Current Classification of Seizures and Epilepsies: Scope, Limitations and Recommendations for Future Action

Sarmast, Shah T; Abdullahi, Abba Musa; Jahan, Nusrat

doi:10.7759/cureus.10549

Cited by 55 publications

(51 citation statements)

References 34 publications

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“…In a study by Sarmast et al, the authors recommended the use of a multidimensional classification model that incorporates the clinical semiology, disease location, aetiology, and associated comorbidities. The benefit of this model results in better patient outcomes [ 7 ]. Long-term antiepileptic therapy affects the frequency and development of cardiovascular diseases [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

The Effects of Antiepileptic Medications on Lipid Profile, Thyroid Panel, and Vitamin Level

Büyükgöl

Güneş

2020

Cureus

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Background: Conventional antiepileptic drugs (AEDs) have been used for many years to treat epilepsy, and physicians are generally familiar with their side-effect profiles and potential drug interactions. However, AEDs affect patient vitamin and mineral levels in a manner that is not well understood. The goal of this study was to determine the relationship between AEDs and patient vitamins and mineral levels. Materials and methods: We conducted a retrospective analysis of liver enzyme levels, thyroid hormone levels, lipid profiles, and vitamin values (e.g., B12 and folic acid) in patients treated with carbamazepine, valproic acid, or levetiracetam at our institution. Patients were included in the study if their medical data included total cholesterol, triglyceride levels, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels obtained on follow-up at least three months after the start of antiepileptic treatment with carbamazepine, valproic acid, or levetiracetam. Patients were grouped according to the antiepileptic drug used. We analyzed liver thyroid function tests, lipid profiles, levels of B12, and folic acid levels using laboratory test results and compared the findings from each group. Results: Carbamazepine, valproic acid, and levetiracetam did not change the levels of liver enzymes such as aspartate transaminase and alanine aminotransferase (p values respectively: .802, .094). Cholesterol and LDL levels were lower in patients using carbamazepine (p values respectively: .005, .005), and no significant difference was observed for HDL and triglyceride levels (p values respectively: .400, .091). While thyroidstimulating hormone levels were significantly higher in patients on medication than the control group (p=.007), the levels were still within reference ranges. No significant difference was found between triiodothyronine and thyroxine levels (p values respectively: .065, .053). The levels of B12 and folic acid were observed to be high in the group using carbamazepine (p values respectively: .049, .004). Conclusion: Valproic acid and carbamazepine do not induce a significant increase in liver enzymes compared to levetiracetam, a new-generation antiepileptic medication, and they had no impact on lipoproteins such as HDL that are protective against coronary artery disease. These medications do not affect the levels of thyroid hormones in comparison to levetiracetam and the control group. Although carbamazepine and valproic acid are metabolized in the liver, liver enzyme monitoring is required; they have only affected liver enzyme values as much as levetiracetam and the control group.

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Section: Discussionmentioning

confidence: 99%

The Effects of Antiepileptic Medications on Lipid Profile, Thyroid Panel, and Vitamin Level

Büyükgöl

Güneş

2020

Cureus

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“…Focal epilepsy (formerly known as partial seizures) refers to the electrical and clinical manifestations of seizures that arise from one portion of the brain 45,46 . An electroencephalogram typically reveals a localized discharge over the area of onset, or regions beyond the initial onset as the abnormal electrical activity propagates.…”

Section: Epilepsy and Its Clinical Evaluationmentioning

confidence: 99%

“…An electroencephalogram typically reveals a localized discharge over the area of onset, or regions beyond the initial onset as the abnormal electrical activity propagates. Focal seizures can originate from any lobe in the brain, with temporal lobe as the most frequently recognized origin 46 . Drug‐resistant focal seizure should be considered in those whose seizure remission is not achieved after two monotherapy trials followed by a dual therapy trial 9 .…”

Section: Epilepsy and Its Clinical Evaluationmentioning

confidence: 99%

Potential surgical therapies for drug‐resistant focal epilepsy

et al. 2021

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Drug‐resistant focal epilepsy (DRFE), defined by failure of two antiepileptic drugs, affects 30% of epileptic patients. Epilepsy surgeries are alternative options for this population. Preoperative evaluation is critical to include potential candidates, and to choose the most appropriate procedure to maximize efficacy and simultaneously minimize side effects. Traditional procedures involve open skull surgeries and epileptic focus resection. Alternatively, neuromodulation surgeries use peripheral nerve or deep brain stimulation to reduce the activities of epileptogenic focus. With the advanced improvement of laser‐induced thermal therapy (LITT) technique and its utilization in neurosurgery, magnetic resonance‐guided LITT (MRgLITT) emerges as a minimal invasive approach for drug‐resistant focal epilepsy. In the present review, we first introduce drug‐resistant focal epilepsy and summarize the indications, pros and cons of traditional surgical procedures and neuromodulation procedures. And then, focusing on MRgLITT, we thoroughly discuss its history, its technical details, its safety issues, and current evidence on its clinical applications. A case report on MRgLITT is also included to illustrate the preoperational evaluation. We believe that MRgLITT is a promising approach in selected patients with drug‐resistant focal epilepsy, although large prospective studies are required to evaluate its efficacy and side effects, as well as to implement a standardized protocol for its application.

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“…Seizures are classified into partial (focal) and generalized [5], where some part of the cerebral hemisphere is affected in focal seizures, and the whole brain is affected in generalized epileptic seizures. Some types of generalized seizures are tonic-clonic or convulsive seizures, absence seizures, atonic seizures, clonic seizures, tonic seizures, and myoclonic seizures [6]. Based on the progress of the event, epilepsy is classified into four stages, namely interictal, preictal, ictal, and postictal.…”

Section: Introductionmentioning

confidence: 99%

Automated Epileptic Seizure Detection in Pediatric Subjects of CHB-MIT EEG Database—A Survey

Prasanna

Subathra

Mohammed

et al. 2021

JPM

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Epilepsy is a neurological disorder of the brain that causes frequent occurrence of seizures. Electroencephalography (EEG) is a tool that assists neurologists in detecting epileptic seizures caused by an unexpected flow of electrical activities in the brain. Automated detection of an epileptic seizure is a crucial task in diagnosing epilepsy which overcomes the drawback of a visual diagnosis. The dataset analyzed in this article, collected from Children’s Hospital Boston (CHB) and the Massachusetts Institute of Technology (MIT), contains long-term EEG records from 24 pediatric patients. This review paper focuses on various patient-dependent and patient-independent personalized medicine approaches involved in the computer-aided diagnosis of epileptic seizures in pediatric subjects by analyzing EEG signals, thus summarizing the existing body of knowledge and opening up an enormous research area for biomedical engineers. This review paper focuses on the features of four domains, such as time, frequency, time-frequency, and nonlinear features, extracted from the EEG records, which were fed into several classifiers to classify between seizure and non-seizure EEG signals. Performance metrics such as classification accuracy, sensitivity, and specificity were examined, and challenges in automatic seizure detection using the CHB-MIT database were addressed.

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Current Classification of Seizures and Epilepsies: Scope, Limitations and Recommendations for Future Action

Cited by 55 publications

References 34 publications

The Effects of Antiepileptic Medications on Lipid Profile, Thyroid Panel, and Vitamin Level

The Effects of Antiepileptic Medications on Lipid Profile, Thyroid Panel, and Vitamin Level

Potential surgical therapies for drug‐resistant focal epilepsy

Automated Epileptic Seizure Detection in Pediatric Subjects of CHB-MIT EEG Database—A Survey

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