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"Epilepsy in adolescence."
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Epilepsy : the ultimate teen guide
An updated overview of epilepsy that specifically addresses how this condition can affect teens. Epilepsy: The Ultimate Teen Guide, Second Edition gives positive, factual information and explains how young people can take control of their situations by understanding, managing, treating, and living normal lives with epilepsy. This edition includes updated chapters, resource lists, and statistics.
Book
60 minutes. Fight for a cure
Katie Couric reports on the movement to raise awareness and research funds for epilepsy.
Streaming Video
The thing with feathers
Emilie Day believes in playing it safe: she's homeschooled, her best friend is her seizure dog, and she's probably the only girl on the Outer Banks of North Carolina who can't swim. Then Emilie's mom enrolls her in public school, and Emilie goes from studying at home in her pj's to halls full of strangers. To make matters worse, Emilie is paired with starting point guard Chatham York for a major research project on Emily Dickinson. She should be thrilled when Chatham shows interest, but she has a problem: she hasn't told anyone about her epilepsy. Emilie lives in fear her recently adjusted meds will fail and she'll seize at school. Eventually, the worst happens, and she must decide whether to withdraw to safety or follow a dead poet's advice and \"dwell in possibility.\"
BOOK
Healing Eating Disorders with Psychodrama and Other Action Methods
Psychodrama and other action methods are especially helpful in the treatment of the classic eating disorders as well as dieting struggles, body dissatisfaction and associated issues of fear, sadness, silence and shame. This book provides clinicians with sound theoretical information, practical treatment guidelines and a wealth of clinically-tested action structures and interventions.
The authors describe how they have introduced action methods to work with a diverse range of clients, and suggest ways in which psychodrama practitioners, experiential therapists and others may integrate these methods into their practice. Offering fresh ideas for tailoring psychodramatic standards such as The Living Newspaper, Magic Shop and the Social Atom to eating disorder issues, they provide extensive examples of psychodrama interventions - classic and specially adapted for eating disorders - for both the experienced practitioner and those new to experiential therapies. They also explain how psychodrama can be used in combination with other expressive, holistic and complementary approaches, including family constellations, music, art, imagery, ritual, Five Element Acupuncture, yoga, Reiki and other energy work.
This pioneering book is essential reading for practitioners and students of psychodrama, drama therapy, experiential psychotherapy, cognitive and expressive arts therapies and mental health professionals, as well as professionals interested in complementary health modalities.
eBook
Fight For A Cure
Katie Couric reports on the movement to raise awareness and research funds for epilepsy.
Streaming Video
Infections, inflammation and epilepsy
Epilepsy is the tendency to have unprovoked epileptic seizures. Anything causing structural or functional derangement of brain physiology may lead to seizures, and different conditions may express themselves solely by recurrent seizures and thus be labelled “epilepsy.” Worldwide, epilepsy is the most common serious neurological condition. The range of risk factors for the development of epilepsy varies with age and geographic location. Congenital, developmental and genetic conditions are mostly associated with the development of epilepsy in childhood, adolescence and early adulthood. Head trauma, infections of the central nervous system (CNS) and tumours may occur at any age and may lead to the development of epilepsy. Infections of the CNS are a major risk factor for epilepsy. The reported risk of unprovoked seizures in population-based cohorts of survivors of CNS infections from developed countries is between 6.8 and 8.3 %, and is much higher in resource-poor countries. In this review, the various viral, bacterial, fungal and parasitic infectious diseases of the CNS which result in seizures and epilepsy are discussed. The pathogenesis of epilepsy due to brain infections, as well as the role of experimental models to study mechanisms of epileptogenesis induced by infectious agents, is reviewed. The sterile (non-infectious) inflammatory response that occurs following brain insults is also discussed, as well as its overlap with inflammation due to infections, and the potential role in epileptogenesis. Furthermore, autoimmune encephalitis as a cause of seizures is reviewed. Potential strategies to prevent epilepsy resulting from brain infections and non-infectious inflammation are also considered.
Journal Article
A systematic review and meta-analysis of factors related to first line drugs refractoriness in patients with juvenile myoclonic epilepsy (JME)
Juvenile Myoclonic Epilepsy (JME) is a prevalent form of epileptic disorder, specifically categorized within the realm of Genetic Generalized Epilepsy (GGE). Its hallmark features encompass unprovoked bilateral myoclonus and tonic-clonic seizures that manifest during adolescence. While most JME patients respond favorably to anti-seizure medication (ASM), a subset experiences refractory JME, a condition where seizures persist despite rigorous ASM treatment, often termed \"Drug-Resistant Epilepsy\" (DRE). This systematic review and meta-analysis aims to determine the prevalence of refractory JME, and further to identify socio-demographic, electrophysiological and clinical risk factors associated with its occurrence. Pinpointing these factors is crucial as it offers the potential to predict ASM responsiveness, enabling early interventions and tailored care strategies for patients.
The systematic review and meta-analysis followed the Cochrane Handbook and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study evaluated outcomes post ASM treatment in JME cohorts by searching papers published up to September 2023 in PubMed/MEDLINE, Scopus, and Google Scholar databases. Predefined inclusion criteria were met by 25 eligible studies, forming the basis for analysis.
A total of 22 potential risk factors for refractory JME were documented. Notably, robust risk factors for treatment resistance included Psychiatric Disorder (Odds Ratio (OR), 3.42 [2.54, 4.61] (95% Confidence Inverval (Cl)), Febrile Seizures (OR, 1.83 [1.14, 2.96] (95% Cl)), Alcohol Consumption (OR, 16.86 [1.94, 146.88] (95%Cl)), Aura (OR, 2.15 [1.04, 4.47] (95%Cl)), childhood absence epilepsy (CAE) evolving into JME (OR, 4.54 [1.61, 12.78] (95%CI)), occurrence of three seizure types (OR, 2.96 [1.96, 4.46] (95%CI)), and Focal EEG abnormalities (OR, 1.85 [1.13, 3.01] (95%Cl)). In addition, there were some non-significant risk factors for DRE because of noticeable heterogeneity.
In aggregate, over 36% of JME patients demonstrated drug resistance, with seven significant risk factors closely linked to this refractoriness. The interplay between these factors and whether they denote treatment non-response or heightened disease burden remains an open question and more studies would be required to fully examine their influence.
Journal Article
Frontal Lobe Epilepsy Surgery in Childhood and Adolescence: Predictors of Long-Term Seizure Freedom, Overall Cognitive and Adaptive Functioning
Abstract
BACKGROUND
Although frontal lobe resections account for one-third of intralobar resections in pediatric epilepsy surgery, there is a dearth of information regarding long-term seizure freedom, overall cognitive and adaptive functioning.
OBJECTIVE
To identify outcome predictors and define the appropriate timing for surgery.
METHODS
We retrospectively analyzed the data of 75 consecutive patients aged 10.0 ± 4.9 yr at surgery that had an 8.1 yr mean follow-up.
RESULTS
Etiology comprised focal cortical dysplasia (FCD) in 71% and benign tumors in 16% cases. All patients but one had a magnetic resonance imaging-visible lesion. At last follow-up, 63% patients remained seizure-free and 37% had discontinued antiepileptic drugs. Presurgical predictors of seizure freedom were a shorter epilepsy duration, strictly regional epileptic discharges in electroencephalography (EEG), and an epileptogenic zone and/or lesion distant from eloquent cortex. Postsurgical predictors were the completeness of resection and the lack of early postoperative seizures or epileptic discharges in EEG. Higher presurgical overall cognitive and adaptive functioning was related to later epilepsy onset and to a sublobar epileptogenic zone and/or lesion. Following surgery, scores remained stable in the majority of patients. Postsurgical gains were determined by higher presurgical performance and tumors vs FCD.
CONCLUSION
Our findings highlight the favorable long-term outcomes following frontal lobe epilepsy surgery in childhood and adolescence and underline the importance of early surgical intervention in selected candidates. Early postsurgical relapses and epileptic discharges in EEG constitute key markers of treatment failure and should prompt timely reevaluation. Postsurgical overall cognitive and adaptive functioning is stable in most patients, whereas those with benign tumors have higher chances of improvement.
Journal Article