Adult Epilepsy - G. Cascino, J. Sirven (Wiley-Blackwell, 2011) WW

306 Pages·2011·11.96 MB·English

Adult Epilepsy

Adult Epileps y, F irs t Edition. Edited by G regory D . C as cino and J os eph I. S irven.
© 2011 J ohn Wiley & Sons , Ltd. P ublis hed 2011 by J ohn Wiley & Sons , Ltd. ISBN: 978-0-470-74122-1

Adult Epilepsy

Edited by Gregory D. Cascino and Joseph I. Sirven
Mayo Clinic College of Medicine, USA

A John Wiley & Sons, Ltd., Publication

This edition first published 2011, © 2011 John Wiley & Sons Ltd.

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Library of Congress Cataloging-in-Publication Data

Adult epilepsy / edited by Gregory Cascino and Joseph Sirven.
p. ; cm.
Includes bibliographical references.
ISBN 978-0-470-74122-1 (cloth)
1.
Epilepsy. 2.
Adult. I.
Cascino, Gregory. II.
Sirven, Joseph I.
[DNLM: 1.
Epilepsy. 2.
Adult. WL 385]
RC372.A44 2010
616.8′53—dc22
2010037013

A catalogue record for this book is available from the British Library.

This book is published in the following electronic formats: ePDF: 978-0-470-97502-2; Wiley Online
Library: 978-0-470-97503-9; ePub: 978-0-470-97619-7

Set in 10.5/13pt Times Roman by Laserwords Private Limited, Chennai, India

First Impression
2011

This book is dedicated to our spouses Teresa Griffin Cascino and Joan
Sirven who have been so gracious of their efforts and remarkable talents
to support our personal and professional careers.

Contents

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

viii
CONTENTS

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

CONTENTS
ix

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

x
CONTENTS

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

CONTENTS
xi

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