Abstract
Epileptic seizures occur as a result of excessive or synchronous neuronal activity in the brain. Epilepsy is a disease of the brain characterized by a continued propensity to produce epileptic seizures and which causes various deleterious effects on cognitive, psychological, and social domains. The causes of seizures are vast and include structural (i.e. malformations of cortical development, mesial temporal sclerosis, etc.), metabolic (many of which are epileptic encephalopathies), genetic (i.e. juvenile myoclonic epilepsy), and autoimmune (i.e. anti-NMDAR encephalitis) etiologies. The operational definition of epilepsy requires two or more unprovoked seizures (>24 h apart), one seizure with high probability of recurrent seizures, or diagnosis of an epilepsy syndrome. Various imaging modalities are available and may assist in the diagnosis of epilepsy, determining the etiology, and serve as an integral part of the epilepsy surgery evaluation. According to the 2017 International League Against Epilepsy (ILAE) seizure classification, seizures are now named according to the area of seizure onset (focal, generalized, unknown).
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Fisher RS, van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005;46(4):470–2.
Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475–82.
Thundiyil JG, Kearney TE, Olson KR. Evolving epidemiology of drug-induced seizures reported to a Poison Control Center System. J Med Toxicol. 2007;3(1):15–9.
Fisher RS, Cross JH, D’Souza C, et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia. 2017;58(4):531–42.
Jallon P, Latour P. Epidemiology of idiopathic generalized epilepsies. Epilepsia. 2005;46(Suppl 9):10–4.
Peljto AL, Barker-Cummings C, Vasoli VM, et al. Familial risk of epilepsy: a population-based study. Brain. 2014;137(Pt 3):795–805.
Beal JC, Cherian K, Moshe SL. Early-onset epileptic encephalopathies: Ohtahara syndrome and early myoclonic encephalopathy. Pediatr Neurol. 2012;47(5):317–23.
Bahi-Buisson N, Nectoux J, Rosas-Vargas H, et al. Key clinical features to identify girls with CDKL5 mutations. Brain. 2008;131(Pt 10):2647–61.
Shahwan A, Farrell M, Delanty N. Progressive myoclonic epilepsies: a review of genetic and therapeutic aspects. Lancet Neurol. 2005;4(4):239–48.
Delgado-Escueta AV. Advances in genetics of juvenile myoclonic epilepsies. Epilepsy Curr. 2007;7(3):61–7.
Wolf NI, Rahman S, Schmitt B, et al. Status epilepticus in children with Alpers’ disease caused by POLG1 mutations: EEG and MRI features. Epilepsia. 2009;50(6):1596–607.
Papetti L, Parisi P, Leuzzi V, et al. Metabolic epilepsy: an update. Brain and Development. 2013;35(9):827–41.
Blumcke I, Thom M, Aronica E, et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia. 2011;52(1):158–74.
Lerner JT, Salamon N, Hauptman JS, et al. Assessment and surgical outcomes for mild type I and severe type II cortical dysplasia: a critical review and the UCLA experience. Epilepsia. 2009;50(6):1310–35.
Sisodiya SM. Malformations of cortical development: burdens and insights from important causes of human epilepsy. Lancet Neurol. 2004;3(1):29–38.
Sheen VL, Ganesh VS, Topcu M, et al. Mutations in ARFGEF2 implicate vesicle trafficking in neural progenitor proliferation and migration in the human cerebral cortex. Nat Genet. 2004;36(1):69–76.
Raymond AA, Fish DR, Stevens JM, et al. Subependymal heterotopia: a distinct neuronal migration disorder associated with epilepsy. J Neurol Neurosurg Psychiatry. 1994;57(10):1195–202.
Barkovich AJ, Hevner R, Guerrini R. Syndromes of bilateral symmetrical polymicrogyria. AJNR Am J Neuroradiol. 1999;20(10):1814–21.
Cendes F, Andermann F, Dubeau F, et al. Early childhood prolonged febrile convulsions, atrophy and sclerosis of mesial structures, and temporal lobe epilepsy: an MRI volumetric study. Neurology. 1993;43(6):1083–7.
Tarkka R, Paakko E, Pyhtinen J, et al. Febrile seizures and mesial temporal sclerosis: no association in a long-term follow-up study. Neurology. 2003;60(2):215–8.
de Tisi J, Bell GS, Peacock JL, et al. The long-term outcome of adult epilepsy surgery, patterns of seizure remission, and relapse: a cohort study. Lancet. 2011;378(9800):1388–95.
Blumcke I, Thom M, Aronica E, et al. International consensus classification of hippocampal sclerosis in temporal lobe epilepsy: a Task Force report from the ILAE Commission on Diagnostic Methods. Epilepsia. 2013;54(7):1315–29.
Chu-Shore CJ, Major P, Camposano S, et al. The natural history of epilepsy in tuberous sclerosis complex. Epilepsia. 2010;51(7):1236–41.
van Breemen MS, Wilms EB, Vecht CJ. Epilepsy in patients with brain tumours: epidemiology, mechanisms, and management. Lancet Neurol. 2007;6(5):421–30.
Lin YJ, Chang WN, Chang HW, et al. Risk factors and outcome of seizures after spontaneous aneurysmal subarachnoid hemorrhage. Eur J Neurol. 2008;15(5):451–7.
Claassen J, Peery S, Kreiter KT, et al. Predictors and clinical impact of epilepsy after subarachnoid hemorrhage. Neurology. 2003;60(2):208–14.
Bladin CF, Alexandrov AV, Bellavance A, et al. Seizures after stroke: a prospective multicenter study. Arch Neurol. 2000;57(11):1617–22.
Lowenstein DH. Epilepsy after head injury: an overview. Epilepsia. 2009;50(Suppl 2):4–9.
Herman ST. Epilepsy after brain insult: targeting epileptogenesis. Neurology. 2002;59(9 Suppl 5):S21–6.
Frey LC. Epidemiology of posttraumatic epilepsy: a critical review. Epilepsia. 2003;44(s10):11–7.
Chang BS, Lowenstein DH. Practice parameter: antiepileptic drug prophylaxis in severe traumatic brain injury: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2003;60(1):10–6.
Annegers JF, Hauser WA, Beghi E, et al. The risk of unprovoked seizures after encephalitis and meningitis. Neurology. 1988;38(9):1407–10.
DeGiorgio CM, Medina MT, Durón R, et al. Neurocysticercosis. Epilepsy Curr. 2004;4(3):107–11.
Garcia HH, Pretell EJ, Gilman RH, et al. A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis. N Engl J Med. 2004;350(3):249–58.
Gaspard N. Autoimmune epilepsy. Continuum (Minneap Minn). 2016;22(1 Epilepsy):227–45.
Quek AM, Britton JW, McKeon A, et al. Autoimmune epilepsy: clinical characteristics and response to immunotherapy. Arch Neurol. 2012;69(5):582–93.
Titulaer MJ, McCracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013;12(2):157–65.
Bien CG, Granata T, Antozzi C, et al. Pathogenesis, diagnosis and treatment of Rasmussen encephalitis: a European consensus statement. Brain. 2005;128(Pt 3):454–71.
Linnoila JJ, Rosenfeld MR, Dalmau J. Neuronal surface antibody-mediated autoimmune encephalitis. Semin Neurol. 2014;34(4):458–66.
Lancaster E. The diagnosis and treatment of autoimmune encephalitis. J Clin Neurol (Seoul, Korea). 2016;12(1):1–13.
Dalmau J, Graus F, Villarejo A, et al. Clinical analysis of anti-Ma2-associated encephalitis. Brain. 2004;127(Pt 8):1831–44.
Lapalme-Remis S, Cascino GD. Imaging for adults with seizures and epilepsy. Continuum (Minneap Minn). 2016;22(5, Neuroimaging):1451–79.
Harden CL, Huff JS, Schwartz TH, et al. Reassessment: neuroimaging in the emergency patient presenting with seizure (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2007;69(18):1772–80.
Xue H, Sveinsson O, Tomson T, et al. Intracranial meningiomas and seizures: a review of the literature. Acta Neurochir. 2015;157(9):1541–8.
West S, Nolan SJ, Cotton J, et al. Surgery for epilepsy. Cochrane Database Syst Rev. 2015;(7):Cd010541.
Carne RP, O’Brien TJ, Kilpatrick CJ, et al. MRI-negative PET-positive temporal lobe epilepsy: a distinct surgically remediable syndrome. Brain. 2004;127(Pt 10):2276–85.
Derry CP, Duncan S. Sleep and epilepsy. Epilepsy Behav. 2013;26(3):394–404.
Loddenkemper T, Fernandez IS, Peters JM. Continuous spike and waves during sleep and electrical status epilepticus in sleep. J Clin Neurophysiol. 2011;28(2):154–64.
Pearl PL, Carrazana EJ, Holmes GL. The Landau-Kleffner Syndrome. Epilepsy Curr. 2001;1(2):39–45.
Malow BA, Bowes RJ, Lin X. Predictors of sleepiness in epilepsy patients. Sleep. 1997;20(12):1105–10.
Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230–5.
Malow BA, Levy K, Maturen K, et al. Obstructive sleep apnea is common in medically refractory epilepsy patients. Neurology. 2000;55(7):1002–7.
Foldvary-Schaefer N, Andrews ND, Pornsriniyom D, et al. Sleep apnea and epilepsy: who’s at risk? Epilepsy Behav. 2012;25(3):363–7.
Chihorek AM, Abou-Khalil B, Malow BA. Obstructive sleep apnea is associated with seizure occurrence in older adults with epilepsy. Neurology. 2007;69(19):1823–7.
Pornsriniyom D, Kim H, Bena J, et al. Effect of positive airway pressure therapy on seizure control in patients with epilepsy and obstructive sleep apnea. Epilepsy Behav. 2014;37:270–5.
Devinsky O, Ehrenberg B, Barthlen GM, et al. Epilepsy and sleep apnea syndrome. Neurology. 1994;44(11):2060–4.
Vaughn BV, D’Cruz OF, Beach R, et al. Improvement of epileptic seizure control with treatment of obstructive sleep apnoea. Seizure. 1996;5(1):73–8.
Malow BA, Weatherwax KJ, Chervin RD, et al. Identification and treatment of obstructive sleep apnea in adults and children with epilepsy: a prospective pilot study. Sleep Med. 2003;4(6):509–15.
Li P, Ghadersohi S, Jafari B, et al. Characteristics of refractory vs. medically controlled epilepsy patients with obstructive sleep apnea and their response to CPAP treatment. Seizure. 2012;21(9):717–21.
Malow BA, Foldvary-Schaefer N, Vaughn BV, et al. Treating obstructive sleep apnea in adults with epilepsy: a randomized pilot trial. Neurology. 2008;71(8):572–7.
Devinsky O, Hesdorffer DC, Thurman DJ, et al. Sudden unexpected death in epilepsy: epidemiology, mechanisms, and prevention. Lancet Neurol. 2016;15(10):1075–88.
Nashef L, So EL, Ryvlin P, et al. Unifying the definitions of sudden unexpected death in epilepsy. Epilepsia. 2012;53(2):227–33.
Harden C, Tomson T, Gloss D, et al. Practice guideline summary: sudden unexpected death in epilepsy incidence rates and risk factors: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2017;88(17):1674–80.
Ryvlin P, Nashef L, Lhatoo SD, et al. Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. Lancet Neurol. 2013;12(10):966–77.
Alexandre V, Mercedes B, Valton L, et al. Risk factors of postictal generalized EEG suppression in generalized convulsive seizures. Neurology. 2015;85(18):1598–603.
Electronic Code of Federal Regulations. 2018. Available from: https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&ty=HTML&h=L&mc=true&=PART&n=pt49.5.391.
Guide for Aviation Medical Examiners. 2011. Available from: https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/app_process/exam_tech/item46/amd/nc/.
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Sazgar, M., Young, M.G. (2019). Seizures and Epilepsy. In: Absolute Epilepsy and EEG Rotation Review. Springer, Cham. https://doi.org/10.1007/978-3-030-03511-2_2
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DOI: https://doi.org/10.1007/978-3-030-03511-2_2
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