warning before a seizure? CT or MRI brain scans may also be helpful in some Sometimes people can feel a seizure coming on. patients to look for differences in brain structure, However, warnings are not experienced by everyone scars, or other physical conditions that may be causing with epilepsy. the seizures. Based on all of the information gathered, the healthcare provider may diagnose the person with epilepsy. Aura Some people have an aura at the very beginning of a How is epilepsy treated? focal seizure or a generalized seizure. Technically, an The goal of epilepsy treatment is to prevent seizures. aura doesn't happen "before" the seizure, because it Anti-seizure medication is the most common way to is actually part of the seizure. Some examples of treat epilepsy. Different medications control different auras are a sudden feeling of fear, an odd smell or types of seizures, and a medication that helps one taste, or a sudden tingling sensation in part of the person may not be effective for someone else. body. About 70% of people with epilepsy have their seizures An aura can also occur by itself. For example, if the controlled with medication. In some cases, epilepsy seizure activity causing the aura does not spread to surgery offers the possibility of a reduction or other brain areas, then the seizure may not progress complete elimination of the seizures. Other non-drug treatments include specialized diets and nerve to a loss of awareness or loss of consciousness. stimulation. Prodrome It’s important to remember that everyone responds Another type of warning, called a prodrome, can differently to treatment, so a person with epilepsy occur minutes, hours, or days before the seizure should discuss their care with their physician before begins. Some examples are headache, mood making any changes to their treatment. changes, or changes in thinking abilities. For more information, see these Spark sheets: Anti- How is epilepsy diagnosed? Seizure Medications, Epilepsy Surgery, Complementary Therapies, and Ketogenic Diet Epilepsy is diagnosed by a physician or nurse Therapy for Epilepsy. practitioner. The healthcare professional will complete a medical history, asking questions about Do people have seizures forever? the seizure, such as what happened before, during, and after it. Some types of epilepsy are limited to a certain age group or stage of development, but in many cases The person will have an electroencephalogram (EEG), epilepsy is a chronic, life-long disease. There are which is a test that records brain waves picked up by treatment options to help people achieve seizure- metal discs (electrodes) placed on the scalp. The brain freedom. Medication will be effective for many waves show patterns of brain activity which may help people. Some people are good candidates for the doctor identify epilepsy and provide more epilepsy surgery. information about any seizures a person may have. (For more information, see our EEG Spark sheet.) 2 / 6 Frequently Asked Questions continued I have not had a seizure for years. Do I still have • Metabolic or autoimmune conditions epilepsy? • Infections such as meningitis or encephalitis If someone is taking anti-seizure medication to control their seizures, they are considered to have What triggers seizures? active epilepsy. The International League Against Triggers vary from person to person. Some people Epilepsy considers epilepsy to be resolved for with epilepsy are able to very clearly identify situations individuals with an age-dependent epilepsy that trigger a seizure, while others are unable to find a syndrome who are past the applicable age or if the pattern to their seizures. A common way to identify individual has been seizure-free for 10 years and off seizure triggers is to keep a seizure record that medication for at least the last five years. includes tracking what happens before each seizure. How common is epilepsy? Common triggers include: Epilepsy is not rare – in fact, about 1 in 100 Canadians • Missed doses of anti-seizure medication (most has epilepsy and over 50 million people worldwide live common trigger) with it. It can affect anyone of any gender, age, and ethnicity. • Lack of sleep or fatigue • Stress or excitation Many famous people have had (or are suspected to have had) epilepsy, including Neil Young, Florence • Elevated body temperature Griffith Joyner, Derek Morris, Harriet Tubman, Hugo • Colds, flu or some kinds of infection Weaving, Fyodor Dostoevsky, Lil Wayne, and many • Hormonal changes during the menstrual cycle others. • Alcohol What causes epilepsy? • Flashing lights or contrasting patterns (photosensitivity), but only in about 5% of all Epilepsy is NOT contagious – you can’t catch it, and people with epilepsy you can’t give it to someone else. In more than half of cases, no clear known cause can be found. Can a person with epilepsy drive? Some types of epilepsy are associated with genetic In Ontario, you can drive with epilepsy if you meet factors. Among the rest, anything that affects the way certain criteria set out in the Ontario Highway Traffic the brain works could increase the chance of Act. Typically, this includes being seizure-free for at developing epilepsy. least 6 months, and taking your medication as Possible causes include: prescribed. • Head injuries This is to ensure your safety, as well as the safety of • Lack of oxygen during birth those around you. Your physician is required by law to • Stroke submit a report to the Ministry of Transportation • Problems in development of the brain before when you have had a seizure that could affect your birth ability to safely drive. • Brain tumors For more information, see our Epilepsy and Driving • Genetic conditions (such as tuberous sclerosis) Spark sheet. 3 / 6 Frequently Asked Questions continued Does epilepsy affect a person’s emotional well- The vast majority of people with epilepsy live long and being? healthy lives. As with many other medical conditions It is normal for a person who has been diagnosed with though, for some people there is an increased risk of epilepsy to experience a range of emotions such as dying caused by epilepsy. anger, frustration, fear, and sadness. Concern for the The overall risk of dying for a person with epilepsy is future and negative responses from friends and family 1.6 to 3 times higher than for the general population1. can leave a person feeling vulnerable and alone. The possible causes of this increased risk include: Living with epilepsy can result in personal challenges, • Complications during or after a seizure, such as but it does not have to result in an inability to live a seizures that do not stop naturally (status rewarding and full life. epilepticus) • Accidents caused by having a seizure, including People with epilepsy experience depression and drowning or car accidents anxiety more frequently than individuals without • The underlying medical cause of someone’s epilepsy. Research hasn’t yet determined why this epilepsy happens, but there may be some common links between the underlying causes of these brain • SUDEP (Sudden Unexpected Death in Epilepsy) disorders. For more information, see our Epilepsy and TIP: SUDEP occurs in about 1 out of every 1000 people Depression and Epilepsy and Anxiety Spark sheets. with epilepsy, and happens more often in people who have frequent convulsive seizures. Does epilepsy affect intelligence? SUDEP is thought to happen when a person with People with epilepsy have the same range of epilepsy, who is in their usual state of health, dies intelligence as people without epilepsy. Some unexpectedly. conditions that lower mental ability also cause epilepsy, but epilepsy itself does not diminish mental The best way to reduce the risk of SUDEP is to ability.
Recommended publications
  • Myths and Truths About Pediatric Psychogenic Nonepileptic Seizures
    Clin Exp Pediatr Vol. 64, No. 6, 251–259, 2021 Review article CEP https://doi.org/10.3345/cep.2020.00892 Myths and truths about pediatric psychogenic nonepileptic seizures Jung Sook Yeom, MD, PhD1,2,3, Heather Bernard, LCSW4, Sookyong Koh, MD, PhD3,4 1Department of Pediatrics, Gyeongsang National University Hospital, 2Gyeongsang Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea; 3Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; 4Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA, USA Psychogenic nonepileptic seizures (PNES) is a neuropsychiatric • PNES are a manifestation of psychological and emotional condition that causes a transient alteration of consciousness and distress. loss of self-control. PNES, which occur in vulnerable individuals • Treatment for PNES does not begin with the psychological who often have experienced trauma and are precipitated intervention but starts with the diagnosis and how the dia- gnosis is delivered. by overwhelming circumstances, are a body’s expression of • A multifactorial biopsychosocial process and a neurobiological a distressed mind, a cry for help. PNES are misunderstood, review are both essential components when treating PNES mistreated, under-recognized, and underdiagnosed. The mind- body dichotomy, an artificial divide between physical and mental health and brain disorders into neurology and psychi- atry, contributes to undue delays in the diagnosis and treat ment Introduction of PNES. One of the major barriers in the effective dia gnosis and treatment of PNES is the dissonance caused by different illness Psychogenic nonepileptic seizures (PNES) are paroxysmal perceptions between patients and providers. While patients attacks that may resemble epileptic seizures but are not caused are bewildered by their experiences of disabling attacks beyond by abnormal brain electrical discharges.
    [Show full text]
  • Epilepsy Syndromes E9 (1)
    EPILEPSY SYNDROMES E9 (1) Epilepsy Syndromes Last updated: September 9, 2021 CLASSIFICATION .......................................................................................................................................... 2 LOCALIZATION-RELATED (FOCAL) EPILEPSY SYNDROMES ........................................................................ 3 TEMPORAL LOBE EPILEPSY (TLE) ............................................................................................................... 3 Epidemiology ......................................................................................................................................... 3 Etiology, Pathology ................................................................................................................................ 3 Clinical Features ..................................................................................................................................... 7 Diagnosis ................................................................................................................................................ 8 Treatment ............................................................................................................................................. 15 EXTRATEMPORAL NEOCORTICAL EPILEPSY ............................................................................................... 16 Etiology ................................................................................................................................................ 16
    [Show full text]
  • Semiological Bridge Between Psychiatry and Epilepsy
    Journal of Psychology and Clinical Psychiatry Semiological Bridge between Psychiatry and Epilepsy Abstract Review Article Epilepsy is a paroxysmal disturbance of brain function that presents as behavioral phenomena involving four spheres; sensory, motor, autonomic and consciousness. These behavioural disturbances though transient but may be Volume 8 Issue 1 - 2017 confused with psychiatric disorders. Thus representing a diagnostic problem Department of Neuropsychiatry, Ain Shams University, Egypt for neurophyschiatrists. Here we review the grey zone between psychiatry and epilepsy on three levels. The first level is the semiology itself, that the behavioral *Corresponding author: Ahmed Gaber, Prof. of phenomenon at a time can be the presentation of an epileptic disorder and at Neuropsychiatry, Ain Shams University, Cairo, Egypt, another time a representation of a psychiatric disorder. The second level is Email: the comorbidity between epilepsy and psychiatric disorders namely epileptic psychosis. The third level is the disorders of the brain that can present by both Received: | Published: epileptic and/or psychiatric disorders. We reviewed the current literature in both June 11, 2017 July 12, 2017 epilepsy and Psychiatry including the main presentations that might be confusing. Conclusion: Epilepsy, schizophrenia like psychosis, intellectual disability, autism are different disorders that may share same semiological presentation, comorbidity or even etiology. A stepwise mental approach and decision making is needed excluding seizure disorder first before diagnosing a psychiatric one. Keywords: Epilepsy, Psychosis; Schizophrenia; Semiology; Autoimmune encephalitis Discussion with consciousness are called dialeptic seizures. Seizures Epilepsy is a brain disorder characterized by an enduring consistingseizures are primarily identified of as autonomic auras. Seizures symptoms that interfere are called primarily either predisposition of recurrent seizures.
    [Show full text]
  • Comprehensive Epilepsy Center the Only Level 4 Designated Center in Metropolitan Washington, D.C
    Comprehensive Epilepsy Center The Only Level 4 Designated Center in Metropolitan Washington, D.C. 3 Seizing Control On the Road Again Daniele Wishnow endured eight Epilepsy affects nearly 3 million people years of medications and side- in the United States or about one out of every 100 Americans. Many effects, a major car accident and losing the ability to drive before spend years—often their entire lives—taking various medications for she finally discovered the epilepsy experts at MedStar Georgetown their disorder, usually with good results. But uncontrolled, epilepsy University Hospital. Months later, can limit an individual’s ability to drive, work or enjoy other activities. her life was back on track. “At my worst, I had a combination of grand mal seizures—losing However, there is hope. consciousness, collapsing and Neurosurgeon Chris Kalhorn, MD, jerking,” Daniele says, “along with performs delicate and intricate surgery multiple small seizures that made to control seizures. When traditional approaches fail, MedStar Georgetown University me blank out for a few seconds or so. For a long time, medications So on January 2013, Christopher Hospital can help. Our Comprehensive Epilepsy Center features kept them pretty much under Kalhorn, MD—director of experts who can accurately locate the precise area of the brain control, but then they quit functional, pediatric and epilepsy working.” neurosurgery—successfully causing seizures in both adults and children. And with the right removed Daniele’s lesion. Today, Daniele underwent evaluation at Daniele’s back on the road and diagnosis, we can tailor personalized treatment plans to reduce or MedStar Georgetown’s Level 4 back to living a full life.
    [Show full text]
  • Psychogenic Nonepileptic Seizures: Diagnostic Challenges and Treatment Dilemmas Taoufik Alsaadi1* and Tarek M Shahrour2
    Alsaadi and Shahrour. Int J Neurol Neurother 2015, 2:1 International Journal of DOI: 10.23937/2378-3001/2/1/1020 Volume 2 | Issue 1 Neurology and Neurotherapy ISSN: 2378-3001 Review Article: Open Access Psychogenic Nonepileptic Seizures: Diagnostic Challenges and Treatment Dilemmas Taoufik Alsaadi1* and Tarek M Shahrour2 1Department of Neurology, Sheikh Khalifa Medical City, UAE 2Department of Psychiatry, Sheikh Khalifa Medical City, UAE *Corresponding author: Taoufik Alsaadi, Department of Neurology, Sheikh Khalifa Medical City, UAE, E-mail: [email protected] They are thought to be a form of physical manifestation of psychological Abstract distress. Psychogenic Non-Epileptic Seizures (PNES) are grouped in Psychogenic Nonepileptic Seizures (PNES) are episodes of the category of psycho-neurologic illnesses like other conversion and movement, sensation or behavior changes similar to epileptic somatization disorders, in which symptoms are psychological in origin seizures but without neurological origin. They are somatic but neurologic in expression [4]. The purpose of this review is to shed manifestations of psychological distress. Patients with PNES are often misdiagnosed and treated for epilepsy for years, resulting in light on this common, but, often times, misdiagnosed problem. It has significant morbidity. Video-EEG monitoring is the gold standard for been estimated that approximately 20 to 30% of patients referred to diagnosis. Five to ten percent of outpatient epilepsy populations and epilepsy centers have PNES [5]. Still, it takes an average of 7 years before 20 to 40 percent of inpatient and specialty epilepsy center patients accurate diagnosis and appropriate referral is made [6]. Early recognition have PNES. These patients inevitably have comorbid psychiatric and appropriate treatment can prevent significant iatrogenic harm, and illnesses, most commonly depression, Post-Traumatic Stress Disorder (PTSD), other dissociative and somatoform disorders, may result in a better outcome.
    [Show full text]
  • How to Identify Migraine with Aura Kathleen B
    How to Identify Migraine with Aura Kathleen B. Digre MD, FAHS Migraine is very common—affecting 20% of women and (continuous dots that are present all of the time but do not almost 8% of men. Migraine with aura occurs in about obscure vision and appear like a faulty analog television set), one-third of those with migraine. Visual symptoms such as (Schankin et al), visual blurring and short visual phenomena photophobia, blurred vision, sparkles and flickering are all (Friedman). Migraine visual auras are usually stereotypic for reported in individuals with migraine. But how do you know if an individual. what a patient is experiencing is aura? Figure: Typical aura drawn by a primary care resident: The International Classification of Headache Disorders (ICHD 3) suggests that auras may be visual (most common—90% of all auras), sensory, speech and or language, motor, brainstem or retinal. The typical aura starts out gradually over 5 minutes and lasts 5-60 minutes, is usually unilateral and may be followed by a headache within 60 minutes. To identify aura, we rely on the patient’s description of the phenomena. One helpful question to ask patients to determine if they are experiencing visual aura is: Was this in one eye or both eyes? Many patients will report it in ONE eye but if they haven’t covered each eye when they have the phenomena and try to read text, they may be misled. If you can have them draw their aura (typical zig-zag lines) with scintillations (movement, like a kaleidoscope) across their vision, you know it is an aura.
    [Show full text]
  • Initiating an Epilepsy Surgery Program with Limited Resources in Indonesia
    www.nature.com/scientificreports OPEN Initiating an epilepsy surgery program with limited resources in Indonesia Muhamad Thohar Arifn1*, Ryosuke Hanaya2, Yuriz Bakhtiar1, Aris Catur Bintoro3, Koji Iida4, Kaoru Kurisu4, Kazunori Arita2, Jacob Bunyamin1, Rofat Askoro1, Surya Pratama Brilliantika1, Novita Ikbar Khairunnisa1 & Zainal Muttaqin1 To share the experiences of organizing the epilepsy surgery program in Indonesia. This study was divided into two periods based on the presurgical evaluation method: the frst period (1999–2004), when interictal electroencephalogram (EEG) and magnetic resonance imaging (MRI) were used mainly for confrmation, and the second period (2005–2017), when long-term non-invasive and invasive video-EEG was involved in the evaluation. Long-term outcomes were recorded up to December 2019 based on the Engel scale. All 65 surgical recruits in the frst period possessed temporal lobe epilepsy (TLE), while 524 patients were treated in the second period. In the frst period, 76.8%, 16.1%, and 7.1% of patients with TLE achieved Classes I, II, and III, respectively, and in the second period, 89.4%, 5.5%, and 4.9% achieved Classes I, II, and III, respectively, alongside Class IV, at 0.3%. The overall median survival times for patients with focal impaired awareness seizures (FIAS), focal to bilateral tonic–clonic seizures and generalized tonic–clonic seizures were 9, 11 and 11 years (95% CI: 8.170– 9.830, 10.170–11.830, and 7.265–14.735), respectively, with p = 0.04. The utilization of stringent and selective criteria to reserve surgeries is important for a successful epilepsy program with limited resources.
    [Show full text]
  • Charles Brock, M.D
    Charles Brock, M.D. Diagnosing Migraine Headdhache Any severe or recurrent headache most likely is a form of migraine Almost all patients will have family histor y of migraines or at least “sick” headaches Only 15% have preceded or accompanied focal neurologic symptoms Usually visual Vis ion loss or dis tor tion in one eye – ‘l‘ocular mii’igraine’ “Classic migraine” Recurrent Headaches Primary Migraine Tension Cluster Other benign –cough, cold temperature, post coital, exertion RRtecurrent HHdheadaches Secondary (pain from complications) Intracranial tumor Intracranial aneurysm IilIntracranial A‐V malformati on Temporal arteritis Migraine with aura – Criteria* At least 2 attacks with 3 of the following: Fully reversible aura symptoms At least 1 aura symptom develops gradually during more than 4 minutes or 2 symptoms occur in succession Any aura symptom lasts less than 60 minutes Headache follows the aura within 60 minutes *International Headache Society - 2004 Migra ine wiihth aura Visual aura common Slowly evolving scintillating scotoma that moves or passes throug h viilsual field Duration of aura –22 minutes Should not be called ocular migraine if bilateral eye involvement Just call them migraine with aura Visua l aura rating scale (VARS) Visual Symptom Risk Score Duration 5 - 60 minutes 3 Develops gradually over 5 min 2 Scotoma 2 Zigzag line (fortification) 2 Unilateral (homonymous) 1 MIGRAINE with AURA DIAGNOSIS ≥ 5 Migraine with aura – vascular risk? Migraine with aura is associated with 2 fold risk of ischemic
    [Show full text]
  • An Approach to Epilepsy
    CONTINUING MEDICAL EDUCATION ARTICLE An approach to epilepsy E B Lee-Pan, MB ChB, MMed (Neurology); L Tucker, MB ChB, MSc, FCP (Neurology) (SA), PhD Division of Neurology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa Corresponding author: E B Lee-Pan ([email protected]) The key to understanding and managing epilepsy is to decide whether seizures are genetic/idiopathic or caused by focal brain pathology. The classification of seizures was modified in 2010 after many variations of the original 1981 system and inconclusive debate. Major changes included abandoning many entrenched words and complete rejection of the Focal subsystem. While most of the reasoning is rational, the focal system is described in a long list of terms; general clinicians are therefore faced with a more challenging task than that required for understanding the old classification system. Some of the difficulties include using common words with non-intuitive neurological definitions, ambiguous words and the tendency to merge seizure categorisation with epilepsy. This article highlights some of the fundamental principles in trying to categorise seizures and offers a simplified way of using descriptive words to structure the organisation of Focal seizures. Focal seizures are broken down to A, B and C – an easy-to-remember schema for general clinicians, patients and carers. Words such as ‘Aura’ and ‘Blank stare’ are strategically used to represent old seizure types and how they may be linked in the same patient. Awareness or the lack thereof is explained and how the same patient may have different seizure types and combinations of these.
    [Show full text]
  • Epilepsy Patient Guide Epilepsy Patient Guide
    Epilepsy Patient Guide Epilepsy Patient Guide Cleveland Clinic Epilepsy Center, established in 1978, medical professionals and support staff provides outstanding is an international pacesetter in the evaluation and service to our epilepsy patients, who come from across the medical and surgical treatment of epilepsy. It is among country and around the world. the world’s largest and most comprehensive centers for Cleveland Clinic Florida’s epilepsy program is fully integrated epilepsy patient care. In 2011, we had more than 6,200 with the epilepsy program at Cleveland Clinic in Ohio. Florida adult patient visits and 2,300 pediatric patient visits and epileptologists work with the Cleveland team of physicians, performed 320 epilepsy surgeries in children and adults. nurses and technologists to diagnose and tailor treatment At our two locations in Cleveland, Ohio, and in Weston, programs for adult patients with epilepsy. All Florida epilep- Florida, we offer state-of-the-art resources to provide you tologists have dual appointments with the Epilepsy Center and with the most advanced specialized care, complemented by Neurological Institute in Cleveland. (For more information on leading programs in research and education. A dedicated, Cleveland Clinic Florida, see page 11.) well-coordinated multidisciplinary team of physicians, other Patient Care EpileptologistsNeurologists At Cleveland Clinic, we believe the best medical care goes beyond the latest equipment and techniques. It also means Technologists compassion; we understand your concerns and are here to help. Neurosurgeons It means comprehensiveness, too. Because epilepsy affects Neuroradiologists so many aspects of the patient’s life — from the physical to Researchers the emotional to the social, and from the family to the work- Pharmacologists place to the school — the Epilepsy Center’s comprehensive Patient care approach addresses challenges across the board.
    [Show full text]
  • Management of Psychogenic Nonepileptic Seizures *W
    Epilepsia, 54(Suppl. 1):53–67, 2013 doi: 10.1111/epi.12106 PSYCHIATRIC DISORDERS IN EPILEPSY Management of psychogenic nonepileptic seizures *W. Curt LaFrance Jr, †Markus Reuber, and ‡Laura H. Goldstein *Neuropsychiatry and Behavioral Neurology Division, Rhode Island Hospital, Brown University, Alpert Medical School, Providence, Rhode Island, U.S.A.; †Academic Neurology Unit, Royal Hallamshire Hospital, University of Sheffield, Sheffield, United Kingdom; and ‡Department of Psychology, Institute of Psychiatry, King’s College London, London, United Kingdom the following: presentation of the diagnosis, early SUMMARY phase treatment, psychological and pharmacologic The International League Against Epilepsy (ILAE) interventions, and maintenance management. The Neuropsychobiology Commission gave the charge aimofthisreportistoprovidegreaterclarityabout to provide practical guidance for health profession- the range and current evidence base for treatment als for the pharmacologic and nonpharmacologic for patients with PNES, with the intention of improv- treatment of patients with psychogenic nonepilep- ing the care of patients with PNES and patients who tic seizures (PNES). Using a consensus review develop PNES as a comorbidity of epilepsy. of the literature, an international group of clini- KEY WORDS: Psychogenic nonepileptic seizures, cian-researchers in epilepsy, neurology, neuropsy- Epilepsy, Differential diagnosis, Electroencephalog- chology, and neuropsychiatry evaluated key raphy, Video electroencephalography monitoring, management approaches
    [Show full text]
  • Care Recommendations for Children
    Recommendations for Care of Children with Epilepsy Seeking the best treatment from the right doctor at the right time! Contents Children withWhat of Doctors Type Treat Epilepsy? Children with New Onset Seizures Epilepsy Medication Children Taking Children with Uncontrolled Seizures (Refractory Epilepsy) Making the Office MostChild’s of Your Visit This booklet is to help parents and caregivers know when it is appropriate to seek treatment for a child experiencing seizures. For additional resources about epilepsy and tools to help manage your child’s condition, please visit www.epilepsyandmychild.org. 1 2 3 4 5 What Type of Doctors Treat Children with Children withWhat of Doctors Type Treat Epilepsy? Children with New Onset Seizures Epilepsy Medication Children Taking Children with Uncontrolled Seizures (Refractory Epilepsy) Making the Office MostChild’s of Your Visit Epilepsy? There are several types of doctors who treat epilepsy. For many children, epilepsy can be treated and success- fully managed by a primary care physician, a family physi- cian, or a pediatrician. This is often the case for those whose seizures are well controlled on one medication or who live in rural areas and must travel for hours to see an epilepsy specialist. Most children with epilepsy under the age of 16 are treated by a pediatric neurologist. A pediatric neurologist specializes in childhood diseases of the brain, spinal cord, and nervous system. A pediatric neurologist learns about treating epilepsy in children and is involved in their care during residency. A pediatric epileptologist is a neurologist who com- pletes a one or two year subspecialty fellowship in clinical neurophysiology and/or epilepsy in addition to the training in epilepsy that a pediatric neurologist receives.
    [Show full text]