110 puzzling cases of epilepsy by Dieter Schmidt, Steven C. Schachter

By Dieter Schmidt, Steven C. Schachter

From pediatric to the aged, from contractible to refractive, epilepsy is an affliction that manifests in lots of kinds and throughout a number of demographics. during this interesting quantity, the writer info multiple hundred circumstances the place healthiness care practitioners confronted strange demanding situations in treating the sickness. All points of epilepsy are explored via those circumstances, from the occasionally complicated preliminary analysis to sufferer responses and remedy equipment. during this best-selling brief textual content, the writer additionally provides the teachings realized from those remarkable instances. one hundred ten complicated circumstances in Epilepsy turns out to be useful for clinical scholars, citizens and all wellbeing and fitness care practitioners, because the practices used to appreciate those instances might be utilized to different diagnoses to boot.

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Ictal recordings, which were initially obscured by muscle artifacts, were characterized by theta-wave activity over the right temporal lobe. Magnetic resonance imaging (MRI) scans were negative but positron emission tomography demonstrated right temporal hypometabolism consistent with the localization of hyperperfusion during an ictal single photon emission computed tomography examination. 1: Intracranial recording of the initial part of a complex partial seizure. Channel 8 shows low-amplitude fast activity in the anterior cingulate gyrus before and during a fast spread of seizure activity to the left hippocampus (channel 7) and right hippocampus (channel 5).

Classifying patients by epilepsy syndrome will result in the choice of proper antiepileptic drugs and can even avoid unnecessary imaging procedures. Thirdly, seizures in certain epilepsy syndromes such as juvenile myoclonic epilepsy can be refractory to inappropriate antiepileptic drugs or can be made more frequent, as in this case. Carbamazepine is a commonly used drug to initiate treatment in young people with generalized tonic–clonic seizures but it can exacerbate seizures in patients with juvenile myoclonic epilepsy.

Therefore, if results from non-invasive examinations are consistent with temporal lobe epilepsy but are not backed by MRI studies, the search for another possible seizure focus should continue and should always include the anterior cingulate gyrus. Further reading Devinsky O, Morrell M, Vogt BA. Contributions of anterior cingulate gyrus to behavior. Brain 1995;118:279–306. Grunwald Th, Kurthen M, Elger CE. Predicting surgical outcome in epilepsy: how good are we? In: Schmidt D, Schachter SC, eds.

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