Epilepsy

From Citizendium
Revision as of 19:23, 23 May 2008 by imported>Anthony.Sebastian
Jump to navigation Jump to search
This article is developing and not approved.
Main Article
Discussion
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
Catalogs [?]
 
This editable Main Article is under development and subject to a disclaimer.

People who have epilepsy suffer from a abnormality of their brain that causes them to have seizures — generalized convulsions of their body (muscle spasms) or more subtle mental or physical behavioral disturbances lasting from seconds to minutes and typically recurring at varying intervals.[1] Some types of seizures manifest as strange sensations or emotional states, and others, unconsciousness.

In technical terms, the U.S. National Library of Medicine, citing Adams et al.,[2] defines epilepsy as "a disorder characterized by recurrent episodes of paroxysmal brain dysfunction due to a sudden, disorderly, and excessive neuronal discharge. Epilepsy classification systems are generally based upon: (1) clinical features of the seizure episodes (e.g., motor seizure), (2) etiology (e.g., post-traumatic), (3) anatomic site of seizure origin (e.g., frontal lobe seizure), (4) tendency to spread to other structures in the brain, and (5) temporal patterns."[3]

Classification

Benign neonatal epilepsy

Partial epilepsy

Febrile seizures

Generalized epilepsy

Landau-Kleffner syndrome

Myoclonic epilepsy

Post-traumatic epilepsy

Reflex epilepsy

Status epilepticus

For more information, see: Status epilepticus.


Treatment

A randomized controlled trial concluded:[4][5]

  • For idiopathic generalised epilepsy or difficult to classify epilepsy, "valproate remains the clinically most effective drug, although topiramate may be a cost-effective alternative for some patients".
  • For partial seizures, "lamotrigine may be a clinical and cost-effective alternative to the existing standard drug treatment, carbamazepine"

References

  1. Epilepsy. MedlinePlus, U.S. National Library of Medicine and National Institutes of Health.
  2. Adams RD, Victor M, Ropper AH. (1998). Principles of neurology. 6th ed. New York: McGraw-Hill, Health Professions Division. ISBN 0070005141.
  3. National Library of Medicine. Epilepsy. Retrieved on 2008-05-23.
  4. Marson AG, Al-Kharusi AM, Alwaidh M, et al (2007). "The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial". Lancet 369 (9566): 1016–26. DOI:10.1016/S0140-6736(07)60461-9. PMID 17382828. Research Blogging. ACP Journal Club summary
  5. Marson AG, Appleton R, Baker GA, et al (2007). "A randomised controlled trial examining the longer-term outcomes of standard versus new antiepileptic drugs. The SANAD trial". Health technology assessment (Winchester, England) 11 (37): 1–154. PMID 17903391[e]

See also