Copyright
ELSEVIER (Source: Neurologic Clinics)
Source: Neurologic Clinics - October 19, 2022 Category: Neurology Source Type: research
Contributors
RANDOLPH W. EVANS, MD (Source: Neurologic Clinics)
Source: Neurologic Clinics - October 19, 2022 Category: Neurology Source Type: research
Contents
Steven C. Schachter (Source: Neurologic Clinics)
Source: Neurologic Clinics - October 19, 2022 Category: Neurology Source Type: research
Forthcoming Issues
Outpatient Neurology (Source: Neurologic Clinics)
Source: Neurologic Clinics - October 19, 2022 Category: Neurology Source Type: research
Management of Psychiatric Symptoms in Dementia
Behavioral and Psychological Symptoms of Dementia (BPSD) are frequent, may start early in the disease and increase in frequency and severity over time. BPSD may be associated with medical, social, emotional, and environmental factors and potential triggers should be eliminated. Each BPSD has a unique anatomic and neurochemical profile that may help in making a diagnosis and choosing a therapy. Structured management plans help create an effective framework. Treatment options are understudied and the evidence is inconclusive for many of the pharmacological interventions. Effective nonpharmacological options should be utilize...
Source: Neurologic Clinics - October 17, 2022 Category: Neurology Authors: Yavuz Ayhan, Selam A. Yoseph, Bruce L. Miller Source Type: research
Telemedicine and Epilepsy Care
Telemedicine is a method of health care delivery well suited for epilepsy care, where there is an insufficient supply of trained specialists. The telemedicine “Hub and Spoke” approach allows patients to visit their local health clinic (‘Spokes’) to establish appropriate care and monitoring for their seizure disorder or epilepsy, and remotely connect with epileptologists or neurologists at centralized centers of expertise (‘Hubs‘). The COVID-19 pandemic resulted in an expansion of telemedicine capabilities and use, with favorable patient and provider experience and outcomes, allowing for its wide scale adoption ...
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Bruce Lavin, Cloe L. Gray, Martin Brodie Source Type: research
The Potential of Wearable Devices and Mobile Health Applications in the Evaluation and Treatment of Epilepsy
Wearable devices and mobile health software applications have a great potential for improving epilepsy-related health outcomes and contributing to personalized medical care for persons with epilepsy. With limitations and challenges, they can be used for tracking seizure occurrence and for seizure detection, prediction, and forecasting in hospital and ambulatory settings. They can also help promote self-monitoring and self-management and thereby contribute to patient empowerment. In this review, we provide an overview of current wearable devices and mobile health software applications for epilepsy. We focus on clinically va...
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Behnaz Esmaeili, Solveig Vieluf, Barbara A. Dworetzky, Claus Reinsberger Source Type: research
Effects of Maternal Use of Antiseizure Medications on Child Development
Most children born to women with epilepsy (WWE) are normal, but have increased risks for malformations and poor neuropsychological outcomes. Antiseizure medications (ASMs) are among the most commonly prescribed teratogenic medications in women of childbearing age. However, WWE typically cannot avoid using ASMs during pregnancy. Teratogenic risks vary across ASMs. Valproate poses a special risk for anatomic and behavioral teratogenic risks compared with other ASMs. The risks for many ASMs remain uncertain. Women of childbearing potential taking ASMs should be taking folic acid. Breastfeeding while taking ASMs seems safe. WW...
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Kimford J. Meador Source Type: research
Epilepsy
The increasing variety of technologies under development and entering clinical practice offer new opportunities to enhance the diagnosis and treatment of patients with epilepsy. While recent experience with these tools by researchers, care providers, and patients has begun to inform treatment options and testing paradigms, there remain many unmet needs in epilepsy that could potentially be solved through the application of technologies. (Source: Neurologic Clinics)
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Steven C. Schachter Tags: Preface Source Type: research
Sleep and Epilepsy
Sleep is a restorative balm for many, often less so for people with epilepsy. Complex bidirectional interactions between sleep and epilepsy can be detrimental to sleep, epilepsy and those affected. Sleep is a state of variable activation of the EEG and seizure occurrence in people with epilepsy. Sleep disorders are highly prevalent and portend worse seizure and epilepsy-related outcomes. Randomized clinical trials of sleep interventions in epilepsy populations are few, yet warranted, given the effects of sleep dysfunction on quality of life and the risk of SUDEP in people with epilepsy. (Source: Neurologic Clinics)
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Madeleine M. Grigg-Damberger, Nancy Foldvary-Schaefer Source Type: research
Dietary Treatments for Epilepsy
The ketogenic diet is one of the four major treatments for epilepsy, along with antiseizure medications, neuromodulation, and surgery. Ketogenic diet therapy has been proven to be a safe and effective antiseizure regimen for a century. There are multiple methods to administer the diet and the initiation should be individualized for each patient. The diet has been shown to be an effective treatment of choice for Glut1 deficiency, pyruvate dehydrogenase deficiency, infantile spasms, and superrefractory status epilepticus among others. This review discusses the administration of ketogenic diet therapy and highlights its role ...
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Babitha Haridas, Eric H. Kossoff Source Type: research
Racialized Inequities in Epilepsy Burden and Treatment
This article provides an overview of contemporary framing of race and health, highlights select literature on racialized inequities in epilepsy, and assesses progress on these issues and remaining gaps. Evidence about racialized inequities in epilepsy is mounting. Particular areas of concern are the greater burden of epilepsy and lower use of specialty care and standard and advanced therapies among some racialized groups compared with whites. Remaining gaps and future directions are discussed. (Source: Neurologic Clinics)
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Magdalena Szaflarski Source Type: research
Autism Spectrum Disorder and Epilepsy
Autism spectrum disorder (ASD), was first described in 1943 as a disorder consisting of a triad of qualitative impairments of social interaction, communication and restricted repetitive patterns of behavior, interests, and activities. The relationship between ASD and epilepsy is well documented. Patients with ASD have an increased risk of epilepsy, while those with epilepsy have a higher risk of ASD, as compared with the general population. Diagnosing epilepsy in those with ASD can be challenging. For example, stereotyped behaviors could be mistaken as ASD stereotypies, when in fact, they may be due to seizures. Fortunatel...
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Churl-Su Kwon, Elaine C. Wirrell, Nathalie Jett é Source Type: research
Emerging Technologies for Epilepsy Surgery
Patients with medically refractory epilepsy, as defined by failure to achieve seizure freedom after adequate trials of 2 antiseizure medications, should be considered for early surgical evaluation. Achieving seizure freedom or meaningful seizure reduction, the goals of surgical treatment, can significantly improve quality of life while decreasing disease-related morbidity and mortality. Preoperative work up and imaging modalities aid in localization of epileptogenic zones that can be targeted in surgery. Resection of a seizure focus yields highest chances of seizure freedom; however, many promising minimally invasive or no...
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Danika L. Paulo, Tyler J. Ball, Dario J. Englot Source Type: research
Prevalence and Diagnosis of Sexual Dysfunction in People with Epilepsy
Even though sexual dysfunction occurs in about half of people with epilepsy (PWE), it is mostly under-reported, under-recognized, and under-treated. Sexual dysfunctions are more common in patients with uncontrolled epilepsy, frequent seizures, and those receiving enzyme-inducing antiseizure medicines (ASMs). The presence of underlying anxiety or depression is associated with a higher frequency of sexual dysfunction in PWE. Even though the evidence is limited, the newer and non –enzyme-inducing ASMs do not largely cause sexual dysfunction. A multidisciplinary and multipronged approach is required for the comprehensive eva...
Source: Neurologic Clinics - September 28, 2022 Category: Neurology Authors: Chaturbhuj Rathore, Kurupath Radhakrishnan Source Type: research
