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More About This Title Adult Epilepsy
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Joseph Sirven is a Professor of Neurology at the Mayo Clinic and chair of neurology at Mayo Clinic Arizona. His main interests are in Epilepsy and Seizure Treatments in Adults and Children (particularly older adults), Epilepsy Surgery, Electroencephalography, Investigational Antiepilepsy Drugs, Status Epilepticus, Vagal Nerve Stimulator, Ketogenic Diet.
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List of contributors xiii
Preface xvii
1 Introduction: epilepsy 1
Gregory D. Cascino
1.1 Epilepsy care: beginnings of observation and recognition 1
1.2 Epilepsy care: initial understanding and treatment 2
1.3 Epilepsy care: the Mayo Clinic 3
Section 1 Pathophysiology and epidemiology of seizures and epilepsy 7
2 Seizure and epilepsy syndromes classification 9
Jerry J. Shih
2.1 Introduction 9
2.2 The classification of epileptic seizures 9
2.3 Conclusion 16
3 Epidemiology of seizure disorders 19
Joseph I. Sirven
3.1 Incidence and prevalence of epilepsy 19
3.2 Incidence and prevalence of acute symptomatic seizures 21
3.3 Looking beyond epidemiology: the state of epilepsy care in the United States 22
3.4 Risk factors for epilepsy 23
3.5 Conclusion 24
Section 2 Diagnostic evaluation 27
4 The role of routine scalp electroencephalography 29
Terrence D. Lagerlund and Gregory A. Worrell
4.1 Introduction 29
4.2 Clinical application of EEG 30
4.3 Scalp EEG recording methods 32
4.4 Activation procedures 33
4.5 Interictal discharges correlated with epilepsy 34
4.6 Epileptic syndromes and the role of EEG 42
4.7 Conclusions 45
5 Neuroimaging in epilepsy 49
Gregory D. Cascino
5.1 Introduction 49
5.2 Magnetic resonance imaging 50
5.3 Functional neuroimaging 57
6 Video-EEG monitoring data 67
Elson L. So
6.1 Introduction 67
6.2 Pre-monitoring evaluation and preparation 67
6.3 Management during monitoring 68
6.4 Discharge management 78
Acknowledgments 78
7 Etiologies of seizures 83
Katherine H. Noe and Korwyn Williams
7.1 Introduction 83
7.2 Acute symptomatic seizures 83
7.3 Febrile seizures 86
7.4 Unprovoked seizures 87
8 The evaluation of nonepileptic paroxysmal events 99
Joseph F. Drazkowski and Matthew Hoerth
8.1 Introduction 99
8.2 Syncope 101
8.3 Transient ischemic events (TIAs) 103
8.4 Transient global amnesia (TGA) 104
8.5 Movement disorders 105
8.6 Sleep disorders 105
8.7 Psychogenic nonepileptic seizures (PNESs) 107
8.8 Summary 108
Section 3 Principles of medical management 113
9 Mechanisms of action of antiepileptic drugs 115
Jeffrey W. Britton, Tarek M. Zakaria, and Eduardo Benarroch
9.1 Introduction 115
9.2 Treatment of epilepsy 116
9.3 Excitatory mechanisms targeted by AEDs 118
9.4 Inhibitory mechanisms targeted by AEDs 120
9.5 Mechanism of action-specific drugs 122
9.6 Conclusions 126
10 Antiepileptic drugs: pharmacology, epilepsy indications, and selection 131
Jeffrey W. Britton and Julie Cunningham
10.1 Introduction 131
10.2 AED selection 132
10.3 Generic AED therapy 145
10.4 The AEDs: summary of clinical use, pharmacokinetics, and efficacy 147
Section 4 Generalized epilepsies 171
11 Idiopathic generalized epilepsies 173
Raj D. Sheth
11.1 Overview of the generalized epilepsies 173
11.2 Introduction 174
11.3 Differentiating generalized seizures from partial seizures 175
11.4 Clinical and EEG characteristics of generalized seizures 176
11.5 Generalized epilepsy syndromes 178
11.6 Treating generalized seizures 180
11.7 Treatment algorithm 180
11.8 Prognosis/outcomes 182
12 Symptomatic generalized epilepsies 183
Katherine C. Nickels and Elaine Wirrell
12.1 Introduction 183
12.2 Infantile onset syndromes 184
12.3 Childhood onset syndromes 190
12.4 Symptomatic generalized epilepsy syndromes of known cause 196
Section 5 Partial epilepsies 211
13 Overview of diagnosis and medical treatment of partial epilepsies 213
Joseph I. Sirven
13.1 Diagnosis and evaluation 213
13.2 Electroencephalography (EEG) 214
13.3 Imaging 215
13.4 Treatment and management 216
13.5 Which patient should be treated with antiseizure drugs? 216
13.6 Evidence-based guidelines 218
13.7 How well do seizure medications work? 218
13.8 Conclusion and summary 219
14 Medial temporal lobe epilepsy 221
William O. Tatum IV
14.1 Introduction 221
14.2 Functional neuroanatomy of the temporal lobe 222
14.3 Pathology 223
14.4 Differential diagnosis 225
14.5 Diagnosis 227
14.6 Concluding statements 239
15 Substrate-directed epilepsy 247
Gregory A. Worrell
15.1 Intractable partial epilepsy 247
15.2 Epilepsy surgery 248
15.3 Localization of the epileptogenic zone 250
15.4 Lesional MRI (or substrate-directed epilepsy syndromes) 253
15.5 Functional neuroimaging and intracranial EEG 253
15.6 Symptomatic partial epilepsy 258
15.7 Non-lesional MRI (non-substrate-directed partial epilepsy) 261
15.8 Non-lesional temporal lobe epilepsy (surgically remediable syndrome?) 262
15.9 Surgical advances 263
16 Non-substrate-directed partial epilepsy 271
Korwyn Williams and Katherine H. Noe
16.1 Introduction 271
16.2 Genetic or IPE syndromes 272
16.3 Medically refractory non-substrate-directed partial epilepsy 272
16.4 Conclusions 279
17 Surgical treatment 285
Cheolsu Shin
17.1 Introduction 285
17.2 The process of presurgical evaluation 286
17.3 Intracranial monitoring 287
17.4 Surgical procedures 289
17.5 Conclusion 294
Index 297
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“To summarize, this book can be used as a practical guide to the diagnosis and management of many of the common aspects of epilepsy. It is suitable for the general neurologist, non-neurologist or trainees who wants a quick review of a specific topic or a general survey of the whole field.” (Canadian Journal of Neurological Sciences, 1 November 2012)
