Epilepsy
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Winter/Spring 1991
Volume 2, Number 1
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Abstracts
of this issue appear
below. Send e-mail or call 303-788-4010 to order a printed copy.
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 Abstracts
Epilepsy:
Clinical Overview and New Management Strategies
Paul M. Levisohn, MD
Proper
diagnosis and classification of epileptic seizures is
critical. Proper diagnosis allows one to more accurately
classify a specific epilepsy syndrome. Proper
identification of a seizure may lead to more specific
antiepileptic drugs treatment plans. If treatment plans
meet with failure, then advanced diagnostic testing, such
as video EEG monitoring or advanced treatments, such as
surgery, should be considered.
Pathophysiology
of Epilepsy
Leston B. Nay, MD
Abnormal
hypersynchronous discharges of large populations of
cortical neurons is a critical factor in the initiation
and propagation of epileptic seizures. The cellular
events responsible for this hypersynchronization are
controlled by various ion channels and receptor systems.
Pharmacologic interventions aimed at these cellular
events hold the key to newer anti-epileptic drugs.
Reviewed are recent concepts concerning excitatory and
inhibitory neurotransmitters, propagation of seizure
activity, interictal neuronal spiking, a brief look at
drug effects, and a review of newer, investigational
agents.
Epilepsy and Pregnancy
Michael S. Swanson, MD, Karen M. Zarlengo, MD
The
overwhelming percentage of pregnancies occurring in
epileptic women are normal. Prenatal counseling and close
monitoring during pregnancy is essential. The effect of
pregnancy on seizures is variable and cannot be predicted
in any given patient. Serum blood level monitoring is
recommended throughout pregnancy. With proper medical
management and patient education, all major
anti-epileptic drugs can be safely used in the woman of
child-bearing potential.
Neuropsychological
Assessment and Management in Epilepsy
Jay L. Schneiders, PhD
The
psychological and psychiatric aspects of seizure
disorders are complex, mercurial and controversial. This
paper presents a process-oriented model for the
evaluation of neuropsychological compromise in persons
with seizures. Then, following Levin et al, the
psychosocial problems frequently encountered in patients
with seizures are separated into four broad categories
with indications that physicians may usefully consider
when taking histories or doing follow-up with their
patients.
Multidisciplinary
Team Management of the Patient with Epilepsy
Kathy M. Goebel, RN, D. John Glatz, MD
The medical
management of the individual with epilepsy is only one
component of their required care. The psychosocial
ramifications of having epilepsy impact the lives of both
patients and their families. The issues surrounding
emotional adjustment, employment, driving and recreation
become potential problem areas for the patient. In our
experience, the most effective way to car for these
patients is through the combined efforts of a
multidisciplinary team.
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