Epilepsy
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
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
- ↑ Epilepsy. MedlinePlus, U.S. National Library of Medicine and National Institutes of Health.
- ↑ Adams RD, Victor M, Ropper AH. (1998). Principles of neurology. 6th ed. New York: McGraw-Hill, Health Professions Division. ISBN 0070005141.
- ↑ National Library of Medicine. Epilepsy. Retrieved on 2008-05-23.
- ↑ 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
- ↑ 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]