Dr H. Gharebaghian MD Neurologist Department of Neurology Kermanshah Faculty of Medicine
|
|
- Reginald Manning
- 5 years ago
- Views:
Transcription
1 Dr H. Gharebaghian MD Neurologist Department of Neurology Kermanshah Faculty of Medicine
2 Definitions Seizures are transient events that include symptoms and/or signs of abnormal excessive hypersynchronous activity in the brain Epilepsy as a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiological, cognitive, psychological, and social consequences of this condition
3 Definitions The traditional definition of epilepsy requires at least two unprovoked seizures The definition proposed by the ILAE in 2005 suggested that one epileptic seizure is sufficient to diagnose epilepsy if there is additional enduring alteration in the brain that increases the likelihood of future seizures The proposed definition has been controversial and has not been widely accepted
4 Definitions Practical clinical definition: Epilepsy was defined as a disease of the brain defined by any of the following conditions: (1) At least two unprovoked seizures occurring >24 hours apart (2) One unprovoked seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years (3) Diagnosis of an epilepsy syndrome
5 Classification Needs for classification: Variety of seizure types and epilepsies Communication and diagnostic purposes Evaluating drug specificity and prescribing the most appropriate therapy Predict response to therapy and prognosis
6 Classification ILAE diagnostic scheme for the classification of seizures and epilepsy recommend the following axes: Axis 1: Ictal phenomenology Axis 2: Seizure type Axis 3: Syndrome (a syndrome diagnosis may not always be possible) Axis 4: Etiology Axis 5: Impairment
7 Classification Classifications developed by the ILAE continue to be used widely: Clinical and Electroencephalographic Classification of Epileptic Seizures published in 1981 Classification of Epilepsies and Epileptic Syndromes introduced in 1989 New ILAE classification for seizures and epileptic syndromes published in 2010
8 1981 classification of seizures
9 2010 classification of seizures New terminology and concepts that better reflect the current understanding, while also striving for clarity and simplicity Maintained the division of seizures based on generalized or focal onset but has recommended replacing partial with focal Updated the definition of focal seizures as originating within networks limited to one hemisphere, with the possibility of the seizures being discretely localized or more widely distributed, and possibly originating in subcortical structures Abandoned simple, complex, and secondarily generalized
10 2010 classification of seizures Generalized seizures were defined as originating at some point within, and rapidly engaging, bilaterally distributed networks, which do not necessarily include the entire cortex Revised concepts acknowledge that generalized seizures can be asymmetrical and that individual seizures may appear to have a localized onset, but the location and laterality of that onset will vary from seizure to seizure
11 2010 classification of seizures For focal seizures, the distinction between the different types (e.g., complex partial and simple partial) is eliminated It is important, however, to recognize that impairment of consciousness/awareness or other dyscognitive features, localization, and progression of ictal events can be of primary importance in the evaluation of individual
12 2010 classification of seizures Descriptors of focal seizures according to degree of impairment during seizure: Without impairment of consciousness or awareness With impairment of consciousness or awareness (Dyscognitive). This roughly corresponds to the concept of complex partial seizure Evolving to a bilateral, convulsive seizure (involving tonic, clonic, or tonic and clonic components). This expression replaces the term secondarily generalized seizure.
13 2010 classification of seizures
14 1989 classification of epilepsies
15 2010 classification of epilepsies Abandoned Localization-related vs generalized. Syndromes were arranged by age at onset. Instead of the terms idiopathic, symptomatic, and cryptogenic, the following three terms were recommended: 1. Genetic- the epilepsy is the direct result of a known or presumed genetic defect in which seizures are the core symptom of the disorder 2. Structural/metabolic 3. Unknown cause
16 2010 classification of epilepsies syndrome will be restricted to a group of clinical entities that are reliably identified by a cluster of electroclinical characteristics Patients whose epilepsy does not fit the criteria for a specific electroclinical syndrome can be described with respect to a variety of clinically relevant factors (e.g., known etiology and seizure types) This does not, however, provide a precise (syndromic) diagnosis of their epilepsy
17 2010 classification of epilepsies A number of entities that are not exactly electroclinical syndromes but which represent clinically distinctive constellations on the basis of specific lesions or other causes. These are diagnostically meaningful forms of epilepsy and may have implications for clinical treatment, particularly surgery. These include mesial temporal lobe epilepsy (with hippocampal sclerosis), hypothalamic hamartoma with gelastic seizures, epilepsy with hemiconvulsion and hemiplegia, and Rasmussen syndrome. Age at presentation is not a defining feature in these disorders, as we understand them; however, they are sufficiently distinctive to be recognized as relatively specific diagnostic entities
18 2010 classification of epilepsies
19 2010 classification of epilepsies
20 Major symptomatic epilepsies
21 Genetic/congenital epilepsies
22 Acquired epilepsies
23 Brain malformations In children, developmental brain malformations are an important cause of epilepsy These can be generalized, hemispheric, or focal They are also classified as related to: Abnormal cell proliferation or differentiation including tuberous sclerosis, focal cortical dysplasia, and hemimegalencephaly Abnormal neuronal migration, including lissencephaly, subcortical band heterotopias, and periventricular nodular heterotopias Abnormal cortical organization, including polymicrogyria and schizencephaly
24 Brain malformations Some of these malformations are genetically determined Many of these malformations have other associated neurological disorders or physical findings Focal malformations associated with epilepsy are less likely to have other neurological manifestations than hemispheric or generalized malformations The severity of epilepsy and its response to therapy can be quite variable, but it is commonly drug-resistant, prompting evaluation for surgical treatment
25 Brain malformations Scizencephaly Lissencephaly Tuberous sclerosis
26 Head trauma Head trauma is an important risk factor for epilepsy, with the greatest risk seen in association with penetrating head injury, depressed skull fracture, and severe head trauma Mild traumatic brain injury (characterized by absence of fracture and a loss of consciousness or post-traumatic amnesia for less than 30 min) is associated with only a 1.5-fold increase in risk Moderate head injury (defined as loss of consciousness or posttraumatic amnesia for 30 minutes to 24 hours or a skull fracture), is associated with a 2.9-fold increase in risk Severe head injury (including brain contusion or intracranial hematoma or loss of consciousness or post-traumatic amnesia for more than 24 hours), is associated with 17-fold increased risk
27 Head trauma The risk was highest in the first year after the injury but remained increased thereafter for a duration that varied with severity of the injury For those with moderate brain injuries, the risk was markedly increased for up to 10 years only; for those with severe traumatic brain injury, the risk continued to be increased Early seizures appeared to be a strong risk factor for late seizures, but early seizures were usually related to the severity of the head injury and intracranial lesions Phenytoin and Levetiracetam are effective in preventing seizures in the first week
28 Vascular Malformations The two vascular malformations most commonly associated with epilepsy are arteriovenous malformations and cavernous malformations Arteriovenous malformations (AVMs) are high-pressure vascular malformations with arteriovenous shunting. They are a tangle of feeding arteries and draining veins without intervening capillary bed They may come to attention during evaluation for seizures or after they bleed; or may be incidental finding on imaging Because of the high pressure, they are susceptible to bleed at a rate of 1% to 3% per year, which is the main reason they require therapy Treatment options include: Surgical resection, Endovascular treatment with embolization and radiosurgery
29 Vascular Malformations Cavernous malformations consist of blood-filled epithelium lined caverns with no discrete arteries or veins On MRI they have a characteristic popcorn appearance with mixed signal within the lesion and a rim of decreased signal, reflecting hemosiderin They may be multiple in approximately a third of cases Cavernous malformations are low-pressure lesions with a much smaller risk of bleeding than AVMs They are strongly associated with epilepsy If seizures are controlled with medical therapy, there is no clear indication for surgical resection when epilepsy is drug resistant, resection of the cavernous malformation is associated with excellent results
30 Vascular Malformations Cavernous malformation Arteriovenous malformation
31 Brain Tumors Brain tumors are a common cause of epilepsy, particularly drugresistant epilepsy. Most drug-resistant epilepsy occurs with low-grade tumors, especially those in the temporal lobe Benign tumors associated with epilepsy are gangliogliomas, dysembryoblastic neuroepithelial tumors (DNET), and low grade gliomas Excellent seizure control most often occurs after removal of gangliogliomas and DNET tumors Seizures contribute to the morbidity of malignant brain tumors in approximately a quarter of patients Grade 3 anaplastic astrocytomas are more likely to present with seizures at onset than glioblastoma multiforme
32 Brain Tumors GBM Meinigioma Metastasis
33 Stroke Stroke increases the risk of seizures and epilepsy at any age It is the most common cause of seizures in the elderly Early seizures that occur within 2 weeks of the stroke The risk of chronic epilepsy is highest in the first year after stroke, with a 17-fold increase in the risk Compared to individuals who did not have early seizures, approximately 30% of individuals who have early poststroke seizures develop later epilepsy. This is a 16-fold increase in risk
34 Stroke Seizures and even status epilepticus can be a presenting symptom of acute stroke. Strokes involving the cortex are more likely to produce epilepsy than deep white-matter strokes The incidence of seizures is also higher in patients with intracerebral hemorrhage Prophylactic AED therapy is contraversial
35 Autoimmune Disorders Immune disorders increase the risk of epilepsy and seizures In SLE, the risk of seizures is 12% to 20% and is more likely with anticardiolipin and anti-sm antibodies Between 2% and 6% of patients with multiple sclerosis have seizures. Those who do tend to have more extensive cortical involvement. Seizures are more likely to occur in the context of acute relapse, but some patients develop chronic epilepsy Seizures are a more common acute manifestation of acute disseminated encephalomyelitis, (approximately 50%). However, chronic epilepsy is much less likely (only about 5% )
36 Autoimmune Disorders Limbic encephalitis is an increasingly recognized cause of epilepsy Suggested diagnostic criteria include one of disturbance of episodic memory, temporal lobe seizures, or affective disturbance plus the presence of either well-characterized antibodies or unexplained increased signal in the mesial temporal structures, or histopathology of mesial temporal encephalitis It can be paraneoplastic or nonparaneoplastic Paraneoplstic cases are associated with small cell lung cancer, testicular cancer, thymoma, breast cancer, or teratoma
37 Autoimmune Disorders An immune basis of epilepsy should be suspected in individuals who have other autoimmune disease, abrupt or recent onset of seizures (particularly if resistant to AEDs and progressive in frequency and severity), associated manifestations such as behavioral changes and psychosis, severe memory disturbances, and abnormal signal on MRI in the hippocampi An immune origin is suspected in several well-described epileptic syndromes. These include West syndrome, Lennox-Gastaut syndrome, LKS, and Rasmussen syndrome
38 Acute Symptomatic Seizures Acute symptomatic seizures occur in close temporal relationship with an acute CNS insult metabolic, toxic, structural, infectious, or inflammatory Metabolic disturbances known to cause seizures include hypoglycemia, hyperglycemia, hyponatremia, hypocalcemia, hypomagnesemia, and uremia Withdrawal from chronic alcohol abuse, benzodiazepines and barbiturates (more commonly with short acting agents) may be associated with generalized tonic-clonic seizures
39 Acute Symptomatic Seizures Several illicit drugs produce acute symptomatic seizures, particularly cocaine and other stimulants Several therapeutic medications can trigger acute symptomatic seizures at high doses or in susceptible individuals These same medications, as well as metabolic derangements, can also trigger seizures in people with epilepsy, at lower thresholds than for people without epilepsy Metabolic and toxic causes of acute symptomatic seizures do not usually cause chronic epilepsy
40
41 Provoked epilepsy The category of provoked epilepsy is differentiated from both idiopathic and symptomatic epilepsy Provoked epilepsy is defined as: An epilepsy in which a systemic or environmental factor is the predominant cause of the seizures and in which there are neuropathological or neuroanatomical changes Many patients with provoked seizures have an increased susceptibility to epilepsy (either genetic or acquired) and the term provoked epilepsy should be applied where the overwhelming influence is the provoking factor and not the underlying susceptibility Provokative factors: Fever; menstrual cycle and catamenial epilepsy; sleep; startle
42 Self assessment questions
43 The diagnosis of epilepsy can be made after : A.Two unprovoked seizures >24 hours apart B.Two unprovoked seizures <24 hours apart C.One unprovoked seizure if there is a coexisting brain lesion D.One provoked seizure and a second unprovoked seizure
44 Thank you
45 References 1. Neurology in clinical practice, Bradley New concepts in classification of the epilepsies: Entering the 21st century 3. Seizures and Epilepsy: Pathophysiology and Principles of Diagnosis 4. The causes of epilepsy 5. Harrison 2015
Classification of Epilepsy: What s new? A/Professor Annie Bye
Classification of Epilepsy: What s new? A/Professor Annie Bye The following material on the new epilepsy classification is based on the following 3 papers: Scheffer et al. ILAE classification of the epilepsies:
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 informationEGI Clinical Data Collection Form Cover Page
EGI Clinical Data Collection Form Cover Page Please find enclosed the EGI Clinical Data Form for my patient. This form was completed by: On (date): _ Page 1 of 14 EGI Clinical Data Form Patient Name: Date
More informationSingle Seizure of Unknown Cause
S1: Medical Standards for Safety Critical Workers with Seizures of Unknown Cause 1. Seizure or Epilepsy of Unknown Cause are the classifications used in these medical standards for a probable seizure(s),
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 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 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 informationFebrile seizures. Olivier Dulac. Hôpital Necker-Enfants Malades, Université Paris V, INSERM U663
Febrile seizures Olivier Dulac Hôpital Necker-Enfants Malades, Université Paris V, INSERM U663 olivier.dulac@nck.aphp.fr Definition Seizures precipitated by fever that is not due to an intracranial infection
More information#CHAIR2016. September 15 17, 2016 The Biltmore Hotel Miami, FL. Sponsored by
#CHAIR2016 September 15 17, 2016 The Biltmore Hotel Miami, FL Sponsored by #CHAIR2016 Seizures and Epilepsies Enrique Serrano, MD University of Miami Miller School of Medicine Miami, FL #CHAIR2016 Learning
More informationEEG in Epileptic Syndrome
EEG in Epileptic Syndrome Surachai Likasitwattanakul, M.D. Division of Neurology, Department of Pediatrics Faculty of Medicine, Siriraj Hospital Mahidol University Epileptic syndrome Electroclinical syndrome
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 informationEGI Clinical Data Collection Form Cover Page
EGI Clinical Data Collection Form Cover Page Please find enclosed the EGI Clinical Data Form for my patient. This form was completed by: On (date): Page 1 of 15 Patient Name: Date of Birth: MM/DD/YYYY
More informationImaging for Epilepsy Diagnosis December 2, 2011
Imaging for Epilepsy Diagnosis December 2, 2011 Samuel Wiebe, MD University of Calgary Canada American Epilepsy Society Annual Meeting Disclosure University of Calgary Hopewell Professorship of Clinical
More informationOutline. What is a seizure? What is epilepsy? Updates in Seizure Management Terminology, Triage & Treatment
Outline Updates in Seizure Management Terminology, Triage & Treatment Joseph Sullivan, MD! Terminology! Videos of different types of seizures! Diagnostic evaluation! Treatment options! Acute! Maintenance
More informationClassification of Status Epilepticus: A New Proposal Dan Lowenstein, M.D. University of California, San Francisco
Classification of Status Epilepticus: A New Proposal Dan Lowenstein, M.D. University of California, San Francisco for the ILAE Taskforce for Classification of Status Epilepticus: Eugen Trinka, Hannah Cock,
More informationIs it epilepsy? Does the patient need long-term therapy?
Is it a seizure? Definition Transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain Is it provoked or unprovoked? Is it epilepsy? Does the
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 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 informationSupplementary appendix
Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Pujar SS, Martinos MM, Cortina-Borja M, et
More informationEpileptic Seizures, Syndromes, and Classifications. Heidi Currier, MD Minnesota Epilepsy Group, PA St. Paul, MN
Epileptic Seizures, Syndromes, and Classifications Heidi Currier, MD Minnesota Epilepsy Group, PA St. Paul, MN Definitions Diagnosis of Seizures A seizure is a sudden surge of electrical activity in the
More informationNEONATAL SEIZURES-PGPYREXIA REVIEW
NEONATAL SEIZURES-PGPYREXIA REVIEW This is a very important Postgraduate topics will few Q asked in undergraduation also. Lets see them in detail. References: 1.Volpe s Neurology of newborn 2.Nelson s
More informationSeizure Disorders. Guidelines for assessment of fitness to work as Cabin Crew
Seizure Disorders Guidelines for assessment of fitness to work as Cabin Crew General Considerations As with all medical guidelines, it is important that each individual case is assessed on its own merits.
More informationEvaluation and management of drug-resistant epilepsy
Evaluation and management of drug-resistant epilepsy Fateme Jahanshahifar Supervised by: Professor Najafi INTRODUCTION 20 to 40 % of patients with epilepsy are likely to have refractory epilepsy. a substantive
More informationMeasures have been taken, by the Utah Department of Health, Bureau of Health Promotions, to ensure no conflict of interest in this activity
Measures have been taken, by the Utah Department of Health, Bureau of Health Promotions, to ensure no conflict of interest in this activity Seizures in the School Setting Meghan Candee, MD MS Assistant
More informationEpilepsy 7/28/09! Definitions. Classification of epilepsy. Epidemiology of Seizures and Epilepsy. International classification of epilepsies
Definitions Epilepsy Dr.Yotin Chinvarun M.D., Ph.D. Seizure: the clinical manifestation of an abnormal and excessive excitation of a population of cortical neurons Epilepsy: a tendency toward recurrent
More informationEpilepsy in the Primary School Aged Child
Epilepsy in Primary School Aged Child Deepak Gill Department of Neurology and Neurosurgery The Children s Hospital at Westmead CHERI Research Forum 15 July 2005 Overview The School Age Child and Epilepsy
More information1/31/2009. Paroxysmal, uncontrolled electrical discharge of neurons in brain interrupting normal function
Paroxysmal, uncontrolled electrical discharge of neurons in brain interrupting normal function In epilepsy abnormal neurons undergo spontaneous firing Cause of abnormal firing is unclear Firing spreads
More informationEpileptic Seizures, Syndromes and Classifications
Epileptic Seizures, Syndromes and Classifications Randa Jarrar, MD Child Neurologist Phoenix Children's Hospital Clinical Assistant Professor, Department of Pediatrics University of Arizona Assistant Professor,
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 informationWhat is the Relationship Between Arachnoid Cysts and Seizure Foci?
Epilepsin, 38( 10):1098-1102, 1997 Lippincott-Raven Publishers, Philadelphia 0 International League Against Epilepsy What is the Relationship Between Arachnoid Cysts and Seizure Foci? Santiago Arroyo and
More informationPRESURGICAL EVALUATION. ISLAND OF COS Hippocrates: On the Sacred Disease. Disclosure Research-Educational Grants. Patients with seizure disorders
PRESURGICAL EVALUATION Patients with seizure disorders Gregory D. Cascino, MD Mayo Clinic Disclosure Research-Educational Grants Mayo Foundation Neuro Pace, Inc. American Epilepsy Society American Academy
More informationJanuary 26, Montgomery County Regional Outpatient Center Dietary Therapies Program (Main Hospital) Comprehensive Pediatric Epilepsy Program
First time Seizure and New onset Epilepsy Stirred not shaken January 26, 2017 First time Seizure and New onset Epilepsy Amy Kao, MD Children s National Health System Center for Neuroscience and Behavioral
More informationEpilepsy. Hyunmi Choi, M.D., M.S. Columbia Comprehensive Epilepsy Center The Neurological Institute. Seizure
Epilepsy Hyunmi Choi, M.D., M.S. Columbia Comprehensive Epilepsy Center The Neurological Institute Seizure Symptom Transient event Paroxysmal Temporary physiologic dysfunction Caused by self-limited, abnormal,
More informationErnie Somerville Prince of Wales Hospital EPILEPSY
Ernie Somerville Prince of Wales Hospital EPILEPSY Overview Classification New and old anti-epileptic drugs (AEDs) Neuropsychiatric side-effects Limbic encephalitis Non-drug therapies Therapeutic wishlist
More informationElectroclinical Syndromes Epilepsy Syndromes. Angel W. Hernandez, MD Division Chief, Neurosciences Helen DeVos Children s Hospital Grand Rapids, MI
Electroclinical Syndromes Epilepsy Syndromes Angel W. Hernandez, MD Division Chief, Neurosciences Helen DeVos Children s Hospital Grand Rapids, MI Disclosures Research Grants: NIH (NINDS) Lundbeck GW Pharma
More informationEEG IN FOCAL ENCEPHALOPATHIES: CEREBROVASCULAR DISEASE, NEOPLASMS, AND INFECTIONS
246 Figure 8.7: FIRDA. The patient has a history of nonspecific cognitive decline and multiple small WM changes on imaging. oligodendrocytic tumors of the cerebral hemispheres (11,12). Electroencephalogram
More informationEpilepsy CASE 1 Localization Differential Diagnosis
2 Epilepsy CASE 1 A 32-year-old man was observed to suddenly become unresponsive followed by four episodes of generalized tonic-clonic convulsions of the upper and lower extremities while at work. Each
More informationPediatrics. Convulsive Disorders in Childhood
Pediatrics Convulsive Disorders in Childhood Definition Convulsion o A sudden, violent, irregular movement of a limb or of the body o Caused by involuntary contraction of muscles and associated especially
More informationStatus Epilepticus in Children
PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Status Epilepticus in Children. These podcasts are designed to give medical students an overview of key topics in pediatrics.
More informationImages have been removed from the PowerPoint slides in this handout due to copyright restrictions.
Seizures Seizures & Status Epilepticus Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. Donna Lindsay, MN RN, CNS-BC, CCRN, CNRN Neuroscience Clinical Nurse
More informationSEIZURES AND EPILEPSY. David Spencer MD. School of Pharmacy 2008
SEIZURES AND EPILEPSY David Spencer MD School of Pharmacy 2008 Outline Definitions and epidemiology Etiology/pathology Pathophysiology: o ogy: Brief overview of molecular and cellular basis of epileptogenesis
More informationCENTRAL NERVOUS SYSTEM TRAUMA and Subarachnoid Hemorrhage. By: Shifaa AlQa qa
CENTRAL NERVOUS SYSTEM TRAUMA and Subarachnoid Hemorrhage By: Shifaa AlQa qa Subarachnoid Hemorrhage Causes: Rupture of a saccular (berry) aneurysm Vascular malformation Trauma Hematologic disturbances
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 informationImaging in Epilepsy. Nucharin Supakul, MD Ramathibodi Hospital, Mahidol University August 22, 2015
Imaging in Epilepsy Nucharin Supakul, MD Ramathibodi Hospital, Mahidol University August 22, 2015 Nothing to disclose Outline Role of Imaging and pitfalls Imaging protocol Case scenarios Clinical & Electrophysiologic
More informationICD-9 to ICD-10 Conversion of Epilepsy
ICD-9-CM 345.00 Generalized nonconvulsive epilepsy, without mention of ICD-10-CM G40.A01 Absence epileptic syndrome, not intractable, with status G40.A09 Absence epileptic syndrome, not intractable, without
More informationCase reports functional imaging in epilepsy
Seizure 2001; 10: 157 161 doi:10.1053/seiz.2001.0552, available online at http://www.idealibrary.com on Case reports functional imaging in epilepsy MARK P. RICHARDSON Medical Research Council Fellow, Institute
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 information*Pathophysiology of. Epilepsy
*Pathophysiology of Epilepsy *Objectives * At the end of this lecture the students should be able to:- 1.Define Epilepsy 2.Etio-pathology of Epilepsy 3.Types of Epilepsy 4.Role of Genetic in Epilepsy 5.Clinical
More informationAMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY, INC. SUBSPECIALTY CERTIFICATION EXAMINATION IN EPILEPSY MEDICINE
SUBSPECIALTY CERTIFICATION EXAMINATION IN EPILEPSY MEDICINE 2014 Content Blueprint (November 26, 2012) Number of questions: 200 I. Classification 7 9% II. Routine EEG 16 20% III. Evaluation 22 26% IV.
More informationEPILEPSY. New Ideas about an Old Disease. Gregory D. Cascino, MD
EPILEPSY New Ideas about an Old Disease Gregory D. Cascino, MD Disclosure Research-Educational Grants Neuro Pace, Inc. American Epilepsy Society American Academy of Neurology Neurology (Associate Editor)
More informationRefractory focal epilepsy: findings by MRI.
Refractory focal epilepsy: findings by MRI. Doctors Nicolás Sgarbi, Osmar Telis Clinical Radiology Department Hospital de Clínicas Montevideo- Uruguay ABSTRACT Epilepsy is one of the most frequent neurological
More information2. Subarachnoid Hemorrhage
Causes: 2. Subarachnoid Hemorrhage A. Saccular (berry) aneurysm - Is the most frequent cause of clinically significant subarachnoid hemorrhage is rupture of a saccular (berry) aneurysm. B. Vascular malformation
More informationChapter 1 Introduction
Chapter 1 Introduction Men think epilepsy divine, merely because they do not understand it. But if they called everything divine which they do not understand, why, there would be no end to divine things.
More informationWho Gets Epilepsy? Etiologies and Risk Factors for Seizures. David Spencer, MD Professor of Neurology Director, OHSU Epilepsy Center Portland, OR
Who Gets Epilepsy? Etiologies and Risk Factors for Seizures David Spencer, MD Professor of Neurology Director, OHSU Epilepsy Center Portland, OR Epidemiology Risk Factors Febrile seizures CNS infection
More informationClassification of Seizures. Generalized Epilepsies. Classification of Seizures. Classification of Seizures. Bassel F. Shneker
Classification of Seizures Generalized Epilepsies Bassel F. Shneker Traditionally divided into grand mal and petit mal seizures ILAE classification of epileptic seizures in 1981 based on clinical observation
More informationEpilepsy in children with cerebral palsy
Seizure 2003; 12: 110 114 doi:10.1016/s1059 1311(02)00255-8 Epilepsy in children with cerebral palsy A.K. GURURAJ, L. SZTRIHA, A. BENER,A.DAWODU & V. EAPEN Departments of Paediatrics, Community Medicine
More informationThe Fitting Child. A/Prof Alex Tang
The Fitting Child A/Prof Alex Tang Objective Define relevant history taking and physical examination Classify the types of epilepsy in children Demonstrate the usefulness of investigations Define treatment
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 informationPsychogenic Disturbances
Psychogenic Disturbances Psychogenic seizures Episodic dyscontrol Dissociative states (dissociative hysterical neuroses) - Psychogenic fugue - Multiple personality disorder - Psychogenic amnesia - Depersonalization
More informationCrackCast Episode 18 Seizures
CrackCast Episode 18 Seizures Episode overview: 1) Define status epilepticus 2) List the doses of common medications used for status epilepticus 3) List 10 differential diagnoses for seizures 4) List 10
More informationSUBSPECIALTY CERTIFICATION EXAMINATION IN EPILEPSY MEDICINE Content Blueprint (December 21, 2015)
SUBSPECIALTY CERTIFICATION EXAMINATION IN EPILEPSY MEDICINE 2016 Content Blueprint (December 21, 2015) Number of questions: 200 1. Classification 8-12% 2. Routine EEG 16-20% 3. Evaluation 23-27% 4. Management
More informationA Study on Clinical and Etiological Factors of New-Onset Seizures in Adults
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X A Study on Clinical and Etiological Factors of New-Onset Seizures in Adults P. S. V. Ramana Murthy Associate Professor, Department of General
More informationSeizure 18 (2009) Contents lists available at ScienceDirect. Seizure. journal homepage:
Seizure 18 (2009) 38 42 Contents lists available at ScienceDirect Seizure journal homepage: www.elsevier.com/locate/yseiz Non-convulsive status epilepticus; the rate of occurrence in a general hospital
More informationEpilepsy Syndromes: Where does Dravet Syndrome fit in?
Epilepsy Syndromes: Where does Dravet Syndrome fit in? Scott Demarest MD Assistant Professor, Departments of Pediatrics and Neurology University of Colorado School of Medicine Children's Hospital Colorado
More informationThe secrets of conventional EEG
The secrets of conventional EEG The spike/sharp wave activity o Electro-clinical characteristics of Spike/Sharp wave The polymorphic delta activity o Electro-clinical characteristics of Polymorphic delta
More information2. Area of the brain affected by the seizures.
Learning Through Storms When discussing learning, we sometimes refer to cognition, or one s ability to think, learn and use information. Seizures can impact cognition, learning and behaviour in a variety
More informationUpdate in Pediatric Epilepsy
Update in Pediatric Epilepsy Cherie Herren, MD Assistant Professor OUHSC, Department of Neurology September 20, 2018 Disclosures None Objectives 1. Identify common pediatric epilepsy syndromes 2. Describe
More informationOrganic Mental Disorders. Organic Mental Disorders. Axes. Damrongsak Bulyalert Department of Internal Medicine
Organic Mental Disorders Damrongsak Bulyalert Department of Internal Medicine www.metadon.net 1 Organic Mental Disorders In DSM (Diagnostic and Statistical Manual of Mental Disorders), OMD includes Delirium,
More informationHamartomas and epilepsy: clinical and imaging characteristics
Seizure 2003; 12: 307 311 doi:10.1016/s1059 1311(02)00272-8 Hamartomas and epilepsy: clinical and imaging characteristics B. DIEHL, R. PRAYSON, I. NAJM & P. RUGGIERI Departments of Neurology, Pathology
More informationCase #1. Inter-ictal EEG. Difficult Diagnosis Pediatrics. 15 mos girl with medically refractory infantile spasms 2/13/2010
Difficult Diagnosis Pediatrics Joseph E. Sullivan M.D. Assistant Professor of Clinical Neurology & Pediatrics Director, UCSF Pediatric Epilepsy Center University of California San Francisco Case #1 15
More informationCurrent views on epilepsy management
Current views on epilepsy management J Helen Cross UCL-Institute of Child Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London & Young Epilepsy, Lingfield, UK What are our current
More informationCase 2: Epilepsy A 19-year-old college student comes to student health services complaining of sporadic loss of memory. The periods of amnesia occur
Case 2: Epilepsy A 19-year-old college student comes to student health services complaining of sporadic loss of memory. The periods of amnesia occur while the student is awake and occasionally in class.
More informationEpilepsy. Epileptic seizures: an abnormal and excessive discharge of brain neurons involving hypersynchrony accompanied by some behavioral change.
Epilepsy Epileptic seizures: an abnormal and excessive discharge of brain neurons involving hypersynchrony accompanied by some behavioral change. Hystory of epilepsy 1. Origin of the name of epilepsy:
More informationIntroduction. 1 person in 20 will have an epileptic seizure at some time in their life
Introduction 1 person in 20 will have an epileptic seizure at some time in their life Epilepsy is diagnosed on the basis of two or more epileptic seizures. Around 450,000 people in the UK have epilepsy
More informationJeffrey W Boyle, MD, PhD Avera Medical Group Neurology Sioux Falls, SD
Jeffrey W Boyle, MD, PhD Avera Medical Group Neurology Sioux Falls, SD Disclosures: None Objectives Recognize the incidence of seizure and epilepsy in the US population Appreciate the differences in seizure
More informationIdiopathic Photosensitive Occipital Lobe Epilepsy
Idiopathic Photosensitive Occipital Lobe Epilepsy 2 Idiopathic photosensitive occipital lobe epilepsy (IPOE) 5, 12, 73, 75, 109, 110 manifests with focal seizures of occipital lobe origin, which are elicited
More informationVASCULAR MALFORMATIONS. Owen Samuels, MD Adam Webb, MD Emory University
VASCULAR MALFORMATIONS Owen Samuels, MD Adam Webb, MD Emory University Introduction Brain and spinal cord vascular malformations can be separated into five main categories: 1) Arteriovenous malformation,
More informationSWI including phase and magnitude images
On-line Table: MRI imaging recommendation and summary of key features Sequence Pathologies Visible Key Features T1 volumetric high-resolution whole-brain reformatted in axial, coronal, and sagittal planes
More informationEpilepsy. Definitions
Epilepsy Definitions An epileptic disorder is a chronic neurological disorder characterized by recurrent epileptic seizures An epileptic syndrome consists of a complex of signs and symptoms that occur
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Absence seizures, 6 in childhood, 95 Adults, seizures and status epilepticus in, management of, 34 35 with first-time seizures. See Seizure(s),
More informationEpilepsy in Children
Epilepsy in Children Elizabeth A., MD, PhD Director, Pediatric Epilepsy Service Director, Carol and James Herscot Center for Tuberous Sclerosis Complex Massachusetts General Hospital Associate Professor
More informationNeurology: The pilot, the AME, the FAA. John Hastings CAMA, Greensboro NC September 2017
Neurology: The pilot, the AME, the FAA John Hastings CAMA, Greensboro NC September 2017 Aviation Safety As AME s and regulators, we have a primary obligation to aviation safety Arguably, we also have an
More informationThere are several types of epilepsy. Each of them have different causes, symptoms and treatment.
1 EPILEPSY Epilepsy is a group of neurological diseases where the nerve cell activity in the brain is disrupted, causing seizures of unusual sensations, behavior and sometimes loss of consciousness. Epileptic
More information5/22/2009. Pediatric Neurosurgery Pediatric Neurology Neuroradiology Neurophysiology Neuropathology Neuropsychology
Current Surgical Treatment Strategies for the Management of Pediatric Epilepsy University of California, San Francisco Department of Neurological Surgery San Francisco, California Kurtis Ian Auguste, M.D.
More informationFORM ID. Patient's Personal Details. SECTION A : Medical Record of the Patient. Name. Policy Number. NRIC/Old IC/Passport/Birth Cert/Others
CRITICAL ILLNESS CLAIM - DOCTOR'S STATEMENT Brain and Nerve Related Conditions Note: This form is to be completed at the Patient s expense by the Attending Physician/ Surgeon who treated the patient. Patient's
More informationWho Gets Epilepsy? Etiologies and Risk Factors for Seizures. David Spencer, MD Professor of Neurology Director, OHSU Epilepsy Center Portland, OR
Who Gets Epilepsy? Etiologies and Risk Factors for Seizures David Spencer, MD Professor of Neurology Director, OHSU Epilepsy Center Portland, OR Epidemiology Risk Factors Febrile seizures CNS infection
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 informationCOMA. DIAH MUSTIKA HW,SpS,KIC INTENSIVE CARE UNIT of EMERGENCY DEPARTMENT
COMA DIAH MUSTIKA HW,SpS,KIC INTENSIVE CARE UNIT of EMERGENCY DEPARTMENT NAVAL HOSPITAL dr RAMELAN, SURABAYA DEFINITIONS Coma State of unresponsiveness to external or internal stimuli in which a patient
More informationEPILEPSY: What is Epilepsy? Is there any treatment? What is the prognosis? What research is being done?
EPILEPSY: What is Epilepsy? The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal
More informationEpilepsy and Brain Tumor. Apasri Lusawat M.D. Pediatric Neurology Prasat Neurological Institute
Epilepsy and Brain Tumor Apasri Lusawat M.D. Pediatric Neurology Prasat Neurological Institute Outline Overview Pathogenesis : Tumor-> epilepsy Etiology of Epilepsy, age EPILEPSY AND BRAIN TUMORS CNS neoplasms
More informationOverview: Idiopathic Generalized Epilepsies
Epilepsia, 44(Suppl. 2):2 6, 2003 Blackwell Publishing, Inc. 2003 International League Against Epilepsy Overview: Idiopathic Generalized Epilepsies Richard H. Mattson Department of Neurology, Yale University
More informationRole of MRI in acute disseminated encephalomyelitis
Original Research Article Role of MRI in acute disseminated encephalomyelitis Shashvat Modiya 1*, Jayesh Shah 2, C. Raychaudhuri 3 1 1 st year resident, 2 Associate Professor, 3 HOD and Professor Department
More informationAutoimmune Encephalitis
Evaluation Approach for Suspected Autoimmune Encephalitis M.R ASHRAFI PROFESSOR OF PEDIATRIC NEUROLOGY CHILDREN S MEDICAL CENTER PEDIATRIC CENTER OF EXCELLENCE TEHRAN UNIVERSITY OF MEDICAL SCIENCES TEHRAN
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 informationIntracranial Studies Of Human Epilepsy In A Surgical Setting
Intracranial Studies Of Human Epilepsy In A Surgical Setting Department of Neurology David Geffen School of Medicine at UCLA Presentation Goals Epilepsy and seizures Basics of the electroencephalogram
More informationCandidates for Epilepsy Surgery. Presurgical Evaluation. Presurgical Evaluation. Presurgical Evaluation. Presurgical Evaluation 8/27/2017
PresurgicalEpilepsy Eval: A multidisciplinary approach to intractable epilepsy Tayard Desudchit MD Faculty Of Medicine Chulalongkorn U. Candidates for Epilepsy Surgery Persistent seizures despite appropriate
More informationEpidemiology and Semiology of Tumor-based Epilepsy December 2, 2012
Epidemiology and Semiology of Tumor-based Epilepsy December 2, 2012 Charles J. Vecht, MD, PhD Medical Center The Hague SEIN Epilepsy Foundation, The Netherlands CHU Pitié-Salpêtrière, Paris, France American
More informationCHILDHOOD OCCIPITAL EPILEPSY OF GASTAUT: A LONG-TERM PROSPECTIVE STUDY
Acta Medica Mediterranea, 2017, 33: 1175 CHILDHOOD OCCIPITAL EPILEPSY OF GASTAUT: A LONG-TERM PROSPECTIVE STUDY MURAT GÖNEN ¹, EMRAH AYTAǹ, BÜLENT MÜNGEN¹ University of Fırat, Faculty of medicine, Neurology
More informationV. CENTRAL NERVOUS SYSTEM TRAUMA
V. CENTRAL NERVOUS SYSTEM TRAUMA I. Concussion - Is a clinical syndrome of altered consiousness secondary to head injury - Brought by a change in the momentum of the head when a moving head suddenly arrested
More information