epilepsy
EPILEPSY
Epilepsy is a clinical multiaxial diagnosis.
Epileptic seizure is a transient occurrence of signs/symptoms brought about by abnormal excessive or synchronous neuronal activity in the brain.
It is recommended that all patients having a first seizure be referred as soon as possible to a specialist to ensure accurate and early diagnosis and initiation of treatment appropriate to the needs of the patients.
  1. American College of Emergency Physicians (ACEP) Clinical Policies Committee; Clinical Policies Subcommittee on Seizures. Clinical policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures. Ann Emerg Med. 2004 May;43(5):605-625. http://dx.doi.org/10.1016/j.annemergmed.2004.01.017. PMID: 15111920
  2. Blau JN. Epilepsy in adolescents and adults. Lancet. 2000 Nov;356(9242):1690. PMID: 11089857
  3. Berg AT, Scheffer IE. New concepts in classification of the epilepsies: entering the 21st century. Epilepsia. 2011 Jun;52(6):1058-1062. PMID: 21635233
  4. Berg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010 Apr;51(4):676-685. Accessed 17 Feb 2012. PMID: 20196795
  5. Blume WT. Diagnosis and management of epilepsy. CMAJ. 2003 Feb;168(4):441-448. http://www.cmaj.ca/content/168/4/441.full.pdf. PMID: 12591787
  6. Brodie MJ, Kwan P. Staged approach to epilepsy management. Neurology. 2002 Apr;58(8)(Suppl 5):S2-S8. PMID: 11971127
  7. Browne TR, Holmes GL. Epilepsy. N Engl J Med. 2001 Apr;344(15):1145-1151. http://www.nejm.org/doi/pdf/10.1056/NEJM200104123441507. PMID: 11297707
  8. Chen DK, So YT, Fisher RS. Use of serum prolactin in diagnosing epileptic seizures: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2005 Sep;65(5):668-675. http://www.neurology.org. PMID: 16157897
  9. Feely M. Fortnightly review: drug treatment of epilepsy. BMJ. 1999 Jan;318(7176):106-109. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114575/pdf/106.pdf. PMID: 9880286
  10. Curry WJ, Kulling DL. Newer antiepileptic drugs: Gabapentin, lamotrigine, felbamate, topiramate and fosphenytoin. Am Fam Physician. 1998 Feb;57(3):513-520. http://www.aafp.org. PMID: 9475899
  11. French JA, Kanner AM, Bautista J, et al. Efficacy and tolerability of the new antiepileptic drugs I: treatment of new onset epilepsy [Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society]. Neurol. 2004 Apr;62(8):1252-1260. https://www.aesnet.org/sites/default/files/file_attach/ClinicalResources/Guidelines/Neurology-2004-French-1252-60.pdf. PMID: 15111659
  12. Fisher RS, Boas WE, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy. Epilepsia. 2005 Apr;46(4):470-472. http://onlinelibrary.wiley.com/doi/10.1111/j.0013-9580.2005.66104.x/pdf. PMID: 15816939
  13. French JA, Kanner AM, Bautista J, et al. Efficacy and tolerability of the new antiepileptic drugs II: treatment of refractory epilepsy [Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society]. Neurol. 2004 Apr;62(8):1261-1273. http://www.neurology.org/content/62/8/1261.full.pdf+html. PMID: 15111660
  14. Lowenstein DH, Alldredge BK. Status epilepticus. N Engl J Med. 1998 Apr;338(14):970-976. http://www.nejm.org/doi/pdf/10.1056/NEJM199804023381407. PMID: 9521986
  15. French JA, Pedley TA. Initial management of epilepsy. N Engl J Med. 2008 Jul;359(2):166-176. PMID: 18614784
  16. Marik PE, Varon J. The management of status epilepticus. Chest. 2004 Aug;126(2):582-591. PMID: 15302747
  17. Meierkord H, Boon P, Engelsen B, et al. EFNS guideline on the management of status epilepticus in adults. Eur J Neurol. 2010 Mar;17(3):348-355. PMID: 20050893
  18. Meierkord H, Boon P, Engelsen B, et al. EFNS guideline on the management of status epilepticus. Eur J Neurol. 2006 May;13(5):445-450. http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2006.01397.x/epdf. PMID: 16722966
  19. Ulvi H, Yoldas T, Mungen B, et al. Continuous infusion of midazolam in the treatment of refractory generalized convulsive status epilepticus. Neurol Sci. 2002 Oct;23(4):177-182. PMID: 12536286
  20. Panayiotopoulos CP. General aspects on the diagnosis of epileptic seizures and epileptic syndrome and their treatment based on the new ILAE diagnostic scheme. Oxfordshire: Blandon Medical Publishing; 2010:172-199
  21. Uysal U, Fountain NB. Seizures and epilepsy in adolescents and adults. In: Bope ET, Kellerman R, Rakel RE. Conn's Current Therapy. Philadelphia: Saunders, an imprint of Elsevier; 2011
  22. MedWormhttp://www.medworm.com/rss/index.php/Neurology/25/http://www.medworm.com/rss/medicalfeeds/specialities/Neurology.xml
  23. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  24. Stokes T, Shaw EJ, Juare-Garcia A, et al. Clinical guidelines and evidence review for the epilepsies: diagnosis and management in adults and children in primary and secondary care. NICE. http://www.nice.org.uk. Oct 2004.
  25. Ministry of Health Singapore. Clinical practice guidelines: diagnosis and management of epilepsy in adults. http://www.moh.gov.sg. Dec 1999.
  26. Ministry of Health Singapore. Clinical practice guidelines: epilepsy in adults. MOH (Singapore). http://www.moh.gov.sg. Jan 2007.
  27. Epilepsy Council, Malaysian Society of Neurosciences. Consensus guidelines on the management of epilepsy. http://www.neuro.org.my. 2005.
  28. Scottish Intercollegiate Guidelines Network. Diagnosis and management of epilepsy in adults. SIGN website. http://www.sign.ac.uk. Apr 2003.
  29. National Institute for Health and Care Excellence. Newer drugs for epilepsy in adults. NICE website. http://www.nice.org.uk. Mar 2004.
  30. National Institute for Health and Care Excellence. Retigabine for the adjunctive treatment in partial onset seizures in epilepsy. NICE. http://www.nice.org.uk. Jul 2011
  31. National Institute of Neurological Disorders and Stroke. Seizures and epilepsy: hope through research. NINDS. http://www.ninds.nih.gov. 2001.
  32. National Institute for Health and Care Excellence. The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care. NICE website. http://www.nice.org.uk. Jan 2012. Accessed 12 May 2012.
  33. Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-482. doi: 10.1111/epi.12550. PMID: 24730690
  34. Glauser T, Menachem EB, Bourgeois B, et al. The ILAE subcommission of AED guidelines updated ILAE evidence review of antiepileptic drug efficacy & effectiveness as initial monotherapy for epileptic seizures & syndromes. Epilepsia. 2013 Mar;54(3):551-563. doi: 10.1111/epi.12074. Accessed 24 Feb 2015. PMID: 23350722
  35. Shih JJ, Tatum WO, Rudzinski LA. New drug classes for the treatment of partial onset epilepsy: focus on perampanel. Ther Clin Risk Manag. 2013;9:285-293. doi: 10.2147/TCRM.S37317. Accessed 18 Mar 2015. PMID: 23874099
  36. Glauser T, Shinnar S, Gloss D, et al. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr. 2016 Jan;16(1):48-61. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4749120/pdf/i1535-7511-16-1-48.pdf. Accessed 11 Apr 2016. PMID: 26900382
  37. Grover EH, Nazzal Y, Hirsch LJ. Treatment of convulsive status epilepticus. Curr Treat Options Neurol. 2016 Mar;18(3):11. doi: 10.1007/s11940-016-0394-5. PMID: 26920416
  38. Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International League Against Epilepsy (ILAE): position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017 Apr;58(4):522-530. doi: 10.1111/epi.13670. PMID: 28276060
  39. Krumholz A, Wiebe S, MD, Gronseth GS, et al. Evidence-based guideline: management of an unprovoked first seizure in adults: report of the Guideline Development Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2015 Apr;84(16):1705-1713. doi: 10.1212/WNL.0000000000001487. PMID: 25901057
  40. Krumholz A, Wiebe S, MD, Gronseth GS, et al. Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007 Nov;69(21):1996-2007. doi: 10.1212/01.wnl.0000285084.93652.43. PMID: 18025394
  41. Scheffer IE, Berkovic S, Capovilla G, et al. International League Against Epilepsy (ILAE) classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017 Apr;58(4):512-521. doi: 10.1111/epi.13709. PMID: 28276062
Editor's Recommendations
Most Read Articles
Tristan Manalac, 22 Mar 2018
The prevalence rates of diabetes mellitus (DM) and dyslipidaemia are higher in long-stay inpatients with schizophrenia than in the general population, a recent Singapore study has shown. Despite this, the two conditions appear to be well-controlled, possibly because of the supervised diets and regular physical activities that inpatients receive.