Progress in Nonepileptic Seizures (NES) Research Benchmarks 2 December 2011
|
|
- Sara Hudson
- 5 years ago
- Views:
Transcription
1 Progress in Nonepileptic Seizures (NES) Research Benchmarks 2 December 2011 W. Curt LaFrance, Jr., MD, MPH Director, Neuropsychiatry and Behavioral Neurology Rhode Island Hospital Asst. Prof. Psychiatry & Neurology (Research) Brown Medical School American Epilepsy Society Annual Meeting
2 Disclosure Name of Commercial Interest Type of Financial Relationship NINDS, AES, EF, Siravo Foundation Grant support Cambridge University Press Editor s royalties for Nonepileptic Seizures, 2010 American Epilepsy Society Annual Meeting
3 Benchmarks Area III: Prevent, limit, and reverse the co-morbidities associated with epilepsy and its treatment. E. Develop effective methods for diagnosis, treatment and prevention of NES. Short-term goals include: 1. Determine types and frequency of NES in general population and in epilepsy. 2. Identify common susceptibility factors and etiologies for NES. 3. Validate at least one effective treatment for NES. (Kelley et al. Epilepsia 2009;50(3): )
4 Learning Objectives: Progress in NES Benchmarks Recognize nonepileptic seizures (NES) Refer patients with NES for appropriate treatment Restore quality of life for patients with NES American Epilepsy Society Annual Meeting
5 Nonepileptic Seizures (NES) Prevalence & Cost 5-20% of the 2.5 million people treated for Epilepsy have nonepileptic seizures (NES) % of SMU admissions have NES up to 40% of patients in general neurology clinics up to 20% status epilepticus pts have NES-status Lifetime cost of treating NES for individual patient $100,000 Annual cost of repeated labs, diagnostic work-ups, AEDs, outpt visits, ER visits in US= $900,000,000 (Martin, 1998; Pakalnis, 2000; Benbadis, 2004)
6 Interdisciplinary NES Research (LaFrance, et al. E&B. 2006;8: )
7 Physiologic Nonepileptic Events (different than psychogenic NES) (Gates J, in: Psychiatric Comorbidity in Epilepsy, Eds: McConnell & Snyder. 1998, p.192)
8 NES, Tremor and Gait Disorder (Schachter & LaFrance, Eds. Nonepileptic Seizures, 3 rd Ed, 2010)
9 Demographic Data: NES and Epileptic Groups NES N = 31 Epileptic N = 31 Age (yrs) Gender (male : female) 11 : : 22 Marital status (% married) Employment status (% employed) Education (% with HS or greater) Income Source Government assisted Supported by family 22 6 Seizure frequency (% with >12 seizures/year) (Krawetz, et al. J Nerv Ment Disord. 2001; 189:38-43)
10 NES: Ictal Characteristics Description (n=33) Generalized trembling, jerking, uncoordinated movements; nonresponsive Staring; nonresponsive 5 Generalized tremor, jerking; responsive 5 Lightheaded, dizzy, faint, weak; nonresponsive 3 Confusion, slowing, lethargy, slurred speech; responsive 3 Falling episodes; responsive 3 Generalized stiffening; nonresponsive 2 Coordinated, complex violent behavior; responsive 2 Unilateral jerking; nonresponsive 1 9 (Rusch, M, et al. E&B 2001;2:277-83)
11 Diagnosing Seizures: Clinical & EEG Findings Epileptic Seizures Characteristics Generalized tonic-clonic seizures Complex partial seizures Nonepileptic Psychogenic seizures EEG during seizure Abnormal and changed from preictal Almost always abnormal and changed from preictal Usually normal and unchanged from preictal EEG immediately after seizure Almost always abnormal and changed from preictal Frequently abnormal and changed from preictal Usually normal and unchanged from preictal (Desai, 1982)
12 IRR: The kappa statistic for interrater reliability of VEEG diagnosis was 0.94 (95% CI, ) at subject-level, indicating excellent agreement. (Syed, et al,. Annals of Neurology. 2011)
13 Prediction of NES prior to veeg The rule of 2 s At least 2 events per week Refractory to at least 2 antiepileptic drugs At least 2 EEGs without epileptiform abnormalities - yielded 85% positive predictive value Davis BJ. European Neurology. 2004;51:153-6
14 Biomarkers: BDNF in NES and Epilepsy vs. HCs LaFrance, et al. Neurology (Siravo Foundation)
15 Biomarkers: Stress, Hippocampus and Depression (Duman. Biol Psy. 2006;59: )
16 NES Outcome Studies: Overview Study Study Group Outcome N = 16 Number Of Subjects Mean Follow-up (months) NES E included % PNESfree % Living independently % PNES on AEDs at FU Range & Mean NA (Reuber, 2003)
17 Quality of Life and Epilepsy: AED Side Effects, Depression and Seizures (Gilliam. Neurology. 2002:58(8Supp8):S9-20)
18 Quality of Life and Nonepileptic Seizures: Symptoms, Depression and Seizures (LaFrance and Syc. Neurology. 2009:73(5): )
19 (Richer, 1881)
20 Evidence Based Outcomes: Classifications Study Characteristic Class of Study I II III IV Control Group Representative Population Assessment Independent of R x Blinded Outcome Assessment Prospective Design Randomized * * Also meets standards of: Yes No Primary outcomes defined; Exclusion/inclusion criteria defined; Dropout rate low and accounted for; Baseline characteristics detailed and substantially equivalent.
21 Historical and Future Approaches to NES: Treatments Review (LaFrance & Devinsky. Epilepsia. 2004;45(sup2):15-21)
22 NES Treatment Studies Review 24 publications in total 13 of which were case reports/case series 7 chart reviews or phone call follow-up 4 prospective, uncontrolled trials (all but 2 were class IV reports) No double blind, prospective, fully-powered randomized controlled trials (LaFrance & Devinsky. Epilepsia. 2004;45(sup2):15-21)
23 What causes functional weakness? Biological Psychological Social Predisposing Genetic Childhood adversity Modelling Precipitating Injury Disease Emotional disorder Life events (Home / Work) Functional Weakness (or NES) Perpetuating Deconditioning CNS Plasticity? Emotional disorder Illness beliefs (LaFrance & Bjørnæs, NES. 2010, adapted Jon Stone, PMD conference, 2003) Reinforcement of illness (family, money, doctors)
24 Standard Medical Care for NES (LaFrance et al. E&B 2008;12: )
25 Treatment of NES Trials 8 week, open label pharmacologic trial 14 week, double blind, pilot randomized placebocontrolled trial for psychogenic NES Psychotherapy trial for NES 14 week pilot trial of Cognitive Behavioral Therapy for NES Multi-center pilot RCT for NES Multi-center NES RCT U01 proposal (submitted) (NINDS 5K23-NS, EF,AES; PI: LaFrance)
26 Pilot Pharm RCT for NES: Seizure frequency LaFrance et al. Neurology. 2010; 75(13): (NINDS K23)
27 Treatments: CBT for NES (LaFrance et al. E&B 2009;14(4): )
28 Seizure Frequency (per week) Figure 1. Seizure frequency per week at baseline, month 1, and final visit Mean Seizure Frequency Median Seizure Frequency Pre-enrollment at week 1 at Month 1 Timeat Final week 0 (LaFrance et al. E&B 2009;14(4): )
29 NES Psychotherapy trial Assessment Ratings at Baseline and Completion (N = 21; Locf) mean (sd) scale cutoffs Baseline Completion Modified Hamilton Depression Scale [<7] 14 (7) 11 (7) Beck Depression Inventory-II [<14] 19 (15) 10 (7)* Davidson Trauma Scale [<17] 58 (38) 36 (27)* Barrett Impulsivity Scale [<70] 63 (14) 60 (9)* Dissociative Experiences Scale [<5] 13 (12) 8 (6) Symptom Checklist 90 [<85] 94 (77) 62 (52)* Global Assessment of Functioning* [>80] 50 (7) 59 (12)* Oxford Handicap Scale [<2] 3.3 (1) 3.5 (1.2)* QOLIE-31* [>63] 46 (24) 62 (19)* Fam Assess Device: Gen Fxn Scr [<2.00] 2.03 (.57) 1.66 (.4)* LIFE-RIFT (QoL measure) [<9] 12.9 (4) 11 (3.7)* NES frequency during trial (Biweekly sum) 17 (23) 7 (14)* NES Frequency (median) 7 0 *p<0.05 (LaFrance et al. E&B 2009;14(4): )
30 NES Pilot Treatment Trials NES patients are symptomatic on a number of fronts Hamilton Depression Scale; Symptom Checklist; Dissociative Experiences Scale; Family Assessment Device NES randomized treatment trials are feasible NES Cognitive Behavioral Therapy; NES Pharmacotherapy Trial Neuropsychiatric patient clinical research requires solutions that are complex, global, and multi-disciplinary Neuropsychiatrist, Epileptologist, Psychologist, Biostatistician (LaFrance et al. AES Abstract Epilepsia 2008)
31 Systems approach to management of seizures (LaFrance & Devinsky. Epilepsy and Beh. 2002;3(5) S19-23)
32 Future Directions: NES Programmatic Research NES Diagnosis NES SCID module NES comorbidities NES Etiology Functional Neuroimaging / Neurophysiology / Genetics NES Treatment(s) Pharmacologic Psychotherapy(ies) Combined Treatments
33
34 (Kerr and ILAE NP commission. Epilepsia, 2011;52:2133-8)
35 Impact on Clinical Care and Practice Summary Video EEG is the Gold Standard for NES Diagnosis Promising treatments exist for NES; fully powered RCTs are needed Assessing comorbidities and quality of life are important components along with addressing seizures
36 Acknowledgements Brown Psychiatry & Neurology Ivan Miller PhD Andrew Blum MD, PhD Christine Ryan PhD Gabor Keitner MD Rhode Island Hospital staff Anita Curran Anne Frank Webb Joan Kelley NINDS Staff Brandy Fureman, PhD NES Consultants Orrin Devinsky MD Michael Trimble MD NINDS Intramural Collaborators Valerie Voon MD Mark Hallett MD Funding NINDS K-23 NIMH T-32 American Epilepsy Society Epilepsy Foundation Rhode Island Hospital Siravo Foundation Other Bio-Logic Systems Corporation Andrews-Reiter Epilepsy Research Program Patients and their families
Developing a core battery of outcome measures
Developing a core battery of outcome measures Markus Reuber Professor of Clinical Neurology Academic Neurology Unit University of Sheffield Royal Hallamshire Hospital Sheffield, 19.06.15 M. Reuber / 1
More informationLong-term adherence with psychiatric treatment among patients with psychogenic nonepileptic seizures
Accepted: 6 November 2017 DOI: 10.1111/epi.13969 BRIEF COMMUNICATION Long-term adherence with psychiatric treatment among patients with psychogenic nonepileptic seizures Benjamin Tolchin 1 Barbara A. Dworetzky
More informationNeuropathophysiologyof
Neuropathophysiologyof Epilepsy and Psychiatric Comorbidity & Diagnosis and Management of Non- Epileptic Attack Disorders N Child Neurologist Auckland City Hospital Psychiatric Disorders associated with
More informationAN APPROACH FOR FUNCTIONAL (PSYCHOGENIC NONEPILEPTIC) SEIZURES
AN APPROACH FOR FUNCTIONAL (PSYCHOGENIC NONEPILEPTIC) SEIZURES Introduction W. Curt LaFrance, Jr., MD, MPH, FAAN Rhode Island Hospital Alpert Medical School of Brown University Providence, RI In this session,
More information33rd International Epilepsy Congress 2019 Sunday
Saturday 22 June 33rd International Epilepsy Congress 2019 Sunday Monday 23 June 24 June Tuesday 25 June Wednesday 26 June 08.00-08.30 08.30-09.00 09.00-09.30 09.30-10.00 10.00-10.30 10.30-11.00 11.00-11.30
More informationMoving Beyond Ruling Out Epilepsy: It Is PNES!
Moving Beyond Ruling Out Epilepsy: It Is PNES! Current Literature In Clinical Science Minimum Requirements for the Diagnosis of Psychogenic Nonepileptic Seizures: A Staged Approach. A Report From the International
More informationNothing Explains Everything
Nothing Explains Everything NES: Psychiatric Comorbidities Diagnosis LaFrance 2005 Lifetime Current MDD 80% 47% Any Affective d/o 98% 64% PTSD 58% 49% Any anxiety d/o except PTSD 51% 47% Any Somatoform
More informationA GUIDE FOR PATIENTS & FAMILIES
A GUIDE FOR PATIENTS & FAMILIES WHAT ARE PSYCHOGENIC NON-EPILEPTIC SEIZURES? A seizure is a temporary loss of control, often with abnormal movements, loss of consciousness, or both. Epileptic seizures
More information33rd International Epilepsy Congress 2019 Sunday
Saturday 22 June 33rd International Epilepsy Congress 2019 Sunday Monday 23 June 24 June Tuesday 25 June Wednesday 26 June 08.00-08.30 08.30-09.00 09.00-09.30 09.30-10.00 10.00-10.30 10.30-11.00 11.00-11.30
More information13th ECE - Programme at a Glance
Neurobiology 14.30-16.00 Sunday 26th August Neonatal Session (5) seizure 14.30-16.00 guidelines 14.00-16.30 Set Up ~ Posters on Display all day ~ Authors present (14.00-14.40) Take Dow Monday 27th August
More information13th ECE Vienna - PROGRAMME AT A GLANCE
Neurobiology 14.30-16.00 Sunday 26th August Neonatal Session (5) seizure 14.30-16.00 guidelines 14.00-16.30 Set Up ~ Posters on Display all day ~ Authors present (14.00-14.40) Take Dow Monday 27th August
More informationBIOGRAPHICAL SKETCH DO NOT EXCEED FIVE PAGES.
OMB No. 0925-0001 and 0925-0002 (Rev. 10/15 Approved Through 10/31/2018) BIOGRAPHICAL SKETCH DO NOT EXCEED FIVE PAGES. NAME: Bullock, Kim Dawn Alina era COMMONS USER NAME (credential, e.g., agency login):
More information13th ECE Vienna - PROGRAMME AT A GLANCE
Neurobiology Symposium 14.30-16.00 Sunday 26th August Neonatal Session (5) seizure 14.30-16.00 guidelines 14.00-16.30 Set Up ~ Posters on Display all day ~ Authors present (14.00-14.40) Take Dow Monday
More informationDiagnosing Epilepsy in Children and Adolescents
2019 Annual Epilepsy Pediatric Patient Care Conference Diagnosing Epilepsy in Children and Adolescents Korwyn Williams, MD, PhD Staff Epileptologist, BNI at PCH Clinical Assistant Professor, Department
More informationEpileptic Disord 2007; 9 (Suppl. 1): S52-8. Jiří Hovorka 1, Tomáš Nežádal 1, Erik Herman 1, Iveta Němcová 1, Michal Bajaček 2
Epileptology in Czech Republic Epileptic Disord 2007; 9 (Suppl. 1): S52-8 Psychogenic non-epileptic seizures, prospective clinical experience: diagnosis, clinical features, risk factors, psychiatric comorbidity,
More informationSocial Factors and Psychopathology in Epilepsy
ORIGINAL ARTICLE Social Factors and Psychopathology in Epilepsy N. Cyriac, P.N. Sureshkumar, A.M. Kunhikoyamu, A.S. Girija* Departments of Psychiatry and Neurology* Medical College Calicut, Kerala, India.
More informationEpilepsy and Epileptic Seizures
Epilepsy and Epileptic Seizures Petr Marusič Dpt. of Neurology Charles University, Second Faculty of Medicine Motol University Hospital Diagnosis Steps Differentiation of nonepileptic events Seizure classification
More informationEpilepsy, co-morbidities and Quality of Life. Professor Gus A Baker PhD FBPS
Epilepsy, co-morbidities and Quality of Life Professor Gus A Baker PhD FBPS Gus A Baker 6/17/2013 1 Aims of Presentation What is Quality of life [QOL]? What do we know about the impact of epilepsy on QOL?
More informationSeizure Management Quality Care for Our Patients
Seizure Management Quality Care for Our Patients Case 6 Jack Pellock, MD 8 year old female with refractory epilepsy Multiple handicaps, developmental delay Cerebral palsy spastic diplegia but ambulatory
More informationIctal pain: occurrence, clinical features, and underlying etiologies.
Thomas Jefferson University Jefferson Digital Commons Department of Neurology Faculty Papers Department of Neurology 8-1-2016 Ictal pain: occurrence, clinical features, and underlying etiologies. Ali Akbar
More informationCharacteristics of Male Veterans with Psychogenic Nonepileptic Seizures
Epilepsia, 46(9):1418 1422, 2005 Blackwell Publishing, Inc. C 2005 International League Against Epilepsy Characteristics of Male Veterans with Psychogenic Nonepileptic Seizures Barbara A. Dworetzky, Andreja
More informationThe Case of MS Non-Epileptic Seizures
MS is a 48 year old right handed female with an extensive psychiatric history (abuse, posttraumatic stress disorder, depression, anxiety) who suffered from seizures since sustaining a head injury in her
More informationFull clinical cases submission template
Full clinical cases submission template TITLE OF CASE Non-epileptic attack disorder: the importance of diagnosis and treatment SUMMARY Up to 150 words summarising the case presentation and outcome (this
More informationFits, Faints and Funny Turns. Dr Aidan Neligan PhD MRCP Consultant Neurologist HUH and NHNN, Queen Square
Fits, Faints and Funny Turns Dr Aidan Neligan PhD MRCP Consultant Neurologist HUH and NHNN, Queen Square 18-01-2016 Moya et al., 2009 What is referred to a First Seizure Clinic? Prospective study of 200
More informationPrevention via Modifiable Risk Factors Saturday, June 23, 2012
Prevention via Modifiable Risk Factors Saturday, June 23, 2012 Dale C Hesdorffer, PhD Gertrude H Sergievsky Center Department of Epidemiology Columbia University Partners Against Mortality in Epilepsy
More informationPsychogenic Non-Epileptic Seizures (PNES) Heather Bernard, LCSW
Psychogenic Non-Epileptic Seizures (PNES) Heather Bernard, LCSW Comprehensive Epilepsy Center What are Psychogenic Non-Epileptic Seizures? Psychogenic non-epileptic seizures (PNES) are made up of abnormal
More informationEfficacy of Levetiracetam: A Review of Three Pivotal Clinical Trials
Epilepsia, 42(Suppl. 4):31 35, 2001 Blackwell Science, Inc. International League Against Epilepsy Efficacy of : A Review of Three Pivotal Clinical Trials Michael Privitera University of Cincinnati Medical
More informationEpilepsy: diagnosis and treatment. Sergiusz Jóźwiak Klinika Neurologii Dziecięcej WUM
Epilepsy: diagnosis and treatment Sergiusz Jóźwiak Klinika Neurologii Dziecięcej WUM Definition: the clinical manifestation of an excessive excitation of a population of cortical neurons Neurotransmitters:
More informationBackground. Correlation between epilepsy and attention deficit hyperactivity disorder. Background. Epidemiology of ADHD among children with epilepsy
Correlation between epilepsy and attention deficit hyperactivity disorder I-Ching Chou M.D. Director, Department of Pediatric Neurology China Medical University Hospital Taiwan Background Attention deficit/hyperactivity
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abuse alcohol, aggression and, 52 53 substance, aggression and, 52 54 ACE. See Aid to Capacity Evaluation (ACE). AEDs. See Antiepileptic
More information2007 UCB Pharma SA. All rights reserved. GLOSSARY OF TERMS
2007 UCB Pharma SA. All rights reserved. GLOSSARY OF TERMS Absence Seizure A type of generalised seizure usually seen in children, characterised by transient impairment or loss of consciousness usually
More informationElectroencephalography. Role of EEG in NCSE. Continuous EEG in ICU 25/05/59. EEG pattern in status epilepticus
EEG: ICU monitoring & 2 interesting cases Electroencephalography Techniques Paper EEG digital video electroencephalography Dr. Pasiri Sithinamsuwan PMK Hospital Routine EEG long term monitoring Continuous
More informationPsykososiale aspekter hos ungdom
Psykososiale aspekter hos ungdom Når det ikke er epilepsi hva da? 2018 Hilde Nordahl Karterud Overview Psychiatric comorbidity Neurological comorbidity Psychosocial risk factors Psychosocial consequences
More informationCHAPTER 1. General Introduction
CHAPTER 1 General Introduction 7 Chapter 1 Psychogenic Non Epileptic Seizures (PNES) are defined as paroxysmal involuntary behavioral patterns that mimic epileptic events covering the full range of hypo-motor
More informationPaediatric Epilepsy Update N o r e e n Te a h a n canp C o l e t t e H u r l e y C N S E p i l e p s y
Paediatric Epilepsy Update 2018 N o r e e n Te a h a n canp C o l e t t e H u r l e y C N S E p i l e p s y Epilepsy Service CUH ~550 children New diagnosis-education, support, clinic follow up Epilepsy
More informationNeuromodulation Approaches to Treatment Resistant Depression
1 Alternative Treatments: Neuromodulation Approaches to Treatment Resistant Depression Audrey R. Tyrka, MD, PhD Assistant Professor Brown University Department of Psychiatry Associate Chief, Mood Disorders
More informationPitfalls of Psychogenic Non-epileptic Status Epilepticus
Pitfalls of Psychogenic Non-epileptic Status Epilepticus Hulya Karatas, 1 F. Irsel Tezer, 1 Nese Dericioglu, 1 and Serap Saygi 2 1 Hacettepe University, Institute of Neurological Sciences and Psychiatry,
More informationParoxysmal Events That Are Not Seizures: A Neurologist s Perspective
Paroxysmal Events That Are Not Seizures: A Neurologist s Perspective Patricia E. Penovich, MD Minnesota Epilepsy Group PA St Paul, MN Adjunct Professor, Department of Neurology University of Minnesota
More informationPaper 1: Defining epilepsy
Paper 1: Defining epilepsy Epilepsy Epilepsy is a condition defined by the occurrence of epileptic seizures. Epileptic seizures are events that arise due to abnormal electrical activity in the brain. These
More informationSeizure Detection/Prediction Devices and Therapies
Seizure Detection/Prediction Devices and Therapies Gregory Worrell MD, PhD Mayo Clinic American Epilepsy Society Annual Meeting Disclosure Company Neuralynx Inc. NeuroPace Inc. Medtronic Inc. NeuroVista
More informationCharles H. Kellner, MD
ECT: Learning From Recent Trials Charles H. Kellner, MD Professor, Department of Psychiatry Icahn School of Medicine at Mount Sinai ISCTM Philadelphia, PA 27 September, 2016 Charles H. Kellner, MD Disclosures
More informationCHAIR SUMMIT 7TH ANNUAL #CHAIR2014. Master Class for Neuroscience Professional Development. September 11 13, Westin Tampa Harbour Island
#CHAIR2014 7TH ANNUAL CHAIR SUMMIT Master Class for Neuroscience Professional Development September 11 13, 2014 Westin Tampa Harbour Island Sponsored by #CHAIR2014 Name That Spell: A Film Festival Joseph
More informationNon-epileptic seizures: delayed diagnosis in patients presenting with electroencephalographic (EEG) or clinical signs of epileptic seizures
Seizure 2002; 11: 193 197 doi:10.1053/seiz.2001.0617, available online at http://www.idealibrary.com on Non-epileptic seizures: delayed diagnosis in patients presenting with electroencephalographic (EEG)
More informationSeizure-Triggered Vagus Nerve Stimulation Using Patient-Specific Seizure Onset Detection
Seizure-Triggered Vagus Nerve Stimulation Using Patient-Specific Seizure Onset Detection Ali Shoeb, Alaa Kharbouch, John Guttag Massachusetts Institute of Technology, Cambridge, MA, USA Trudy Pang, Steven
More informationThis is a repository copy of Differences in illness perceptions between patients with non-epileptic seizures and functional limb weakness.
This is a repository copy of Differences in illness perceptions between patients with non-epileptic seizures and functional limb weakness. White Rose Research Online URL for this paper: http://eprints.whiterose.ac.uk/96433/
More informationAdvances in Understanding Cognitive Impairment of Epilepsy
Advances in Understanding Cognitive Impairment of Epilepsy December 2, 2011 David W. Loring, Ph.D., ABPP (Cn) Departments of Neurology and Pediatrics Emory University Atlanta, GA 30322 American Epilepsy
More informationThe perceived health status of people with psychologically derived non-epileptic attack disorder and epilepsy: a comparative study
Seizure 2004; 13: 71 75 doi:10.1016/s1059-1311(03)00158-4 The perceived health status of people with psychologically derived non-epileptic attack disorder and epilepsy: a comparative study SUAD M. AL MARZOOQI,
More informationEpilepsy DOJ Lecture Masud Seyal, M.D., Ph.D. Department of Neurology University of California, Davis
Epilepsy DOJ Lecture - 2005 Masud Seyal, M.D., Ph.D. Department of Neurology University of California, Davis Epilepsy SEIZURE: A temporary dysfunction of the brain resulting from a self-limited abnormal
More informationUnderstanding Brain-Behavior Relationships in Children p. 123 Medical and Neurological Disorders of Childhood p. 124 Issues Particular to Pediatric
Contributors About this handbook p. 3 Clinical Neuropsychology: General Issues The Medical Chart: Efficient Information-Gathering Strategies and Proper Chart Noting p. xix The Chart Review p. 10 The Progress
More informationNon-Epileptic Attack Disorder in the Emergency Unit
Non-Epileptic Attack Disorder in the Emergency Unit Khalid Hamandi, Consultant Neurologist Malisa Pierri, Epilepsy Specialist Nurse University Hospital of Wales COI declaration none relevant to this talk
More informationObjectives. Amanda Diamond, MD
Amanda Diamond, MD Objectives Recognize symptoms suggestive of seizure and what those clinical symptoms represent Understand classification of epilepsy and why this is important Identify the appropriate
More informationSeizure remission in adults with long-standing intractable epilepsy: An extended follow-up
Epilepsy Research (2010) xxx, xxx xxx journal homepage: www.elsevier.com/locate/epilepsyres Seizure remission in adults with long-standing intractable epilepsy: An extended follow-up Hyunmi Choi a,, Gary
More informationIntroduction to seizures and epilepsy
Introduction to seizures and epilepsy Selim R. Benbadis, M.D. Professor Departments of Neurology & Neurosurgery Director, Comprehensive Epilepsy Program Symptomatic seizures Head injury (trauma) Stroke
More informationDiagnosis, Assessment and Evaluation for Seizures
Lehigh Valley Health Network LVHN Scholarly Works Neurology Update for the Non-Neurologist 2013 Neurology Update for the Non-Neurologist Feb 20th, 7:40 PM - 8:10 PM Diagnosis, Assessment and Evaluation
More informationEpilepsy. Presented By: Stan Andrisse
Epilepsy Presented By: Stan Andrisse What Is Epilepsy Chronic Neurological Disorder Characterized by seizures Young children or elderly Developing countries Famous Cases Socrates Muhammad Aristotle Joan
More informationEpilepsy: 10 Things Patients & Family Members Should Know
Epilepsy: 10 Things Patients & Family Members Should Know 1. Seizure Disorder = Epilepsy (but not all seizures are epilepsy) Epilepsy is a brain condition that causes seizures. Some doctors might use the
More informationThe MMPI-2 as an adjunct to the diagnosis of pseudoseizures
Seizure 1996; 5:35-40 The MMPI-2 as an adjunct to the diagnosis of pseudoseizures PAUL A. DERRY* & RICHARD S. McLACHLANt *Department of Psychology and f-department of Clinical Neurological Sciences, University
More informationAll patients with a diagnosis of treatment resistant (intractable) epilepsy.* Denominator Statement
MEASURE #7 Referral to Comprehensive Epilepsy Center Measure Description Percent of all patients with a diagnosis of treatment resistant (intractable) epilepsy who were referred for consultation to a comprehensive
More information2 nd Line Treatments for Dravet. Eric BJ Ségal, MD Northeast Regional Epilepsy Group
2 nd Line Treatments for Dravet Eric BJ Ségal, MD Northeast Regional Epilepsy Group Disclosures Accepted honoraria from Greenwich Pharmaceuticals, Zogenix, Eisai, Lundbeck, Lineagen. Overview Evidence
More informationAttending: a medical doctor (MD or OD) who has completed medical school, residency, and often a specialized fellowship
Descriptions for members of the Epilepsy Team Attending: a medical doctor (MD or OD) who has completed medical school, residency, and often a specialized fellowship Fellow: a medical doctor (MD or OD)
More informationClinical Commissioning Policy: Vagal Nerve Stimulation (VNS) December Reference : NHSCB/D4/c/7
Clinical Commissioning Policy: Vagal Nerve Stimulation (VNS) December 2012 Reference : NHSCB/D4/c/7 NHS Commissioning Board Clinical Commissioning Policy: Vagal Nerve Stimulation (VNS) First published:
More informationQuantitative analysis of surface electromyography during epileptic and nonepileptic convulsive seizures
FULL-LENGTH ORIGINAL RESEARCH Quantitative analysis of surface electromyography during epileptic and nonepileptic convulsive seizures * 1 Sandor Beniczky, * 1 Isa Conradsen, Mihai Moldovan, #Poul Jennum,
More informationHow does epilepsy get complicated? altered molecules, cells and circuits
How does epilepsy get complicated? altered molecules, cells and circuits Tallie Z. Baram, MD, PhD Pediatrics, Anatomy/Neurobiology, Neurology Danette Shepard Professor of Neurological Sciences Scientific
More informationIdiopathic Epileptic Syndromes
Idiopathic Epileptic Syndromes Greek words idios = self, own and personal pathic = suffer Kamornwan Katanuwong MD Chiangmai University Hospital 1 st Epilepsy Camp, Hua Hin 20 th August 2010 Is a syndrome
More informationEpilepsy T.I.A. Cataplexy. Nonepileptic seizure. syncope. Dystonia. Epilepsy & other attack disorders Overview
: Clinical presentation and management Markus Reuber Professor of Clinical Neurology Academic Neurology Unit University of Sheffield, Royal Hallamshire Hospital. Is it epilepsy? Overview Common attack
More informationINTRODUCTION TO NEUROLOGICAL DISEASE. Learning in Retirement: Epilepsy
INTRODUCTION TO NEUROLOGICAL DISEASE Learning in Retirement: Epilepsy Lesson Overview Seizures VS Epilepsy What Causes Seizures? Types of Seizures Epilepsy Pathology General Cellular Molecular Diagnosis
More informationChallenges In Treatment of NCSE NCSE. Definition 22/07/56
Challenges In Treatment of NCSE Anannit Visudtibhan, MD. Division of Neurology, Department of Pediatrics, Faculty of Medicine-Ramathibodi Hospital NCSE Definition & Classification Diagnosis Issues in specific
More informationEpilepsy is Seizure Recognition & Response. Epilepsy Facts. Possible Causes of Epilepsy. What happens to the brain during a seizure?
Epilepsy is Seizure Recognition & Response NOT contagious NOT a mental illness NOT a mental impairment NOT a single disease Epilepsy is A neurological disorder of the brain characterized by the tendency
More informationEpilepsy and EEG in Clinical Practice
Mayo School of Professional Development Epilepsy and EEG in Clinical Practice November 10-12, 2016 Hard Rock Hotel at Universal Orlando Orlando, FL Course Directors Jeffrey Britton, MD and William Tatum,
More informationEpilepsy. Annual Incidence. Adult Epilepsy Update
Adult Epilepsy Update Annual Incidence J. Layne Moore, MD, MPH Associate Professor Department of Neurology and Pharmacy Director, Division of Epilepsy The Ohio State University Used by permission Health
More informationPSYCHOGENIC NONEPILEPTIC SEIZURES PNES
PSYCHOGENIC NONEPILEPTIC SEIZURES PNES Kimberly Vaughn, R.EEG T., Cleveland Clinic Jean-Martin Charcot (1825-1893) Hystero-epilepsy is a historical term that refers to a condition described by 19 th century
More informationEpilepsy and intellectual disability a workshop
Epilepsy and intellectual disability a workshop Professor Mike Kerr Institute of psychological medicine and clinical neurosciences, Cardiff University, Wales. UK Aim and structure To understand diagnostic
More informationPrognosis of chronic epilepsy with complex partial
Journal of Neurology, Neurosurgery, and Psychiatry 1984;47:1274-1278 279/83 Prognosis of chronic epilepsy with complex partial seizures D SCHMIDT From the Department ofneurology, University of Berlin,
More informationUsing Multi-electrode Array Recordings to detect unrecognized electrical events in epilepsy
Using Multi-electrode Array Recordings to detect unrecognized electrical events in epilepsy December 1, 2012 Catherine Schevon, MD, PhD Columbia University New York, NY American Epilepsy Society Annual
More informationImaging and EEG in Post-traumatic Epilepsy
Imaging and EEG in Post-traumatic Epilepsy Michael R. Sperling, M.D. Thomas Jefferson University Philadelphia, PA American Epilepsy Society Annual Meeting Disclosure Name Upsher-Smith Sunovion, Eisai,
More informationPsychiatric Comorbidity and Quality of Life in People with Epilepsy
Reprinted from the German Journal of Psychiatry http://www.gjpsy.uni-goettingen.de ISSN 1433-1055 Comorbidity and Quality of Life in People with Epilepsy Rajesh Jacob 1 and Prathap Tharyan 2 1 Consultant
More informationChild-Youth Epilepsy Overview, epidemiology, terminology. Glen Fenton, MD Professor, Child Neurology and Epilepsy University of New Mexico
Child-Youth Epilepsy Overview, epidemiology, terminology Glen Fenton, MD Professor, Child Neurology and Epilepsy University of New Mexico New onset seizure case An 8-year-old girl has a witnessed seizure
More informationThis presentation is the intellectual property of the author. Contact them for permission to reprint and/or distribute.
Medically Refractory Epilepsy with a Temporal Lobe Lesion Steven Ellis, MD Neurophysiology Fellow, PGY-5 UT Health San Antonio History No history of febrile seizures, meningitis, encephalitis, or head
More informationSeizures are a common emergency
FEATURE Evaluation of Seizures and Seizure-like Activity in the Emergency Department: Part 1 Courtney M. Johnson, MD; J. Stephen Huff, MD In part 1 of this 2-part review, the authors discuss determining
More informationDEFINITION AND CLASSIFICATION OF EPILEPSY
DEFINITION AND CLASSIFICATION OF EPILEPSY KAMORNWAN KATANYUWONG MD. 7 th epilepsy camp : Bang Saen, Thailand OUTLINE Definition of epilepsy Definition of seizure Definition of epilepsy Epilepsy classification
More informationEpilepsy Specialist Symposium Treatment Algorithms in the Diagnosis and Treatment of Epilepsy
Epilepsy Specialist Symposium Treatment Algorithms in the Diagnosis and Treatment of Epilepsy November 30, 2012 Fred Lado, MD, Chair Montefiore Medical Center Albert Einstein College of Medicine Bronx,
More informationGanaxolone as a Treatment for Drug-Resistant Epilepsy in Children
Ganaxolone as a Treatment for Drug-Resistant Epilepsy in Children ANTIEPILEPTIC DRUG and DEVICE TRIALS XIII May 13-15, 2015 Turnberry Isle Miami Hotel Gail M. Farfel, PhD Chief Development & Regulatory
More informationEEG in Investigating NEAD. Sarah Lawrence Ros Kandler Sheffield Teaching Hospitals Foundation Trust
EEG in Investigating NEAD Sarah Lawrence Ros Kandler Sheffield Teaching Hospitals Foundation Trust Aims Assess the role of verbal suggestion in inducing PNES The effect of suggestion on the yield of PNES
More informationSomnolence and Sedation Were Transient Adverse Events for Most Patients Receiving Clobazam Therapy: Post Hoc Analysis of Trial OV-1012 Data
Elmer ress Short Communication J Neurol Res. 2015;5(4-5):252-256 Somnolence and Sedation Were Transient Adverse Events for Most Patients Receiving Clobazam Therapy: Post Hoc Analysis of Trial OV-1012 Data
More informationEMG, EEG, and Neurophysiology in Clinical Practice
Mayo School of Continuous Professional Development EMG, EEG, and Neurophysiology in Clinical Practice Matthew T. Hoerth, M.D. Ritz-Carlton, Amelia Island, Florida January 29-February 4, 2017 2016 MFMER
More informationThe Placebo Effect in Epilepsy Trials: Where Does it Come From?
The Placebo Effect in Epilepsy Trials: Where Does it Come From? Emilio Perucca Institute of Neurology and Clinical Pharmacology Unit, University of Pavia, Pavia, Italy AED XI, 28 April 2011 Outline v Definitions
More informationU.S. 1 February 22, 2013
U.S. 1 February 22, 2013 A Placebo-controlled, Randomized, Blinded, Dose Finding Phase 2 Pilot Safety Study of MDMA-assisted Therapy for Social Anxiety in Autistic Adults Study Code: MAA-1 Sponsor: Multidisciplinary
More informationThe value of provocation methods in patients suspected of having non-epileptic seizures
Seizure 1999; 8: 152 156 Article No. seiz.1999.0277, available online at http://www.idealibrary.com on The value of provocation methods in patients suspected of having non-epileptic seizures N. DericioĞlu,
More informationDo seizures beget seizures?
Does MTLE cause progressive neurocognitive damage? Andrew Bleasel Westmead Do seizures beget seizures? The tendency of the disease is toward self-perpetuation; each attack facilitates occurrence of another
More informationSome basic terms, approaches, and issues in our study of human psychopathology. Term 1: abnormal What is abnormal? Term 2: psychopathology
Some basic terms, approaches, and issues in our study of human psychopathology Three basic terms: (next slides) Term 1: abnormal What is abnormal? The term abnormal is vague A better term is psychopathology.
More informationVENKATESH NAGARADDI, MD
- 1 - VENKATESH NAGARADDI, MD 7777 Forest Lane, C-650 Dallas, Texas 75230 vnagaraddi@hotmail.com (972) 566 8579 NEUROLOGY/EPILEPTOLOGY North Dallas Epilepsy Sep, 16 present Director of Neurodiagnostics
More informationJennifer A. Vickers MD Associate Professor of Neurology
Jennifer A. Vickers MD Associate Professor of Neurology Conflict of Interest Disclosure Speaker: _Jennifer A. Vickers, MD X 1. I do not have any potential conflicts of interest to disclose, OR 2. I wish
More informationA Pilot Study of Interpersonal Psychotherapy for Depressed Women with Breast Cancer
A Pilot Study of Interpersonal Psychotherapy for Depressed Women with Breast Cancer CARLOS BLANCO, M.D., Ph.D.* JOHN C. MARKOWITZ, M.D.* DAWN L. HERSHMAN, M.D., M.S.# JON A. LEVENSON, M.D.* SHUAI WANG,
More informationDiagnostic and Therapeutic Role of Long Term Video-EEG Monitoring in Patients With Psychogenic Non-Epileptic Attacks
Razavi Int J Med. 2013 November; 1(1): 17-21. Published online 2013 November 20. DOI: 10.5812/rijm.14201 Research Article Diagnostic and Therapeutic Role of Long Term Video-EEG Monitoring in Patients With
More informationIDENTIFYING TARGET POPULATIONS & DESIGNING CLINICAL TRIALS FOR ANTIEPILEPTOGENESIS. Ettore Beghi Istituto Mario Negri, Milano ITALY
IDENTIFYING TARGET POPULATIONS & DESIGNING CLINICAL TRIALS FOR ANTIEPILEPTOGENESIS Ettore Beghi Istituto Mario Negri, Milano ITALY OUTLINE Definitions & background risks in epilepsy End-points Target populations
More informationAn 18-Year-Old Woman with Prolonged Eyes Closed Unresponsiveness during Multiple Sleep Latency Testing
pii: jc-00317-16 http://dx.doi.org/10.5664/jcsm.6410 SLEEP MEDICINE PEARLS An 18-Year-Old Woman with Prolonged Eyes Closed Unresponsiveness during Multiple Sleep Latency Testing Romy Hoque, MD 1 ; Victoria
More informationNonlesional Neocortical Epilepsy: Benefits v Risk December 8, 2013
Nonlesional Neocortical Epilepsy: Benefits v Risk December 8, 2013 Orrin Devinsky, MD NYU Langone School of Medicine American Epilepsy Society Annual Meeting Disclosure Name of Commercial Interest None
More informationCHAPTER 3 SCHIZOPHRENIA. Highlights
CHAPTER 3 SCHIZOPHRENIA Highlights Schizophrenia affects 1% of the Canadian population. Onset is usually in early adulthood. Schizophrenia can be treated effectively with a combination of medication, education,
More informationMyoclonic status epilepticus in juvenile myoclonic epilepsy
Original article Epileptic Disord 2009; 11 (4): 309-14 Myoclonic status epilepticus in juvenile myoclonic epilepsy Julia Larch, Iris Unterberger, Gerhard Bauer, Johannes Reichsoellner, Giorgi Kuchukhidze,
More informationBenign infantile focal epilepsy with midline spikes and waves during sleep: a new epileptic syndrome or a variant of benign focal epilepsy?
riginal article Epileptic Disord 2010; 12 (3): 205-11 Benign infantile focal epilepsy with midline spikes and waves during sleep: a new epileptic syndrome or a variant of benign focal epilepsy? Santiago
More information