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OVERVIEW of EPILEPSY Psychological Imitators of Epilepsy

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OVERVIEW of EPILEPSY Psychological Imitators of Epilepsy Medical Imitators of Seizures................................... 12 OVERVIEW OF EPILEPSY Psychological Imitators of Epilepsy ......................... 13 Circumstances that Provoke Seizures ....................... 15 Robert Fisher, M.D., Ph.D., Tests for Epilepsy ..................................................... 16 Maslah Saul MD Professor, Postictal: The Aftermath of a Seizure ...................... 17 Stanford Neurology MEDICATIONS FOR EPILEPSY ....................... 18 Comprehensive Epilepsy Center, Room A343 General Points .......................................................... 19 300 Pasteur Drive, Stanford, CA 94305-5235 Brief Summary of Antiepileptic Drugs .................... 20 carbamazepine (brief) ....................................................... 20 clonazepam (brief) ............................................................ 20 copyright 1997, 2006, 2010 gabapentin (brief) ............................................................. 20 lacosamide (brief) ............................................................. 20 lamotrigine (brief) ............................................................ 20 DEFINITION OF EPILEPSY................................. 2 levetiracetam (brief) ......................................................... 21 lorazepam (brief) .............................................................. 21 WHO GETS EPILEPSY? ....................................... 3 oxcarbazepine (brief) ........................................................ 21 World Leaders: ............................................................... 3 phenobarbital (brief) ......................................................... 21 Writers and Artists: ........................................................ 4 phenytoin (brief) ............................................................... 21 Actors: ............................................................................ 4 pregabalin (brief) .............................................................. 21 Athletes: ......................................................................... 5 rufinamide (brief) ............................................................. 21 Other public figures: ....................................................... 5 topiramate (brief) .............................................................. 21 valproic acid (brief) .......................................................... 22 SEIZURE CLASSIFICATION ............................... 5 vigabatrin (brief) ............................................................... 22 Partial Seizures ............................................................... 6 zonisamide (brief) ............................................................. 22 Complex Partial Seizures .................................................... 6 others (brief) ..................................................................... 22 Generalized Seizures ...................................................... 6 ANTIEPILEPTIC DRUG SELECTION .................. 22 Absence Seizures ................................................................ 6 Benzodiazepines: ......................................................... 23 Tonic-Clonic Seizures......................................................... 6 Secondarily Generalized Seizures ....................................... 7 Carbamazepine (Tegretol, Novartis; Carbatrol) ........... 24 Atonic Seizures ................................................................... 7 Ethosuximide ............................................................... 25 Myoclonic Seizures ............................................................ 7 Felbamate (Felbatol) .................................................... 25 Tonic Seizures .................................................................... 7 Gabapentin (Neurontin) ............................................... 26 Mixed Seizure Types .......................................................... 7 Lacosamide (Vimpat) ................................................... 27 What Types are Common? ............................................. 7 Lamotrigine (Lamictal) ................................................ 28 Classification of Epilepsy Syndromes .................... 7 Levetiracetam (Keppra) ............................................... 29 Localization-Related Epilepsy .................................... 7 Methsuximide (Celontin) ............................................. 29 Infantile spasms / West‟s syndrome ........................... 7 Oxcarbazepine (Trileptal) ............................................ 30 Lennox-Gastaut Syndrome ......................................... 8 Phenobarbital (Luminal) .............................................. 31 Phenytoin (Dilantin) ..................................................... 32 Febrile seizures ........................................................... 8 Pregabalin (Lyrica) ...................................................... 33 Benign Rolandic Epilepsy .......................................... 8 Primidone (Mysoline) .................................................. 33 Juvenile Myoclonic Epilepsy ...................................... 8 Rufinamide (Banzel) .................................................... 34 CAUSES (ETIOLOGIES) OF SEIZURES: ........... 8 Tiagabine (Gabitril) ...................................................... 35 Causes for Focal Seizures ........................................... 9 Topiramate (Topamax)................................................. 35 Head Trauma .................................................................. 9 Valproic Acid (Depakote, Depakene, Depacon) .......... 36 Stroke ............................................................................. 9 Vigabatrin (Sabril) ....................................................... 37 Infection ......................................................................... 9 Zonisamide (Zonegran) ................................................ 38 Vascular Malformations ................................................. 9 Other Medications ........................................................ 39 Tumors (Neoplasms) ...................................................... 9 Explaining Prescriptions .......................................... 39 Dysplasia ...................................................................... 10 Switching medicines ................................................ 40 Mesial Temporal Sclerosis ........................................... 10 Research Testing of New Drugs ............................... 40 Causes for Generalized Seizures .............................. 10 Stopping Seizure Medicines ..................................... 41 Metabolic ...................................................................... 10 Uncontrolled (Refractory) Epilepsy ...................... 42 Medication Reactions ................................................... 10 Idiopathic (cause unknown) ......................................... 10 EPILEPSY SURGERY ......................................... 44 Genetic Causes of Seizures .......................................... 10 Candidates for Epilepsy Surgery .............................. 44 Photosensitive Seizures ................................................ 11 Pre-surgical evaluation ............................................. 44 1 Temporal Lobectomy Surgical Procedure .................... 46 Other Surgical Procedures ........................................ 47 Surgery Conclusion .................................................. 47 The Ketogenic Diet ............................................... 47 DEFINITION OF EPILEPSY Biofeedback for Seizures ...................................... 48 n epileptic seizure is a transient occurrence of signs What Can a Person do to Control Seizures? ......... 48 A and/or symptoms due to abnormal excessive or syn- Vagus Nerve Stimulation ...................................... 48 chronous neuronal activity in the brain. Epilepsy is a disorder The Patient-Doctor Relationship........................... 49 of the brain characterized by an enduring predisposition to SOCIAL ISSUES IN EPILEPSY: ........................ 49 generate epileptic seizures, and by the neurobiological, cogni- tive, psychological, and social consequences of this condition. Employment.............................................................. 50 The definition of epilepsy requires the occurrence of at least School ....................................................................... 51 one epileptic seizure. Pregnancy ................................................................. 51 Risks of Epilepsy .................................................. 53 herefore, a seizure is the event and epilepsy is the dis- Driving ...................................................................... 53 T order. By definition, one seizure does not make epi- Water Safety ............................................................. 53 lepsy, nor does a small series of seizures that have an im- Burn safety ................................................................ 53 mediate precipitating factor, for example, alcohol with- Heights ...................................................................... 54 drawal seizures. The seizures must be spontaneous and Equipment and Power Tools ..................................... 54 recurrent to represent epilepsy. Child Care Safety ...................................................... 54 eizures result from an electrochemical disorder in the Sudden
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