المؤلفون: Fawcett, Joanna, Davis, Sarah, Manford, Mark

المصدر: Journal of Neurology; Nov2023, Vol. 270 Issue 11, p5655-5670, 16p

مصطلحات موضوعية: EPILEPSY, PARTIAL epilepsy, PEOPLE with epilepsy, STATUS epilepticus, TECHNOLOGICAL innovations, STEREOTAXIC techniques, NURSE practitioners

مستخلص: In 2017, one of us reviewed advances in epilepsy (Manford in J Neurol 264:1811–1824, 2017). The current paper brings that review up to date and gives a slight change in emphasis. Once again, the story is of evolution rather than revolution. In recognition that most of our current medications act on neurotransmitters or ion channels, and not on the underlying changes in connectivity and pathways, they have been renamed as antiseizure (ASM) medications rather than antiepileptic drugs. Cenobamate is the one newly licensed medication for broader use in focal epilepsy but there have been a number of developments for specific disorders. We review new players and look forward to new developments in the light of evolving underlying science. We look at teratogenicity; old villains and new concerns in which clinicians play a vital role in explaining and balancing the risks. Medical treatment of status epilepticus, long without evidence, has benefitted from high-quality trials to inform practice; like buses, several arriving at once. Surgical treatment continues to be refined with improvements in the pre-surgical evaluation of patients, especially with new imaging techniques. Alternatives including stereotactic radiotherapy have received further focus and targets for palliative stimulation techniques have grown in number. Individuals' autonomy and quality of life continue to be the subject of research with refinement of what clinicians can do to help persons with epilepsy (PWE) achieve control. This includes seizure management but extends to broader considerations of human empowerment, needs and desires, which may be aided by emerging technologies such as seizure detection devices. The role of specialist nurses in improving that quality has been reinforced by specific endorsement from the International League against Epilepsy (ILAE). [ABSTRACT FROM AUTHOR]

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المؤلفون: Manford, Mark¹ mark.manford@icloud.com

المصدر: Journal of Neurology. Aug2017, Vol. 264 Issue 8, p1811-1824. 14p.

مصطلحات موضوعية: *EPILEPSY, *THERAPEUTICS, *ANTICONVULSANTS, *MENTAL depression, *SPASMS

مستخلص: This paper reviews advances in epilepsy in recent years with an emphasis on therapeutics and underlying mechanisms, including status epilepticus, drug and surgical treatments. Lessons from rarer epilepsies regarding the relationship between epilepsy type, mechanisms and choice of antiepileptic drugs (AED) are explored and data regarding AED use in pregnancy are reviewed. Concepts evolving towards a move from treating seizures to treating epilepsy are discussed, both in terms of the mechanisms of epileptogenesis, and in terms of epilepsy's broader comorbidity, especially depression. [ABSTRACT FROM AUTHOR]