Concept Of Epilepsy Research Articles

Transient epileptic amnesia complex syndrome and epileptic cognitive impairment resembling Alzheimer's disease: Should the concept of epilepsy be extended?

Transient epileptic amnesia complex syndrome and epileptic cognitive impairment resembling Alzheimer's disease: Should the concept of epilepsy be extended?

Hippocratic Diagnosis, Solomonic Therapy, Roman Amulets: Epilepsy, Exorcism, and the Diffusion of a Jewish Tradition in the Roman World

Abstract Two contrasting portraits of exorcism in the Roman period for patients with symptoms consistent with epilepsy, drawn by Josephus (A.J. 8.45–47) and Lucian (Philops. §16), illustrate a substantial albeit contested diffusion of that ancient technique from the Jewish tradition to a wider Mediterranean public. The process is reflected in a similarly complex traditional background and textual composition of a group of inscribed Greek amulets for epilepsy. A sidelight on attitudes towards the practice of exorcism, on its way to wider popularity, and the conception of epilepsy is cast by these amulets, which have not yet been studied as a group. Their texts witness the application of precise Greek medical terminology, yet to an end, and in a compositional company, that authors in the Hippocratic tradition would have rejected. More generally, the artifacts offer a cross-section of amuletic practice and its diversity in the Roman and late ancient periods.

Peritoneum as an origin of epilepsy from the viewpoint of Avicenna.

There are studies that show that the concepts of epilepsy have been rooted in Persian medicine; Avicenna "Ibn-e-Sina"-one of the great Persian physicians in the Islamic golden age (9th-12th century AD)-has considered some types of epilepsy with the association of the stomach, the spleen, the "Maraqq," and the whole body which has not been reviewed properly. These organs influence on the brain and can cause epilepsy. This article presents concept of Maraqq-related epilepsy; according to Avicenna's view, "Maraqq" is a membranous structure which is located in the abdomen (equivalent of parietal peritoneum in current nomenclature). We discuss his viewpoint about the diagnosis and treatment of Maraqq-related epilepsy with focus on herbal remedies. The concept of a relationship between the "Maraqq" and the brain is well discussed in the old Persian medicine texts; however, it seems that further studies in this area are required to clarify Avicenna's view about the pathophysiological mechanisms, clinical manifestations, and treatment strategies.

The long-term development of public attitudes towards people with epilepsy in the Czech Republic: 1981, 1984, 1998 and 2009 studies

The long-term development of public attitudes towards people with epilepsy (PWE) was studied. Four questions (Q) used in Czech questionnaires for studies in 1981, 1984, 1998 and 2009 concerned: Q1, familiarity with the concept of epilepsy; Q2, tolerance towards children with epilepsy; Q3, whether epilepsy is considered to be a mental disease; and Q4, attitudes towards employment of PWE. The quality of information about epilepsy increased significantly between 1981 and 1998, 1981 and 2009, and 1998 and 2009. The 1981 and 1984 studies reflected a level of information inferior to the levels seen in Germany and the USA, and the difference had almost disappeared in 1998 and 2009. The long-term follow-up studies in Czech Republic displayed a permanent increase in knowledge about epilepsy. This may reflect the progress in the spread of information, the efforts of patient associations and specialists and perhaps also a change in general attitudes towards people with disabilities. The dramatic change of information levels in Czech surveys could also reflect the change of the political system in 1989. A question that remains to be answered is the extent to which the positive trend reflects positive attitudes in real life. The answers to questions concerning whether people would be willing to help a person having a seizure remain unsatisfactory. Greater efforts should be made to improve the situation of PWE and to minimize their stigmatization.

Epilepsie und Fahreignung: die neue Richtlinie

The Swiss Guideline concerning epilepsy and driving has recently been revised. Recommendations have changed significantly in several respects. Some modifications arise indirectly from a change in the overall concept of epilepsy. As a consequence of the application of the new ILAE definition and diagnostic criteria for epilepsy, there are now cases in which the diagnosis of epilepsy is established even after one single seizure. Furthermore, a concept of imminent epilepsy was introduced to identify patients without seizures, but with a high risk of a first seizure within twelve months. On the other hand, the concept of a "resolved epilepsy" was established to loosen driving regulations for longterm seizure-free patients. In addition, the new guideline provides differential recommendations for provoked vs. unprovoked seizures in several clinical constellations.

Sociocultural dimension of epilepsy: An anthropological study among Guaraní communities in Bolivia—An International League Against Epilepsy/International Bureau for Epilepsy/World Health Organization Global Campaign Against Epilepsy Regional Project

This study was performed to analyze sociocultural beliefs about epilepsy among Guaraní communities in Bolivia. People with epilepsy, their family members, the general population, and local health care personnel were interviewed about the meaning of and beliefs, feelings, and practices concerning epilepsy. Epilepsy is called mano-mano, a term that means being in a constant passage between life and death. The disease is attributed mainly to a failure to observe a fasting period and to other eating habits. Natural remedies are the most recommended treatments even though half of respondents reported that antiepileptic drugs may be effective. The concept of epilepsy as an embodied disease with natural causes appears to differ from that documented in other traditional societies. People with epilepsy do not represent a threat to the community, which seems to have an attitude aimed at their protection. Moreover, people from these communities appear to favor a combination of biomedical and traditional care systems.

The growing recognition of immunotherapy-responsive seizure disorders with autoantibodies to specific neuronal proteins

The concept of epilepsy and seizure disorders caused by autoantibodies to specific neuronal membrane proteins has developed significantly during the past few years. Antibodies to cell-surface membrane proteins such as voltage-gated potassium channels or N-methyl-D-aspartate receptors, or to glutamic acid decarboxylase, are found in patients with different forms of limbic encephalitis, and in a few patients with epilepsy as their main or only condition. Many of these patients do not show a good response to conventional antiepileptic drugs, but respond to immunotherapies. By contrast, studies of other antibodies in idiopathic forms of epilepsy, or epilepsy associated with systemic lupus erythematosus or coeliac disease, have not in general disclosed consistent, clinically helpful results. There are a growing number of specific antibodies associated with new onset epilepsy. These patients are likely to have an immune-mediated disorder that may benefit from immunotherapies. In autoimmune diseases such as systemic lupus erythematosus or coeliac disease, antibodies to specific membrane targets may also prove to be important in the future.

77. The transcultural concept of epilepsy in traditional beliefs

77. The transcultural concept of epilepsy in traditional beliefs

Spatiotemporal imaging of ‘generalized' seizure activity using MEG

Event Abstract Back to Event Spatiotemporal imaging of ‘generalized' seizure activity using MEG Pauly Ossenblok1*, Bert Kornips1, Hans Carpay2, Paul Boon1 and Gilles Van Luijtelaar3 1 Epilepsy Centre Kempenhaeghe, Netherlands 2 Tergooi Hospitals , Netherlands 3 Donders Center for Cognition, Netherlands Studies in the WAG/Rij rat [1] challenge the theory of primary generalized absence epilepsy by showing a crucial role for the cortex in generating the spike-and-wave discharges (SWDs). Association analysis of MEG signals recorded for children with absence epilepsy also demonstrated a focal onset region, followed by a recurrent pattern of regional activity during the spikes alternated by generalized activity during the slow-wave of the SWDs [2]. More recent findings of our study raised the question whether clinically distinct types of absence epilepsy differ by origin, while sharing a common corticothalamic network during the evolvement of the SWDs. The population studied (n=20; 6 – 14 years of age) ranges from patients with typical childhood absence epilepsy, who can be treated quite successfully with anti-epileptics, to more complex atypical forms and children who had absences and complex partial clinical features. For each of the seizures of these children the non-linear association analysis was performed, yielding both the dynamics of the SWDs and the regional distribution of the spikes, while the cortical origin of the SWDs was studied using advanced source analysis. The association analysis results of the SWDs indicated the involvement of mesiofrontal cortex and the bilateral frontal and temporoparietal regions during the spikes of the SWDs for each of the patients studied. However, the initial onset of the SWDs of the patients differing with regard to their clinical features may reflect either left or right frontal or temporoparietal regional activity or in case of complex partial semiology regional onset activity e.g. at the temporal lobe, a result which was in concordance with the dipole scan (MUSIC). If cortical structures activated before generalization can be identified for distinct subpopulations of absence epilepsy patients, this will change not only the concept of epilepsy, but also will improve the differential diagnosis of childhood absence epilepsy and may open new ways for treatment.

Commentary: The Epilepsy Diathesis

Commentary: The Epilepsy Diathesis

Epilepsy, psychiatry, and neurology

This article reviews the relationship between the psychiatry and neurology of epilepsy, especially in the last 100 years. Throughout most of its recorded history of 3 to 4 millennia epilepsy has been viewed as a supernatural or mental disorder. Although first suggested by Hippocrates in the 5th century B.C., the concept of epilepsy as a brain disorder only began to take root in the 17th and 18th centuries. The discipline of neurology emerged from "nervous disorders" or neuropsychiatry in the late 19th century, when vascular theories of epilepsy predominated. By the turn of the 19th century psychiatry and neurology were diverging and epilepsy remained to some extent in both disciplines. It was only in the middle of the 20th century with the development of electromagnetic theories of epilepsy that the concept of epilepsy per se as a neurological disorder was finally adopted in international classifications of disease. This was associated with a refined definition of the ictal, pre-, post-, and interictal psychological disorders of epilepsy, which have contributed to a renaissance of neuropsychiatry. At the beginning of the 21st century and the centenary of the ILAE psychiatry and neurology have been converging again, led in some respects by epilepsy, which has provided several useful models of mental illness and a bridge between the two disciplines.

Neuroprotection in epilepsy: the role of antiepileptic drugs

During the last 15 years, accumulating experimental and clinical evidence suggested that the epileptic brain may undergo significant modifications as a result of recurrent seizures or due to the underlying seizure etiology. This concept of epilepsy as an evolving neurodegenerative process is best exemplified by temporal lobe epilepsy. According to current thinking, in patients with temporal lobe epilepsy a triggering factor, such as complicated febrile seizures or head trauma, sets in motion the process of epileptogenesis, that is a cascade of events leading to a gradual increase of brain excitability and eventually the occurrence of spontaneous seizures. In a subset of patients, this process further evolves due to a complex interaction of neurodegenerative and neuroplastic changes brought about by recurrent seizures. At a clinical level, this evolving process becomes evident by the onset of pharmacoresistant epileptic seizures sometimes accompanied by cognitive decline. The current pharmacological treatment of epilepsy is directed towards suppressing epileptic seizures and therefore it is essentially a symptomatic approach. The recent unraveling of the cellular mechanisms underlying epileptogenesis, however, has led to the discovery of pharmacological agents with neuroprotective and antiepileptogenic properties, which include a number of clinically available antiepileptic drugs. These agents hold promise as disease modification strategies which may ultimately improve the long-term outcome of epileptic patients by mitigating cognitive compromise and preventing the transition to pharmacoresistance. This presentation reviews the available evidence regarding the neuroprotective properties of antiepileptic drugs and discusses some methodological difficulties in designing clinical trials with a view to investigating neuroprotective strategies in epilepsy. from International Society on Brain and Behaviour: 3rd International Congress on Brain and Behaviour Thessaloniki, Greece. 28 November – 2 December 2007

Acerca del concepto de epilepsia

This leading article is written bearing in mind the disparities between different texts and studies on epilepsy. These concern the concept and the definition of epilepsy, although there is now little disparity in the classification of crises and syndromes. We also consider the increasing tendency to include other disorders with their own names and characteristics within the concept of epilepsy. Many of these disorders are also characterized by mental retardation, dementia and neurological deterioration. This contributes to maintain the sombre, ominous concept implicit in the world 'epilepsy' for centuries and is a major factor in the social discrimination of people with epilepsy. We suggest a concept and definition of the disorder differentiating it from epileptic crises and other processes.

A Behaviour Medicine Approach to Epilepsy - Time for a Paradigm Shift?

The major contribution of the behavioural approach to the understanding and treatment of epilepsy has been the construction of a self-management model comprising: (i) recognition that external factors influence the occurrence and inhibition of the epileptic seizure and (ii) teaching people with epilepsy to recognize and utilize these factors to influence seizure occurrence. The behavioural medicine model regards the epileptic seizure as any behaviour, amenable to classical and operant conditioning. Part one of this paper presents a literature review of behavioural medicine treatment of people with epilepsy. Part two presents a study illustrating spontaneous means by which people with epilepsy predict, prevent and inhibit seizure occurrence. A total of 160 children and adults with refractory seizures were studied over a 10-year period. This study addresses the issues of which types of seizures or what categories of people with epilepsy might be more amenable to learning factors and thus respond to behavioural treatment. The need for a paradigm shift from the traditional medical concept of epilepsy to a behavioural medicine concept, as has been the case with chronic pain, is discussed.

Public awareness and attitudes towards epilepsy in the United Arab Emirates

The aim of this paper is to obtain an initial estimate of people awareness, attitudes and understanding towards epilepsy and to provide a basis for international comparisons. A cross-sectional study conducted during 1995 in Al-Ain City, Dubai and Sharjah Emirates, United Arab Emirates (UAE). We used a simple questionnaire following a two-stage sampling technique. A total of 1050 subjects aged 15 years and above were selected randomly. Of these a total of 892 individuals (86.4%) responded to the study. Seventy-five percent of respondents (665 people) had heard or read about epilepsy. Males and females were similarly familiar with the concept of epilepsy. The age group and education had a positive significant effect on awareness of epilepsy (p < 0.001). Thirty-four percent had occasionally seen a seizure. Nineteen suggested that there is not treatment. Those acquainted with a person with epilepsy were more likely to know that there is treatment. Among those familiar with epilepsy 18.5% believed in cautery and 40% believed in faith healing. A small percentage (7%) of respondents had objections to allowing their children associating with a person with epilepsy at school or in the playground; 68% objected to their children marrying an epileptic person; 10% believed that epileptic people should not be employed in jobs as other people are. In conclusion, unfortunately, knowledge, awareness and attitudes towards epilepsy in the UAE were less compared with surveys conducted in Western countries. The majority lacked information about the causes, nature and treatment of the disease.

Chapter 23 Involvement of glutamate in human epileptic activities

Publisher Summary Epilepsy may be described as a disruption of the normal balance between excitation and inhibition. Much effort has been devoted toward understanding the role of perturbations of the excitatory neurotransmitter glutamate. Glutamatergic abnormalities are well established for certain human epilepsies. In the past, elevated brain glutamate was found in the brain of a child who died because of the status epilepticus related to pyridoxine dependency; a genetic condition in which glutamic acid decarboxylase (GAD)—the enzyme that converts glutamate to gamma-aminobutyric acid (GABA)—does not function normally. In this patient, the effect of dysfunctional GAD could not be isolated from the effects of status epilepticus. Several antiepileptic drugs have anti-glutamatergic actions that may account for a part of their antiepileptic effects. Felbamate inhibits binding of glycine at the NMDA receptor. Lamotrigine and perhaps carbamazepine may decrease presynaptic glutamate release by blocking sodium and perhaps calcium channels. The concept of epilepsy as an excess of excitatory activity has made glutamate an appealing target for study. Most evidence of its involvement is indirect, as elevated glutamate levels in brain or cerebrospinal fluid (CSF) of individuals with frequent seizures could be a result of metabolic, rather than neurotransmitter, glutamate.

Concepts of Epilepsy

The word "epilepsy" refers to a group of disorders characterized by recurrent epileptic seizures. Differential diagnosis first requires distinction between epileptic seizures and the many systemic, neurologic, and psychiatric disorders associated with paroxysmal behaviors that might be mistaken for epilepsy. By definition, isolated epileptic seizures that occur as a natural reaction to a noxious insult are not sufficient evidence for a diagnosis of epilepsy. Many factors contribute to the appearance of an epileptic condition, including nonspecific predisposing factors that alter the threshold for epilepsy and specific epileptogenic disturbances that cause chronic epilepsy to become manifest in susceptible individuals, both of which can be either genetic or acquired. Endogenous or exogenous precipitating factors determine when specific ictal events occur. The many clinical expressions of epileptic seizures reflect the location and extent of the cerebral disturbance, as well as diverse fundamental mechanisms that involve alterations of excitatory and inhibitory influences, resulting in hyperexcitability, hypersynchronization, or both. The various forms of epilepsy and epileptic syndromes are defined by a constellation of signs and symptoms that include characteristic seizure types, other clinical features, and family history. Whereas treatment is largely based on seizure type, identification of a specific epileptic syndrome often provides additional insights into management and prognosis. An example of the usefulness of syndromic classification is the existence of surgically remediable syndromes that have a known poor prognosis with pharmacotherapy, but an excellent prognosis with surgical intervention. Research on underlying basic mechanisms of the epilepsies, particularly molecular genetics designed to identify specific biological defects in idiopathic epilepsies and invasive investigations carried out in the epilepsy surgery setting to elucidate the pathophysiology of symptomatic epilepsies, may reveal definitive substrates that will ultimately permit epileptic syndromes to be reclassified as diseases.

Development in Children??s Causal Theories of Their Seizure Disorders

Despite the prevalence of seizure disorders in children, little is known about how youngsters with epilepsy understand the cause of their disorder. Fifty children and adolescents with idiopathic seizure disorders, between 5- and 16-years-old, were questioned about the etiology of seizure episodes and of seizure disorders, as well as their understanding of physical causality, general illness causality, and brain functioning. Responses were scored for their conceptual complexity according to scales paralleling Piaget's stages of cognitive development. Older children had more cognitively sophisticated concepts of epilepsy than did younger children. Overall, however, children scored significantly lower on questions about their seizure disorders than on questions assessing their understanding of physical causality, general illness causality, and brain functioning. Many children had misconceptions about seizure disorders and lacked disease-related information; only 41% of the children identified epilepsy as a disease involving the brain. These findings underline the need for including educational intervention in the comprehensive care of pediatric seizure disorders.

Psychopathology in epilepsy. The role of psychology in altering paradigms of research, treatment, and prevention.

This article offers a brief review of the literature examining epilepsy and abnormal behavior. The generally accepted concept of epilepsy as a high psychiatric risk disorder is reexamined in light of research that has investigated the influence of selection bias. A conceptual model that organizes the known or postulated risk variables (neurological, psychosocial, and medication) is presented, with emphasis on psychology's potential contribution.

Basic Concepts in Epilepsy

Basic Concepts in Epilepsy