Acute Symptomatic Seizures and Epileptiform Abnormalities: Management and Outcomes PDF Download

Author: Vineet Punia
Publisher: Frontiers Media SA
ISBN: 2832521592
Category : Science
Languages : en
Pages : 95

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Author: Julia Herzig-Nichtweiß
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Abstract: Background Acute symptomatic epileptic seizures are frequently seen in neurocritical care. To prevent subsequent unprovoked seizures, long-term treatments with antiseizure medications are often initiated although supporting evidence is lacking. This study aimed at prospectively assessing the risk of unprovoked seizure relapse with respect to the use of antiseizure medications. It was hypothesized that after a first acute symptomatic seizure of structural etiology, the cumulative 12-month risk of unprovoked seizure relapse is ≤ 25%. Methods Inclusion criteria were age ≥ 18 and acute symptomatic first-ever epileptic seizure; patients with status epilepticus were excluded. Using telephone and mail interviews, participants were followed for 12 months after the acute symptomatic first seizure. Primary endpoint was the occurrence and timing of a first unprovoked seizure relapse. In addition, neuro-intensivists in Germany were interviewed about their antiseizure treatment strategies through an anonymous online survey. Results Eleven of 122 participants with structural etiology had an unprovoked seizure relapse, resulting in a cumulative 12-month risk of 10.7% (95%CI, 4.7%-16.7%). None of 19 participants with a non-structural etiology had a subsequent unprovoked seizure. Compared to structural etiology alone, combined infectious and structural etiology was independently associated with unprovoked seizure relapse (OR 11.1; 95%CI, 1.8-69.7). Median duration of antiseizure treatment was 3.4 months (IQR 0-9.3). Seven out of 11 participants had their unprovoked seizure relapse while taking antiseizure medication; longer treatment durations were not associated with decreased risk of unprovoked seizure relapse. Following the non-representative online survey, most neuro-intensivists consider 3 months or less of antiseizure medication to be adequate. Conclusions Even in case of structural etiology, acute symptomatic seizures bear a low risk of subsequent unprovoked seizures. There is still no evidence favoring long-term treatments with antiseizure medications. Hence, individual constellations with an increased risk of unprovoked seizure relapse should be identified, such as central nervous system infections causing structural brain damage. However, in the absence of high-risk features, antiseizure medications should be discontinued early to avoid overtreatment

Author: Gregory D. Cascino
Publisher: John Wiley & Sons
ISBN: 1119431824
Category : Medical
Languages : en
Pages : 550

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Designed to provide a comprehensive but accessible introduction to epilepsy and seizure disorders, Epilepsy, 2nd edition provides state-of-the-art information in a concise format useful to a wide audience, from neurology residents to epilepsy fellows and practitioners. This illustrated guide to the assessment, diagnosis, and treatment of epilepsy is a valuable resource enabling clinicians to stay on top of the latest recommendations for best practice.

Author: S.R. Benbadis
Publisher: Springer Science & Business Media
ISBN: 1848821271
Category : Medical
Languages : en
Pages : 1966

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Atlas of Epilepsies is a landmark, all-encompassing, illustrated reference work and hands-on guide to the diagnosis, management and treatment of epilepsy in all its forms and across all age groups. The premier text in the field with over one thousand images, the Atlas’s highly illustrative approach tackles the difficult subject of epileptic seizures and epileptic syndromes, accompanied by sequential photographs of each management step. Intraoperative photographs are accompanied by detailed figure legends describing nuances, subtleties, and the thought processes involved in each step, providing a fuller understanding of each procedure. The Atlas draws on the expertise of over 300 internationally-renowned experts, and is liberally interspersed with clinical insights and personal vignettes that offer helpful tips, technical advice and critical knowledge to the clinician and scholar. The thorough and complete table of contents includes dedicated sections or chapters on important topics such as neonatal and pediatric seizures; imitators of epilepsy; EEG and neuroimaging; psychiatric and quality of life aspects of epilepsy; and a complete guide to treatment options including current and up-to-date chapters on pharmaceuticals, surgical procedures, and additional and alternative treatments. No other publication addresses epilepsies as thoroughly and completely as the Atlas of Epilepsies. Exhaustive and illustrative, convenient and current, this reference is sure to be the premier text on epilepsy for many years to come.

Author: S. Andrew Josephson
Publisher: Cambridge University Press
ISBN: 1139501828
Category : Medical
Languages : en
Pages :

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Over the past decade, the hospitalist model has become a dominant system for the delivery of inpatient care. Forces such as national mandates to improve safety and quality, and intense pressure to safely reduce length of hospital stays, are now exerting pressure on neurologists. To meet these challenges, a new neurohospitalist model is emerging. This is the first authoritative text to detail the advances and strategies for treating neurologic disease in a hospital setting. It includes chapters on specific acute neurologic diseases including stroke, epilepsy, neuromuscular disease and traumatic brain injury and also addresses common reasons for neurologic consultation in the hospital including encephalopathy, electrolyte disturbances and neurologic complications of pregnancy. Ethical and structural issues commonly encountered in neurologic inpatients are also addressed. This will be a key resource for any clinician or trainee caring for neurologic patients in the hospital including practising neurologists, internists and trainees across multiple subspecialities.

Author: Chrysostomos P. Panayiotopoulos
Publisher: Springer
ISBN:
Category : Medical
Languages : en
Pages : 570

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This book gives an exhaustive account of the classification and management of epileptic disorders. It provides clear didactic guidance on the diagnosis and treatment of epileptic syndromes and seizures through thirteen chapters, complemented by a pharmacopoeia and CD ROM of video-EEGs.

Author: Daniel Laskowitz
Publisher: CRC Press
ISBN: 1498766579
Category : Medical
Languages : en
Pages : 388

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Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme

Author: S.D. Shorvon
Publisher: Butterworth-Heinemann
ISBN: 1483182681
Category : Medical
Languages : en
Pages : 121

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Neurological Emergencies presents a comprehensive guide on the initial assessment and early treatment of patients with neurological emergencies. It discusses the diagnosis, emergency investigations, and handling of coma patients. It addresses the management of focal supratentorial lesion. Some of the topics covered in the book are the diffuse neurological or systemic disturbance; emergency resuscitation; diagnosis and treatment of transtentorial herniation; diagnosis and treatment of acute viral encephalitis; raised intracranial pressure; diagnosis and treatment of non-viral infective encephalitis; viral meningitis; meningovascular syphilis; diagnosis and treatment of cerebral abscess; diagnosis and treatment of intracranial subdural empyema; and diagnosis and treatment of cerebral venous thrombosis. The diagnosis and treatment ofstroke is fully covered. An in-depth account of the difference between haemorrhage and infarction is provided. The diagnosis of subarachnoid haemorrhage is completely presented. A chapter is devoted to the prevention of more cranial bleeding.

Author: Norman Delanty
Publisher: Springer Science & Business Media
ISBN:
Category : Medical
Languages : en
Pages : 392

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Seizures are frightening events. They frighten the patients who experience them; they frighten those who witness them; they also frighten many physicians who have to deal with them. Most individuals with seizures present to family physicians or to emergency room physicians. However, despite the fact that seizures are among the most common neurological conditions, most general practitioners, family practice specialists, and intemists do not see large numbers of patients with seizures. Given the apoplectic appearance of generalized tonic clonic convulsions, it is not difficult to understand why they arouse such emotional responses in those that experience them, those that witness them, and those whose care is sought for them. Seizures are symptoms of something wrong with the brain. Many different kinds of perturbations in brain anatomy, chemistry, or physiology can produce seizures. For many individuals, seizures occur in the context of an acute illness and will not recur once that illness is treated. These individuals do not have epilepsy. They have transient disturbances in brain function attributable to systemic medical conditions. It is important to recognize these issues, because, first, the seizure may be the initial, or even only, manifestation of the underlying medical problem and this needs to be recognized.

Author: Simon Shorvon
Publisher: Cambridge University Press
ISBN: 1108420753
Category : Medical
Languages : en
Pages : 1013

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Book Description
Expanded and revised, this unique book provides concise descriptions of the many causes of epilepsy, for use in clinical practice.