To an outside observer, Psychogenic Non-Epileptic Seizures (PNES) look like epileptic seizures. The manifestations of PNES include collapses, impaired consciousness, and seizure-related injuries. However, unlike epileptic seizures, which are the result of abnormal electrical discharges in the brain, most PNES are an automatic psychological response to a trigger perceived as threatening. Not least because the changes in the brain that underpin PNES cannot be visualised easily with clinical tests (such as the EEG), there are many uncertainties and controversies surrounding the condition. Patients often provoke a mixture of emotions in healthcare professionals. In the authors' previous book, In Our Words: Personal Accounts of Living with Non-Epileptic Seizures, over 100 individuals with PNES and their family wrote about their experiences with the condition. While some had positive care experiences, many were left feeling confused, angry, and abandoned by the clinicians they had encountered. Non-Epileptic Seizures in Our Experience: Accounts of Health Care Professionals complements the authors' previous book by presenting the perspectives of over 90 members of different healthcare professions from around the world. The anonymous publication format has enabled many not only to share success stories but also to be open about difficulties and failures. This volume will be an invaluable resource for both highly experienced professionals as well as relative novice and those experiencing PNES. This book will challenge negative attitudes surrounding the condition, improve understanding between healthcare professionals and patients, and - ultimately - advance the quality of care provided for those with PNES.
This book tackles some of the common and difficult problems encountered by the clinical neurologist by providing practical guidance. The contributors approach the clinical challenges presented from their own points of view. Up-to-date references support the claims for preferred therapeutical and surgical treatments.
This text presents firsthand accounts written by women with seizure disorders. In their own words, these patients describe the experiences of coping with seizures, undergoing treatment, and coming to terms with the impact of epilepsy on their lives and relationships. These real-life stories offer insights into the issues encountered by women with epilepsy at every stage of life and the reproductive cycle.
The clinical management of patients with epilepsy and the associated medical literature are rapidly evolving. Evidence-based Management of Epilepsy differs from other epilepsy textbooks by focusing specifically on topics where the available evidence is sufficiently well developed to be synthesized into straightforward summaries of proven therapies. When evidence is missing or there is doubt, controversy or ambiguity, the distinguished authors offer treatment recommendations based on practice guidelines or consensus statements that span the gaps in evidence while pointing to those areas where further research is needed. The initial chapters cover critically important aspects of antiepileptic drugs (AEDs) and surgical treatment such as when to start and stop AEDs, how to monitor their effectiveness, special considerations in women who become pregnant, and when to consider surgery to alleviate seizures. The following chapters cover the therapy of seizures when they develop after traumatic brain injury or stroke, and the treatment of concomitant depression and anxiety in patients with epilepsy. The final chapters discuss emerging topics in epilepsy: the treatment of the postictal state, technologies to predict and detect seizures, strategies for closing the treatment gap and sudden unexpected death in epilepsy. The contributors are renowned experts in their fields who successfully and succinctly present state-of-the-art reviews based on the medical evidence designed to help the clinician be as best informed as possible in the care of patients with epilepsy.
This common and very important disorder of Epilepsy is led by Dr. Steven Schachter in this issue of Neurologic Clinics. The majority of articles review methods for application of standards, guidelines, and consensus statement to clinical practice by Primary Care physicians and general Neurologists using validated and evidence-based tools such as screening instruments and algorithms for a number of critically important topics, ranging from initial evaluation to monitoring patients on treatment to counseling and educating patients on SUDEP and driving. Topics in this issue include: Guidelines and quality standards for adult epilepsy patients; Guidelines and quality standards in care of children with epilepsy; Initial evaluation of the patient with suspected epilepsy; Starting, choosing, changing, and discontinuing treatment; Methods for measuring seizure frequency and severity; Assessment of treatment side effects and quality of life; Screening for depression and anxiety; Counseling patients on driving and employment; Issues for women with epilepsy; Patient education (SUDEP - Sudden Unexpected Death in Epilepsy; Self-management; Adherence; Rescue medication); Optimizing the patient-physician therapeutic alliance.
The field of epilepsy and behavior has grown considerably in the past number of years, reflecting advances in the laboratory and clinic. Behavioral Aspects of Epilepsy: Principles and Practice is the definitive text on epilepsy behavioral issues, from basic science to clinical applications, for all neurologists, psychosocial specialists, and researchers in the fields of epilepsy, neuroscience, and psychology/psychiatry. Behavioral aspects of epilepsy include a patient's experiences during seizures, his or her reaction during and between seizures, the frequency of episodes and what can be determined from the number of seizures. With contributions by dozens of leading international experts, this is the only book to cover all aspects of this critical emerging science. Adult and pediatric patients, animal models, and epilepsy surgery and its effects are all covered in detail. Behavioral Aspects of Epilepsy is the only source for up-to-date information on a topic that has significant and growing interest in the medical community. This comprehensive, authoritative text has a bench to bedside, approach that covers: The mechanisms underlying epilepsy and behavior Neurophysiologic function Neuropsychiatric and behavioral disorders in patients with epilepsy The effects of treatments and surgery on behavior Pediatric and adolescent epilepsy Disorders associated with epilepsy that impact behavior And much more
Written by three distinguished epileptologists with a long-standing interest in alternative therapies, this book provides an evidence-based consideration of the use of complementary and alternative (CAM) therapies in epilepsy care. Organized by problem, the authors review alternative approaches to epilepsy- related conditions to help physicians, healthcare professionals, CAM providers, and patients understand the options and safely integrate treatments that work into their regimens. The book begins with an overview of the therapies themselves, including herbal remedies, nutrition, alternative pharmacological therapies, physical treatments, and neurobehavioral approaches, and also discusses medication-related considerations and caveats. The next group of chapters covers CAM and preventive approaches to mitigating the effects of epilepsy and epilepsy therapies, such as drug toxicity and side effects of anti-epileptic drugs (AEDs), seizures, enhancing cognitive function, issues for women (pregnancy, breast feeding, menopause), and managing anxiety and depression. The final part of the book focuses on quality of life and lifestyle modifications to reduce seizure risk, including techniques for stress reduction, sleep disturbances and aids to normalize, alcohol and recreational drugs, and environmental factors. Features of Alternative Therapies for Epilepsy Include: Evidence-based review of CAM therapies for epilepsy Problem-oriented, practical approach to integrating alternative treatments into traditional regimens for healthcare providers Written by distinguished epileptologists with broad clinical experience Addresses all aspects of health for persons with epilepsy (not just seizures) and offers practical suggestions for improving patient care and patient health
Now more than ever, doctors are being targeted by government prosecutors and whistleblowers challenging the legality of their relationships with drug and device companies. With reputations at stake and the risk of civil and criminal liability, it is incumbent upon doctors to protect themselves. Managing Relationships with Industry: A Physician's Compliance Manual is an indispensable resource for doctors, professional societies, academic medical centers, community hospitals, and group practices struggling to understand the ever changing law and ethical standards on interactions with pharmaceutical and device companies. It is the first comprehensive summary of the law and ethics on physician relationships with industry written for the physician. Authored by a former state Attorney General, Harvard Medical School Professor, health care lawyer and professor of ethics, Managing Relationships approaches the topic from a balanced and reasoned perspective adding to the on-going national dialogue and debate on the proper limits to medicine's relationship with industry. - The first complete and up-to-date summary and analysis of the law and ethics on physician-industry relationships - Focuses on major enforcement actions and whistleblower lawsuits and the lessons learned for physicians - Provides options and guidance for maintaining compliant relationships and avoiding traps for the unwary - Covers both drug and device company relationships - Summarizes the types of industry relationships that are necessary and productive and those that are harmful and abusive - Details the law and ethics for each type of relationship including gifts, off-label uses and marketing, CME, speaker's bureaus, free samples, grants, consulting arrangements, etc. - Includes sample contracts for permissible consulting and CME speaker engagements
Nearly three million people in the United States live with epilepsy every day and another 180,000 Americans develop epilepsy every year. Around the world, more than 60 million people have epilepsy. Epilepsy impacts everyone in different ways, as well as their families, friends and professional caregivers. This enlightening book presents the firsthand personal accounts of children with seizure disorders and their parents. In their own words, these children and parents vividly describe the experiences of handling the crisis of the initial seizure, adjusting to the diagnosis of epilepsy, coping with seizures, managing medications and side effects, and dealing with health care providers, teachers, schoolmates, siblings, and friends. Their stories reveal the terror, uncertainty, and frustration felt by children an dparents after an initial seizure or a diagnosis of epilepsy and document the ongoing trials, tribulations, and triumphs of coping with seizures, medication schedules and side effects, health care providers and hospitals, schoolmates, siblings, relatives and friends. These accounts provide realistic insights into the myriad issues encountered in living with childhood epilepsy. The book also includes a straightforward medical discussion of childhood seizures, written in layperson's terms; a glossary of medical terms; and a guide for schoolteachers and parents.
The clinical management of patients with epilepsy and the associated medical literature are rapidly evolving. Evidence-based Management of Epilepsy differs from other epilepsy textbooks by focusing specifically on topics where the available evidence is sufficiently well developed to be synthesized into straightforward summaries of proven therapies. When evidence is missing or there is doubt, controversy or ambiguity, the distinguished authors offer treatment recommendations based on practice guidelines or consensus statements that span the gaps in evidence while pointing to those areas where further research is needed. The initial chapters cover critically important aspects of antiepileptic drugs (AEDs) and surgical treatment such as when to start and stop AEDs, how to monitor their effectiveness, special considerations in women who become pregnant, and when to consider surgery to alleviate seizures. The following chapters cover the therapy of seizures when they develop after traumatic brain injury or stroke, and the treatment of concomitant depression and anxiety in patients with epilepsy. The final chapters discuss emerging topics in epilepsy: the treatment of the postictal state, technologies to predict and detect seizures, strategies for closing the treatment gap and sudden unexpected death in epilepsy. The contributors are renowned experts in their fields who successfully and succinctly present state-of-the-art reviews based on the medical evidence designed to help the clinician be as best informed as possible in the care of patients with epilepsy.
Epilepsy is a difficult illness to control; up to 35% of patients do not respond fully to traditional medical treatments. For this reason, many sufferers choose to rely on or incorporate complementary and alternative medicine (CAM) into their treatment regimens. Written for physicians, knowledgeable laypersons, and other professionals, Complementary and Alternative Therapies for Epilepsy bridges the worlds of traditional medicine and CAM to foster a broader perspective of healthcare for patients. The book respects cultural differences that may incorporate alternative medicine into a medical management program, and encourages patients to safely continue receiving necessary medical treatments. Wherever possible, scientific evidence supports the choice of treatment modalities, as well as the effectiveness of a combined traditional and CAM approach. Readers will find incisive discussions in sections on: Learning to Reduce Seizures Asian, Herbal and Homeopathic Therapies Nutritional Therapies Alternative Medical Therapies Oxygen Therapies Manipulation and Osteopathic Therapies Music, Art, and Pet Therapies From stress and epilepsy, to acupuncture, massage, craniosacral therapies, homeopathy, ketogenic diets, aromatherapy, hypnosis, and more, the book is all-inclusive and enlightening. Additional commentary by the editors provides a critical vantage point from which to interpret the data and viewpoints of the contributors, all experts in the therapies presented. This balanced, scientific approach will appeal to even those most skeptical of alternative therapies, making the book essential for every professional who seeks to provide the broadest range of effective patient care.
Psychiatric Controversies in Epilepsy addresses controversial clinical issues of the psychiatric aspects of epilepsy. The book explores the reasons behind the poor communication between psychiatrists and neurologists and suggests potential remedies to this important problem, and two chapters are devoted to examining whether psychiatrists and neurologists are properly trained to recognize and treat conditions that both disciplines commonly encounter in clinical practice. Identification of the causes behind the high rate of comorbidity between epilepsy and mood, anxiety, psychotic and attention deficit disorders is given high priority in the volume, and a specific review of the evidence of common pathogenic mechanisms that may be operant in epilepsy and these psychiatric disorders is included. Recently identified bidirectional relationship between mood disorders and epilepsy and its implication in the course and response to treatment of the seizure disorder are also explored. Several chapters are devoted to rectify common misunderstandings of the use of psychotropic drugs in patients with epilepsy, including the use of antidepressant and central nervous system stimulants. Finally, one chapter explores the possibility of organic causes of psychogenic non-epileptic seizures. - Compiles into one source the important controversial issues of the psychiatric aspects of epilepsy, which have significant implications in clinical practice - Authors are internationally recognized authorities in the field of psychiatric aspects of epilepsy
Epilepsy is a difficult illness to control; up to 35% of patients do not respond fully to traditional medical treatments. For this reason, many sufferers choose to rely on or incorporate complementary and alternative medicine (CAM) into their treatment regimens. Written for physicians, knowledgeable laypersons, and other professionals, Complementary and Alternative Therapies for Epilepsy bridges the worlds of traditional medicine and CAM to foster a broader perspective of healthcare for patients. The book respects cultural differences that may incorporate alternative medicine into a medical management program, and encourages patients to safely continue receiving necessary medical treatments. Wherever possible, scientific evidence supports the choice of treatment modalities, as well as the effectiveness of a combined traditional and CAM approach. Readers will find incisive discussions in sections on: Learning to Reduce Seizures Asian, Herbal and Homeopathic Therapies Nutritional Therapies Alternative Medical Therapies Oxygen Therapies Manipulation and Osteopathic Therapies Music, Art, and Pet Therapies From stress and epilepsy, to acupuncture, massage, craniosacral therapies, homeopathy, ketogenic diets, aromatherapy, hypnosis, and more, the book is all-inclusive and enlightening. Additional commentary by the editors provides a critical vantage point from which to interpret the data and viewpoints of the contributors, all experts in the therapies presented. This balanced, scientific approach will appeal to even those most skeptical of alternative therapies, making the book essential for every professional who seeks to provide the broadest range of effective patient care.
Nearly three million people in the United States live with epilepsy every day and another 180,000 Americans develop epilepsy every year. Around the world, more than 60 million people have epilepsy. Epilepsy impacts everyone in different ways, as well as their families, friends and professional caregivers. With the Brainstorms series, one of the world's leading authorities on epilepsy, Dr. Steven C. Schachter has gathered together the personal testimonies of patients, family members, and professional caregivers to create a poignant and gripping series of books on this misunderstood and often devastating disorder. This volume, Epilepsy in Our Words, features 68 personal accounts of seizure activity from people with epilepsy that illustrates the wide range of experiences associated with seizures and living with epilepsy. Many have had epilepsy for yers, and their passages are heartfelt and realistic. An introductory section explains epilepsy and different seizure types from a medical perspective. An index helps readers focus on particular symptoms and other specific aspects of seizures, such as seizure warnings and triggers.
Written by three distinguished epileptologists with a long-standing interest in alternative therapies, this book provides an evidence-based consideration of the use of complementary and alternative (CAM) therapies in epilepsy care. Organized by problem, the authors review alternative approaches to epilepsy- related conditions to help physicians, healthcare professionals, CAM providers, and patients understand the options and safely integrate treatments that work into their regimens. The book begins with an overview of the therapies themselves, including herbal remedies, nutrition, alternative pharmacological therapies, physical treatments, and neurobehavioral approaches, and also discusses medication-related considerations and caveats. The next group of chapters covers CAM and preventive approaches to mitigating the effects of epilepsy and epilepsy therapies, such as drug toxicity and side effects of anti-epileptic drugs (AEDs), seizures, enhancing cognitive function, issues for women (pregnancy, breast feeding, menopause), and managing anxiety and depression. The final part of the book focuses on quality of life and lifestyle modifications to reduce seizure risk, including techniques for stress reduction, sleep disturbances and aids to normalize, alcohol and recreational drugs, and environmental factors. Features of Alternative Therapies for Epilepsy Include: Evidence-based review of CAM therapies for epilepsy Problem-oriented, practical approach to integrating alternative treatments into traditional regimens for healthcare providers Written by distinguished epileptologists with broad clinical experience Addresses all aspects of health for persons with epilepsy (not just seizures) and offers practical suggestions for improving patient care and patient health
To an outside observer, Psychogenic Non-Epileptic Seizures (PNES) look like epileptic seizures. The manifestations of PNES include collapses, impaired consciousness, and seizure-related injuries. However, unlike epileptic seizures, which are the result of abnormal electrical discharges in the brain, most PNES are an automatic psychological response to a trigger perceived as threatening. Not least because the changes in the brain that underpin PNES cannot be visualised easily with clinical tests (such as the EEG), there are many uncertainties and controversies surrounding the condition. Patients often provoke a mixture of emotions in healthcare professionals. In the authors' previous book, In Our Words: Personal Accounts of Living with Non-Epileptic Seizures, over 100 individuals with PNES and their family wrote about their experiences with the condition. While some had positive care experiences, many were left feeling confused, angry, and abandoned by the clinicians they had encountered. Non-Epileptic Seizures in Our Experience: Accounts of Health Care Professionals complements the authors' previous book by presenting the perspectives of over 90 members of different healthcare professions from around the world. The anonymous publication format has enabled many not only to share success stories but also to be open about difficulties and failures. This volume will be an invaluable resource for both highly experienced professionals as well as relative novice and those experiencing PNES. This book will challenge negative attitudes surrounding the condition, improve understanding between healthcare professionals and patients, and - ultimately - advance the quality of care provided for those with PNES.
This common and very important disorder of Epilepsy is led by Dr. Steven Schachter in this issue of Neurologic Clinics. The majority of articles review methods for application of standards, guidelines, and consensus statement to clinical practice by Primary Care physicians and general Neurologists using validated and evidence-based tools such as screening instruments and algorithms for a number of critically important topics, ranging from initial evaluation to monitoring patients on treatment to counseling and educating patients on SUDEP and driving. Topics in this issue include: Guidelines and quality standards for adult epilepsy patients; Guidelines and quality standards in care of children with epilepsy; Initial evaluation of the patient with suspected epilepsy; Starting, choosing, changing, and discontinuing treatment; Methods for measuring seizure frequency and severity; Assessment of treatment side effects and quality of life; Screening for depression and anxiety; Counseling patients on driving and employment; Issues for women with epilepsy; Patient education (SUDEP - Sudden Unexpected Death in Epilepsy; Self-management; Adherence; Rescue medication); Optimizing the patient-physician therapeutic alliance.
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