Epilepsy and Related Disorders

2018 ◽  
Author(s):  
Barbara Dworetzky ◽  
Jong Woo Lee
Keyword(s):  
Differential Diagnosis ◽  
Generic Drugs ◽  
Sudden Change ◽  
Epileptic Seizures ◽  
Quality Measures ◽  
The Elderly ◽  
Childhood And Adolescence ◽  
Nonepileptic Seizures ◽  
Infancy And Early Childhood ◽  
The Brain

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy.  This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures

Epilepsy and Related Disorders

2018 ◽  
Author(s):  
Barbara Dworetzky ◽  
Jong Woo Lee
Keyword(s):  
Differential Diagnosis ◽  
Generic Drugs ◽  
Sudden Change ◽  
Epileptic Seizures ◽  
Quality Measures ◽  
The Elderly ◽  
Childhood And Adolescence ◽  
Nonepileptic Seizures ◽  
Infancy And Early Childhood ◽  
The Brain

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy.  This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures

Epilepsy and Related Disorders

2019 ◽  
Author(s):  
Barbara Dworetzky ◽  
Jong Woo Lee
Keyword(s):  
Differential Diagnosis ◽  
Generic Drugs ◽  
Sudden Change ◽  
Epileptic Seizures ◽  
Quality Measures ◽  
The Elderly ◽  
Childhood And Adolescence ◽  
Nonepileptic Seizures ◽  
Infancy And Early Childhood ◽  
The Brain

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy.  This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures

Epilepsy and Related Disorders

2018 ◽  
Author(s):  
Barbara Dworetzky ◽  
Jong Woo Lee
Keyword(s):  
Differential Diagnosis ◽  
Generic Drugs ◽  
Sudden Change ◽  
Epileptic Seizures ◽  
Quality Measures ◽  
The Elderly ◽  
Childhood And Adolescence ◽  
Nonepileptic Seizures ◽  
Infancy And Early Childhood ◽  
The Brain

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy.  This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures

Epilepsy and Related Disorders

2018 ◽  
Author(s):  
Barbara Dworetzky ◽  
Jong Woo Lee
Keyword(s):  
Differential Diagnosis ◽  
Generic Drugs ◽  
Sudden Change ◽  
Epileptic Seizures ◽  
Quality Measures ◽  
The Elderly ◽  
Childhood And Adolescence ◽  
Nonepileptic Seizures ◽  
Infancy And Early Childhood ◽  
The Brain

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy.  This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures

scholarly journals Neuropsychological aspects of psychogenic nonepileptic seizures

2007 ◽  
Vol 13 (4 suppl 1) ◽  
pp. 24-27
Author(s):  
Mirna Wetters Portuguez ◽  
Danielle Irigoyen da Costa ◽  
Sabine Possa Marroni ◽  
Vanessa Pagliarini ◽  
Karin Vieira
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Multidisciplinary Team ◽  
Emotional Abuse ◽  
Epileptic Seizures ◽  
Mental Processes ◽  
Psychogenic Nonepileptic Seizures ◽  
Therapeutic Procedures ◽  
Nonepileptic Seizures ◽  
The Brain

Psychogenic nonepileptic seizures (PNES) may be defined as paroxysmal changes in behavior that are similar to epileptic seizures but are not associated with quantifiable alterations in the electrical activity of the brain. At the Epilepsy Surgery Program (ESP) of the São Lucas Hospital at PUCRS (HSL-PUCRS), we studied 52 individuals (37 females and 15 males) with a diagnosis of PNES, associated (57%) or not (23%) with refractory epileptic seizures. We found emotional abuse (100%), physical abuse (80%), emotional neglect (80%), physical negligence (70%) and sexual abuse (30%), mood (40%) and anxiety disorders (50%), as the main psychological components in such population. Although the medical and psychosocial impact of PNES can be estimated as significant, the absence of specialized services for its treatment is striking. Multiple diagnostic and therapeutic procedures and the participation of a specialized multidisciplinary team – where neuropsychology functions as a link between the mental processes/psychopathologies and the brain – are required to ensure proper management of such cases.

#3079 Investigating the feasibility of automating the differential diagnosis of transient loss of consciousness

2021 ◽  
Vol 92 (8) ◽  
pp. A7.1-A7
Author(s):  
Nathan Pevy ◽  
Heidi Christensen ◽  
Traci Walker ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Random Forest ◽  
Epileptic Seizures ◽  
The Other ◽  
Future Research ◽  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Audio Recordings ◽  
Transient Loss ◽  
Nonepileptic Seizures

BackgroundThere are three common causes of Transient Loss of Consciousness (TLOC), syncope, epileptic and psychogenic nonepileptic seizures (PNES). Many individuals who have experienced TLOC initially receive an incorrect diagnosis and inappropriate treatment. Whereas syncope can be distinguished from the other two causes relatively easily with a small number of yes/no questions, the differentiation of the other two causes of TLOC is more challenging. Previous qualitative research based on the methodology of Conversation Analysis has demonstrated that epileptic and nonepileptic seizures are described differently when patients talk to clinicians about their TLOC experiences. One particularly prominent difference is that epileptic seizure descriptions are characterised by more formulation effort than accounts of nonepileptic seizures.AimThis research investigates whether features likely to reflect the level of formulation effort can be automatically elicited from audio recordings and transcripts of speech and used to differentiate between epileptic and nonepileptic seizures.MethodVerbatim transcripts of conversations between patients and neurologists were manually produced from video and audio recordings of interactions with 45 patients (21 epilepsy and24 PNES). The subsection of each transcript containing the patients account of their first seizure was manually extracted for the analysis. Seven automatically detectable features were designed as markers of formulation effort. These features were used to train a Random Forest machine learning classifier.ResultsThere were significantly more hesitations and repetitions in descriptions of first epileptic than nonepileptic seizures. Using a nested leave-one-out cross validation approach, 71% of seizures were correctly classified by the Random Forest classifier.ConclusionsThis pilot study provides proof of principle that linguistic features that have been automatically extracted from audio recordings and transcripts could be used to distinguish between epileptic seizures and PNES and thereby contribute to the differential diagnosis of TLOC. Future research should explore whether additional observations can be incorporated into a diagnostic stratification tool. Moreover, future research should explore the performance of these features when they have been extracted from transcripts produced by automatic speech recognition and when they are combined with additional information provided by patients and witnesses about seizure manifestations and medical history.

scholarly journals Differential diagnosis between epileptic seizures and psychogenic nonepileptic seizures based on semiology

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Xiaohui Xiang ◽  
Jiajia Fang ◽  
Yi Guo
Keyword(s):  
Differential Diagnosis ◽  
Clinical Signs ◽  
Epileptic Seizures ◽  
Signs And Symptoms ◽  
Standard Test ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures ◽  
Clinical Signs And Symptoms ◽  
Symptoms And Signs ◽  
Synchronous Recording

Abstract Psychogenic nonepileptic seizures present as paroxysmal symptoms and signs mimicking epileptic seizures. The gold standard test is the synchronous recording by video, electrocardiogram and electroencephalogram. However, video electroencephalogram is not available at many centers and not entirely independent of semiology. Recent studies have focused on semiological characteristics distinguishing these two circumstances. Clinical signs and symptoms provide important clues when making differential diagnosis. The purpose of this review is to help physicians differentiating psychogenic nonepileptic seizures better from epileptic seizures based on semiology, and improve care for those patients.

scholarly journals Symptomatic Epileptogenic Lesions

PRILOZI ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 45-52
Author(s):  
Tatjana Chepreganova-Changovska ◽  
Dragana Petrovska-Cvetkovska ◽  
Marija Srceva-Jovanovski ◽  
Venko Filipce
Keyword(s):  
Hippocampal Sclerosis ◽  
Epileptic Seizures ◽  
The Elderly ◽  
Seizure Type ◽  
Mri Findings ◽  
Outpatient Unit ◽  
Neurology Clinic ◽  
Symptomatic Epilepsy ◽  
Post Traumatic ◽  
The Brain

Abstract Background and objectives: The main aim of this study is to prove the association of seizure types with the MRI findings of the brain (etiological factor). Also, to prove which type of lesion is mostly represented in which age-group, and with which type of seizure. Methods: A total of 100 patients with symptomatic epilepsy, aged from 16 to 80 years, were hospitalized at the Neurology Clinic or in its Outpatient Unit, in the period from 2009 to 2012. They were neurologically examined and the seizure type registered. All patients underwent MRI of the brain. Results: (56%) men and 44 (44%) women were examined. The represented type of epileptic seizures were 41.0% with SPC + CPC, followed by 15.0% GTCC, and 14.0% CPC with secondary generalization, 12,0% CPC, 10,0% SPC and 8.0% with absences. The epileptic lesions of 25.0% were hippocampal sclerosis, 20.0% post-traumatic injuries, 19.0%, post-vascular and brain tumours, and the lowest percentage of 17.0% with post-infectious lesions. Conclusions: Post-traumatic lesions occur more frequently in the elderly population with the accent on the male, while hippocampal sclerosis occurs in the adolescent and younger population with higher frequency in the female.

scholarly journals Pszichogén nem epilepsziás rosszullétek a klinikai gyakorlatban

2016 ◽  
Vol 157 (20) ◽  
pp. 767-775 ◽  
Author(s):  
Bernadett Szita ◽  
Zoltán Hidasi
Keyword(s):  
Behavioral Therapy ◽  
Early Adulthood ◽  
Epileptic Seizures ◽  
Pharmacological Interventions ◽  
Psychogenic Nonepileptic Seizures ◽  
Traumatic Life Events ◽  
High Prevalence ◽  
Nonepileptic Seizures ◽  
The Brain ◽  
Video Eeg

Psychogenic nonepileptic seizures are enigmatic disorders at the interface of neurology and psychiatry. Seizures resemble epileptic seizures but are not associated with electrical discharges in the brain. Symptoms typically start in early adulthood and women are far more affected than men. Video-EEG is widely considered to be the gold standard for diagnosis. Still psychogenic nonepileptic seizures are often misdiagnosed and treated as epilepsy for years that is burdensome to patients and costly to the healthcare system. Patients having psychogenic nonepileptic seizures show a high prevalence of traumatic life events, therefore, psychosocial factors are thought to play an important role in the etiology. Neurobiological factors may also contribute to the development of seizures as a subgroup of patients are characterized by cognitive impairment and subtle structural and functional brain abnormalities. Treatment includes psychotherapeutic procedures, particularly cognitive behavioral therapy and additional pharmacological interventions. This article presents an overview of the clinical context, diagnosis, etiology and treatment of psychogenic nonepileptic seizures. Orv. Hetil., 2016, 157(20), 767–775.

scholarly journals Pseudoseizure with Pseudo-ventricular Tachycardia

2018 ◽  
Vol 04 (01) ◽  
pp. 28
Author(s):  
Ozlem Karabulut ◽  
Ozcan Ozeke ◽  
Ilke Erbay ◽  
Ertan Ekici ◽  
Serkan Cay ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Body Movement ◽  
Epileptic Seizures ◽  
Clinical History ◽  
Careful Analysis ◽  
Interesting Case ◽  
Psychological Disturbance ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures ◽  
The Brain

Psychogenic nonepileptic seizures (PNES), or pseudoseizures, are paroxysmal episodes that resemble, and are often misdiagnosed as, epileptic seizures; however, they are psychological (i.e., emotional, stress-related) in origin. Unlike epileptic seizures, PNES do not result from an abnormal electrical discharge from the brain; they are a physical manifestation of a psychological disturbance. We present an interesting case of PNES with pseudo-ventricular tachycardia due to body movement related artefacts. A careful analysis of the whole 12-lead electrocardiogram is required to rule out an artefact-related appearance of ventricular tachycardia. Correct interpretation of electrocardiograms and their co-relation to clinical history and presentation is key.

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