Epilepsy

Abstract

To provide a critical review of studies published between December 2005 and November 2006, and detect the advances of basic and clinical research in epilepsy. The complexity of the mechanisms underlying epileptogenesis and drug resistance was repeatedly highlighted. Seizure diagnosis and classification are still difficult, despite the use of valid and reliable instruments. Even well defined epilepsy syndromes may exhibit complex genetic patterns and atypical electroencephalogram features. Low prevalence rates of active epilepsy have been reported from several countries, suggesting underreporting for sociocultural reasons. Several pregnancy and neonatal factors can be found to increase the risk of epilepsy when accurate data are available from well defined populations. Early remission of seizures does not always predict terminal remission after prolonged follow-up. Cognitive regression may be associated with the presence of interictal electroencephalographic epileptiform abnormalities. A Cochrane review showed lamotrigine to be less frequently withdrawn than carbamazepine. However, these findings are contrasted by clinical practice, which showed no individual drug to be more likely to confer seizure freedom than any other. Recent research highlights the complexity of the mechanisms of epileptogenesis and drug response, and the difficulties with the classification of epilepsy into separate phenotypic categories.