This is the second edition of this book, the first edition of which is already “the” reference book in epilepsy. The editors, together with 5 associate editors and a. Written and edited by world-renowned authorities, this three-volume work is, to quote a reviewer, "the definitive textbook about seizures and. Epilepsy: A Comprehensive Textbook. Edited by Jerome Engel, Jr, and Timothy A . Pedley. Philadelphia, Lippincott–Raven, 3, pp (3.

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𝗣𝗗𝗙 | On Apr 1, , S Wiebe and others published Epilepsy: A comprehensive textbook on CD-ROM. Written and edited by world-renowned authorities, this three-volume work is, to quote a reviewer, "the definitive textbook about seizures and epilepsy". A comprehensive textbook about epilepsy and its management. Worldwide, more than 50 million people are affected by epilepsy, and their.

Approaches to refractory epilepsy

This article has been cited by other articles in PMC. Patients are considered to have refractory epilepsy if disabling seizures continue despite appropriate trials of two antiseizure drugs, either alone or in combination.

At this point, patients should be referred to multidisciplinary epilepsy centers that perform specialized diagnostic testing to first determine whether they are, in fact, pharmacoresistant, and then, if so, offer alternative treatments.

Apparent pharmacoresistance can result from a variety of situations, including noncompliance, seizures that are not epileptic, misdiagnosis of the seizure type or epilepsy syndrome, inappropriate use of medication, and lifestyle issues.

For patients who are pharmacoresistant, surgical treatment offers the best opportunity for complete freedom from seizures.

Epilepsy Board Review

Surgically remediable epilepsy syndromes have been identified, but patients with more complicated epilepsy can also benefit from surgical treatment and require more specialized evaluation, including intracranial EEG monitoring.

For patients who are not surgical candidates, or who are unwilling to consider surgery, a variety of other alternative treatments can be considered, including peripheral or central neurostimulation, ketogenic diet, and complementary and alternative approaches.

When such alternative treatments are not appropriate or effective, quality of life can still be greatly improved by the psychological and social support services offered by multidisciplinary epilepsy centers. A major obstacle remains the fact that only a small proportion of patients with refractory epilepsy are referred for expert evaluation and treatment.

Among primary disorders of the brain, it is equivalent to depression and other affective disorders, Alzheimer's disease and other dementias, and substance abuse. Ten percent of the world's population will have at least one seizure during their lifetime and one-third of these will develop epilepsy at any given time.


Treatment objectives for epilepsy are no seizures, and no side effects, as soon as possible. Early effective interventions provide the best opportunity to prevent adverse psychological and social consequences of recurrent seizures, progressive deficits that lead to irreversible disability, and premature death.

In particular, seizures that interfere with school, work, and interpersonal relationships, during adolescence and early adulthood, prevent the acquisition of vocational and social skills necessary to live independently.

When available treatments with the potential to eliminate disabling seizures are delayed for instance, in the United States the average time from onset of epilepsy to surgery is 22 years[ 5 ] , patients who do become seizure free often cannot be rehabilitated and remain dependent on their families and society.

Early identification of pharmacoresistant epilepsy and institution of alternative treatments can prevent a lifetime of disability. The best predictor of pharmacoresistance is failure of the first antiseizure drug, due to efficacy and not intolerance. Of the latter, there are conditions that are remediable but require specialized diagnostic and therapeutic approaches, and conditions that are not remediable and require supportive care. Early distinction between the two is critical in maximizing quality of life.

About this book This concise text mirrors the content of the Epilepsy Board as distributed by the American Board of Psychiatry and Neurology. Show all.

Pages Status Epilepticus Klein, Pavel Pages Dietary Therapies Kao, Amy Pages Neuroimaging in Epilepsy Singh, Anuradha et al.

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Say you need to know about the significance of epileptiform discharges found in the electroencephalogram of a non-epileptic person. A quick glance at the entries shows a section on this topic, complete with an adequately referenced table summarising the results of the most relevant evidence.Log out of ReadCube.

Epilepsy: A comprehensive textbook

It is of primary interest to child neurologists caring for children with epilepsy, but pediatricians, pharmacists, neurosurgeons, neuropsychologists, and other allied health professionals caring for children with epilepsy will find this an invaluable reference. The image viewer is equipped with a zoom facility that provides good access to the many figures.

Returning user. Changes in the diet over the years have made it more palatable. Forgot your password? Section VI Epilepsy Surgery and Neurostimulation provides an overview of presurgical evaluation the range of surgical options available, and outcomes of epilepsy surgery, but does not provide details of surgical technique. Table 2 Open in a separate window Neocortical resections are always tailored, in which case the presurgical evaluation must not only localize, but also determine the extent of the epileptogenic region.

An additional chapter is nearly entirely devoted to vagal nerve stimulation therapy, which seems appropriate for a textbook geared to child neurologists, but other surgical options are only briefly touched upon.

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