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Epilepsy is more a social condition than a medical one 26th August 11.30- 12.15 12th European Conference on Epilep

.... For the PWE, social adjustements are apt to be difficult, . not only because of the problems which arise due to the threat of attacks........, but also. due to the attitudes of those who surround him, at home, in school and college, at play and at work...". Francis McNaughton - 1954. Th

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Epilepsy is more a social condition than a medical one 26th August 11.30- 12.15 12th European Conference on Epilep

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    1. “Epilepsy is more a social condition than a medical one” 26th August (11.30- 12.15) 12th European Conference on Epilepsy and Society  

    2. “.... For the PWE, social adjustements are apt to be difficult,

    3. “The “Central Core” of Epilepsy management is medical” Definitions Epileptic seizures Epilepsy Etiologies Secondary/Simptomatic Primary/Idiopatic Diagnosis Clinic Laboratory Management/control of the seizures Medical Surgery Others (ENV, Diet,..) Prognosis

    4. “....... an epileptic seizure is a transient ocurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the Brain......”

    5. “....... epilepsy is a chronic condition of the brain characterized by an enduring propensity to generate epileptic seizures and by the neurobiological, cognitive, psychological and social consequences of this condition......”

    6. Classification – Five axis Axis 1 – Ictal phenomenology Axis 2 – Seizure type Axis 3 – Syndrome Axis 4 – Etiology Axis 5 – Impairment

    7. Classification – Five axis Axis 1 – Ictal phenomenology Axis 2 – Seizure type Axis 3 – Syndrome Axis 4 – Etiology Primary / Idiopathic / Genetic Secondary /Symptomatic/ Probably Symptomatic Axis 5 – Impairment

    9. Incidence / 100 000 / year of unprovoked seizures

    10. Antiepileptic drugs -Lancet Neurol (2006) 1064-7

    11. Antiepileptic drugs - Lancet Neurol (2006) 1064-7

    12. Treatment issues in epilepsy recomendations for pediatric epilepsies

    14. Alternatives

    15. Epilepsy surgery

    16. Epilepsy surgery

    18. Epilepsy surgery - results

    19. Epidemiologic classification of Seizures Idiopatic or cryptogenic Remote symptomatic epilepsy - trauma/brain tumors/CVdisease/chronic degeneration /others. Acute symptomatic seizures within one week of an insult – trauma/ infection/ cv disease/others. Major neurological dysfunction mainly congenital (MR/CP/others)

    20. Epidemiologic classification of seizures / Standardized mortality ratios SMR Idiopatic or cryptogenic 1.3 Remote symptomatic epilepsy 3.7 Acute symptomatic seizures 3.0 Major neurological dysfunction 25.0

    21. Increased standardized mortality ratios Epilepsy – Status, accidental, drowning, suicide Sudden unnexpected death - SUDEP Morbidity linked with the AED – osteoporosis, idiosyncratic. Subjacent risk factors – tumors, CVD, trauma, degenerative disorders

    22. Sept. '99

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