Epilepsy (often referred to as a seizure disorder) is a chronic neurological condition characterized by recurrent unprovoked seizures. The condition is named from the Greek epilepsis ("to take a firm grip on"). It is commonly controlled with medication, although surgical methods are used as well.

Diagnosis

The diagnosis of epilepsy requires the presence of recurrent, unprovoked seizures; accordingly, it is usually made based on the medical history. EEG, brain MRI, SPECT, PET, and magnetoencephalography may be useful to discover an etiology for the epilepsy, discover the affected brain region, or classify the epileptic syndrome, but these studies are not useful in making the initial diagnosis.

Long-term video-EEG monitoring for epilepsy is the gold standard for diagnosis, but it is not routinely employed owing to its high cost and inconvenience. It is, however, sometimes used to distinguish psychogenic non-epileptic seizures from epilepsy.

Convulsive or other seizure-like activity, non-epileptic in origin, can be observed in many other medical conditions, including:

psychogenic non-epileptic seizures (often wrongly called "pseudoseizures")
tics
syncope (fainting)
narcolepsy
cataplexy
parasomnias
breath-holding spells of childhood
non-epileptic myoclonus
hypoglycemia and associated neuroglycopenia
opsoclonus
hyperekplexia
paroxysmal kinesiogenic dyskinesia
infantile gratification / masturbation (onanism)
repetitive behaviors

Neurologists are often called upon to distinguish among the above diagnoses and epilepsy.

Epilepsies are classified five ways:

By their first cause (or etiology).
By the observable manifestations of the seizures, known as "semiology."
By the location in the brain where the seizures originate.
As a part of discrete, identifiable medical syndromes.
By the event that triggers the seizures, as in primary reading epilepsy.

Causes

All the causes (or etiologies) of epilepsy are not known, but many predisposing factors have been identified, including brain damage resulting from malformations of brain development, head trauma, neurosurgical operations, other penetrating wounds of the brain, brain tumor, high fever, bacterial or viral encephalitis, stroke, intoxication, or acute or inborn disturbances of metabolism. Hereditary or genetic factors also play a role.

Seizures may occur in any person under certain circumstances, including acute illness and drug overdoses, but these provoked seizures are not part of the definition of epilepsy. Epilepsy connotes that an individual has unprovoked seizures which recur over time. In about 50% of all cases, there is no cause for epilepsy that is currently detectable even with state of the art investigations. In about 50% of cases, evidence of a brain injury, scar or malformation is found, to which the epilepsy is attributed. In many, but not all cases, abnormal electrical activity can be detected in the brain with an electroencephalogram (EEG), either during or in between seizures.

Read more at Wikipedia.org

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Complementary and Alternative Therapies for Epilepsy
From Alternative Medicine Review, 9/1/05 by Steve Helms

Complementary and Alternative Therapies for Epilepsy

Orrin Devinsky, MD, Steven Schachter, MD, and Steven pacia, MD (eds) Demos Medical Publishing, 386 Park Avenue South, New York, NY 10016 www.demosmedpub.com ISBN 1-888799-89-7; Hardcover; 330 pages; $79.95

Complementary and Alternative Therapies for Epilepsy reports the perspective of many professionals (MD, ND, DO, DC, PhD) in treating this confounding nervous system pathology. Therapeutics are covered in 31 chapters that range in diversity from neurofeedback, meditation, acupuncture, hyperbaric oxygen, hormones, and manipulation, to music, art and pet therapies. Each chapter is organized at the author's discretion, includes a foundational review of the treatment modality, and maintains a brief position paper written by the editors (a commentary section) that describes each modality's application in modern medicine. Presenting the modalities that have scientific efficacy, their application, and for whom they best apply is the stalwart focus of Complementary and Alternative Therapies for Epilepsy.

An evidence-based approach is noted throughout the text and highlights the academic occupations of the editors. The introductory chapters clarify the distinctions between different study methods and explain the validity of scientific studies. Of note is the chapter regarding the over-reporting of double-blind studies.

The broad range of modalities are grouped into seven distinct sections. All physicians will benefit from the knowledge of the use of meditation, exercise, and the ketogenic diet in epilepsy, while incorporating other therapies into patient care may necessitate referral. The chapter on herbal therapy also covers herb-drug interactions, while the chapter entitled, Comprehensive Neurobehavioral Approach, highlights the 12 essential steps for patients seeking control of their epilepsy. Numerous approaches to promoting endocrine regulation are also discussed, as this appears to play a part in seizure frequency and severity in some women.

Unfortunately, the information is sometimes presented at a rudimentary level and therefore the text should not be confused with a protocol-specific resource. Nonetheless, Complementary and Alternative Therapies for Epilepsy is a helpful and necessary text toward the relief of epileptic suffering. It will be of great benefit to practitioners trying to review epilepsy treatment options and acquire appreciation for a fitting patient referral. Overall, the text does a great service to medicine by acting as a bridge for skeptical physicians and even hospital and insurance administrators, while also presenting an overview of modalities not often discussed given society's focus on the immediate results of pharmacological drugs and surgery. Successful epilepsy treatments are a great persuader.

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