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: Francesco Pisani
Publisher: Elsevier Publishing Company
ISBN:
Category : Medical
Languages : en
Pages : 216

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The pharmacological fight against epilepsy began many centuries ago when Hippocrates discovered that the cause of epilepsy is natural, as opposed to supernatural and, as a consequence, must be treated with a natural remedy. Even though science has significantly progressed since that era, the challenge to find remedies for epilepsy is ever present. The aim of this particular volume is to offer an up-to-date review of the most recent advances in antiepileptic drug development, considered from various viewpoints: (i) general, by taking into account the size of refractory epilepsy and its related problems; (ii) experimental, by exploring the mechanisms of epileptogenesis and the possiblility of influencing it through drugs, and (iii) clinical, by describing the results obtained with compounds currently at an advanced stage of testing.

Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309259533
Category : Medical
Languages : en
Pages : 568

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Although epilepsy is one of the nation's most common neurological disorders, public understanding of it is limited. Many people do not know the causes of epilepsy or what they should do if they see someone having a seizure. Epilepsy is a complex spectrum of disorders that affects an estimated 2.2 million Americans in a variety of ways, and is characterized by unpredictable seizures that differ in type, cause, and severity. Yet living with epilepsy is about much more than just seizures; the disorder is often defined in practical terms, such as challenges in school, uncertainties about social situations and employment, limitations on driving, and questions about independent living. The Institute of Medicine was asked to examine the public health dimensions of the epilepsies, focusing on public health surveillance and data collection; population and public health research; health policy, health care, and human services; and education for people with the disorder and their families, health care providers, and the public. In Epilepsy Across the Spectrum, the IOM makes recommendations ranging from the expansion of collaborative epilepsy surveillance efforts, to the coordination of public awareness efforts, to the engagement of people with epilepsy and their families in education, dissemination, and advocacy for improved care and services. Taking action across multiple dimensions will improve the lives of people with epilepsy and their families. The realistic, feasible, and action-oriented recommendations in this report can help enable short- and long-term improvements for people with epilepsy. For all epilepsy organizations and advocates, local, state, and federal agencies, researchers, health care professionals, people with epilepsy, as well as the public, Epilepsy Across the Spectrum is an essential resource.

Author: Joseph J. Volpe
Publisher: Elsevier Health Sciences
ISBN: 0443105456
Category : Medical
Languages : en
Pages : 1845

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**Selected for Doody's Core Titles® 2024 in Neurology**Stay up to date with today's latest advances in diagnosis and management, as well as the many scientific and technological advances that are revolutionizing neonatal neurology, with the definitive text in the field. Volpe's Neurology of the Newborn, 7th Edition, shares the knowledge and expertise of world authority Dr. Joseph Volpe, who, along with Dr. Terrie E. Inder of Children's Hospital of Orange County and other distinguished editors, brings a wealth of insight to this classic text. Known for its clear, engaging writing style, vibrant, full-color illustrations, and authoritative information throughout, this reference is an indispensable resource for those who provide care for neonates with neurological conditions. - Provides clear, comprehensive coverage of neonatal neurology in Dr. Joseph Volpe's own legendary, readable manner—for a masterful, cohesive source of answers to any question that arises in your practice. - Brings the latest science into the clinical setting, with an emphasis on translating new knowledge to the infant's bedside. - Offers comprehensive updates with summary tables and text to reflect major advances in the study of hemorrhage; new insights into molecular genetics and molecular characterization of brain tumors; significant advances in drugs and the developing nervous system; and much more. - Includes new chapters on fetal neurology which address the importance of understanding and investigating the maternal-fetal origins of neonatal disease, as well as new chapters on neurodevelopmental follow-up, inflammation, and neurology in low-resource settings. - Contains more than 1,000 illustrations: clinical and pathological specimens, key experimental findings, schematics, algorithms, anatomical drawings, and neuroimaging throughout, as well as numerous tables and boxes that synthesize key points. - Any additional digital ancillary content may publish up to 6 weeks following the publication date.

Author:
Publisher: Elsevier
ISBN: 0080861431
Category : Medical
Languages : en
Pages : 223

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Experimental Epilepsy

Author: World Health Organization
Publisher:
ISBN: 9789241548304
Category : Medical
Languages : en
Pages : 95

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Book Description
Neonatal seizures represent one of the most frequent neurological events in newborn infants, often reflecting a variety of different pre-, peri-, or postnatal disorders of the central nervous system (CNS). They are also a common manifestation of metabolic abnormality in newborn period and often represent the first sign of neurological dysfunction in neonates. They may be symptomatic or cryptogenic, herald subsequent epilepsy, can be associated with potential morbidity and mortality, and may be used as a factor in considering long-term prognosis. Despite the enormous clinical significance of these events, many aspects of their management are not well supported with evidence- based recommendations. These guidelines are intended to be of use for neonatologists, paediatric neurologists, paediatricians, general practitioners, nurse practitioners, nurses and other health professionals who may be in contact with infants experiencing seizures within the first 28 days of life (age up to 44 weeks postconception). The guidelines are framed so as to be applied by health care providers practicing in a wide range of health care facilities, from those with limited resources to tertiary care centers.

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

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

Author: Stavros V. Konstantinides
Publisher: Springer Science & Business Media
ISBN: 1597452874
Category : Medical
Languages : en
Pages : 273

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This practical volume highlights traditional, novel, and evolving aspects of the diagnosis and treatment of pulmonary embolism (PE). The contributors comprise an international team of experts. Important aspects of diagnosis, risk stratification, and differential treatment of patients with PE are presented in a concise, yet comprehensive manner. Emphasis is placed on specific issues related to PE, including pregnancy, cancer, thrombophilia, and air travel.

Author: Vikram Patel
Publisher: World Bank Publications
ISBN: 1464804281
Category : Medical
Languages : en
Pages : 307

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Book Description
Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.