Handbook on Epilepsy for Physicians PV Rai, HV Srinivas, P Satishchandra, GT Subhas
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table
A
Acetazolamide 52
Acidosis 49
Alcohol withdrawal 56
Alopecia, transient 102
Alpha amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid 96
Alzheimer's dementia 32
Alzheimer's disease 43
American Academy of Pediatrics 23, 51
American Epilepsy Society 90
Anemia 102
aplastic 102
Anion gap acidosis 73
Anorexia 102
Anoxia, perinatal 27
Antashubba 1
Anterior temporal resection 131
Antibiotics 43
Antibody
antinuclear 38
autoimmune 31, 38
paraneoplastic 38
Antidepressants 43
specific serotonergic 61
Antidiscriminatory law 147
Antiepileptic drugs 5, 12, 22, 32, 48, 56, 60, 74, 78, 85, 99, 101t, 115, 122, 126t, 148, 151
adverse effects of 102t
choice of 99, 125t
induced cardiac malformations 49
pharmacodynamics of 41
pharmacokinetics of 41
role of 60
selection 44
teratogenic effects of 49
Antiepileptic medications 44, 88
Anti-gamma-aminobutyric acid 31
receptor antibodies 31
Anti-leucine-rich glioma-inactivated 31, 96
Anti-N-methyl-D-aspartate 31
Antipyretic drugs 13
Anti-thyroid peroxidase 37
Anxiety disorders 26, 58, 60
Apasmara 1
Arrhythmias, cardiac 41
Aspirin 14
Astrocytoma 36
Ataxia 92, 102
Atkins diet, modified 128
Atresia, pulmonary 49
Atrial septal defect 49
Attacks
severe recurrent 15
shuddering 17
transient ischemic 30, 41, 43
Attention-deficit hyperactivity disorder 26, 65
Autism-spectrum disorders 26
Autonomic function tests 30
Autosomal dominant 70
disorder 11
frontal lobe epilepsy 70
juvenile myoclonic epilepsy 70
nocturnal frontal lobe epilepsy 69
partial epilepsy with auditory features 70
B
Bangalore Urban and Rural
Neuroepidemiological Survey 42
Beck's depression inventory 141
Behavioral changes 102
Behavioral problems 111
Behavioral therapies 141
Benzodiazepines 105
gamma-aminobutyric acid 60
oral 88
parenteral 89
trial 95f
Biochemical tests 77
Bone marrow depression 102
Bradyarrhythmia 55
Brain 1, 73, 99
damage
risk of 15
structural 56
disorder of 30
human 4
injury, traumatic 36, 43, 144
neurotransmitters 45
presence of 8
tumor 36, 90
Breath-holding spell 10, 17, 18
Brivaracetam 105
Broad-spectrum parenteral anticonvulsants effective against multiple seizure types 89
Brudzinski signs 10
C
Calcification 83
Calcium 8
Carbamazepine 5, 33, 44, 49, 60, 72, 100103, 116, 125, 126
Cardiopulmonary resuscitative procedures 15
Carotid sinus syndrome 41
Catamenial epilepsy 52
Catastrophic seizure syndromes 28
Cavernous angiomas 32
Central nervous system 32, 34, 89
infection 10, 144
rule out 10
Centrotemporal spikes 80, 110
Cerebrovascular disease 144
Charaka Samhita 1
Chest
infections 42
X-ray of 43
Chills 10
Chromosomal microarray 75
Clinical psychologist, role of 141
Clobazam 33, 52, 92, 101, 102, 105, 125, 126
oral 88
Clonazepam 92, 102
Cognitive behavioral therapy 61, 141
Commissure
anterior 82
posterior 82
Commitment therapy 61
Comprehensive epilepsy care centers 129
Computed tomography 126, 127
scan 112
Computer 156
Confusion 92, 102
Consciousness 94f
assessment of 10
Continuous therapy 13
indications for 13
Contraception 51
Conventional antiepileptic drug therapy 23
Convulsions
neonatal 27
study of 2
Convulsive diseases, chronic 3
Corpus callosotomy 132
Cortical development, malformations of 24, 25
Corticotrophin-releasing hormone 153
Cough syncope 55
Craniofacial defects 49
Cysticercosis 89
D
De novo
mutation 11
psychosis after epilepsy surgery 63
Deep brain stimulation 133
Deep tendon reflex, assessment of 10
Dementias 43, 90
Deoxyribonucleic acid 71
Depression 58, 102
cardiac 92
respiratory 92
screening for 60
treatment strategies for 60
Depressive disorder 26
Diabetes 55
gestational 49
Diazepam 13, 90
oral 88
Diet 156
Diffusion-tensor imaging 83
Diffusion-weighted image 34
Diphtheria/tetanus/pertussis 8
Diplopia 102
Divalproate 60
Dizziness 102
Doose syndrome 68
Doshas 1
Down syndrome 90
Dravet syndrome 8, 10, 11, 26, 68, 72, 111
Drop attacks 18, 28
Drowsiness 92
Drug 56
compliance 124
resistant epilepsy 105, 122, 123, 129
management of 123
withdrawal
after seizure freedom 115
benefits of 116
risks of 117
Duloxetine 61
Dysautonomia, primary 55
Dysembryoplastic neuroepithelial tumors 24, 129
Dyskinesia, paroxysmal 30
Dyslipidemia 26
Dysplasia 24
focal cortical 32, 83, 131
E
Edema, perilesional 35f
Electrocardiogram 30, 43
Electroclinical syndromes 90
Electroconvulsive therapy 93
Electroencephalogram 3, 11, 18, 20, 22, 31, 42, 63, 107, 152
Electroencephalography 77, 85fc, 99, 112, 117, 123
abnormalities 80t
continuous 93
role of 93
Electrolytes, serum 43
Electrophysiological procedures 80
Electrophysiology 77
clinical 130
Elekta Neuromag® Triux Magnetoencephalography Machine 81f
Encephalitis 10, 55, 90, 111
autoimmune 32, 37, 96
viral 56
Encephalopathy 92
autoimmune 31
developmental 23
epileptic 16, 23, 69, 72
hepatic 56
metabolic 56
mitochondrial 70
renal 56
steroid-responsive 37
Enzyme
inducibility 45
induction 92
Ephedrine 32, 56
Epigenetics 71
Epilepsy 13, 6, 1619, 26, 30, 36, 42, 46, 48, 54, 56, 56t, 58, 61, 64, 65, 67, 77, 77t, 83, 85, 99, 104, 107, 109, 133, 137, 138, 143, 148, 151, 158
absence of 65, 80
adult-onset 16, 34
and cognition 153
and counseling 137
and disability 147
and driving 146
and employment 147
and epilepsy syndromes 16
and exercise 152
and functional anatomy 4
and income tax 147
and insurance 147
and law 146
and marriage 146
and psychiatric aspects 58
and yoga 151
anxiety disorders in 60
benign 26
childhood 16, 17, 21, 25, 26, 80
classification 28, 107
cryptogenic 125
development of 14
diagnosis of 41, 80, 107, 109, 112
education and employment 148
emergencies in 88
epidemiology of 41
etiology of 41
famous persons with 164
focal 109, 110
frontal lobe 18, 65
generalized 8, 25, 109, 110
genetic 67
basis of 67
causes of 69, 73
diagnosis of 67
history of 1
idiopathic 16, 31
generalized 68, 80, 110, 122, 125
in elderly 41
investigation of 77, 112
juvenile
absence 90, 110, 122
myoclonic 31, 32, 51, 64, 79, 80, 90, 110, 116, 122
management of 4, 52, 143
medical treatment of 73, 99
medically refractory 73, 105
mesial temporal 33, 83, 130
metabolic 111
mitochondrial 72
myoclonic 32, 70
neurological disorders depression inventory for 60, 141
new-onset 3032, 38
idiopathic generalized 100
partial 100
on pregnancy 48
pediatric 25, 27, 28, 134
pharmacokinetics of 73
pharmacoresistant 27
phenotypic characteristics of 16
post-traumatic 36
prevention of 143
primary
generalized 94f
new-onset 31
protocol magnetic resonance imaging 82t
pyridoxine-dependent 72
recent classification of 116
refractory 105, 105t, 122, 123
secondary new-onset 34
self-limited 110
occipital 110
severe myoclonic 8
short history of 1
stigma of 54
sudden unexplained death in 151
surgery for 129
symptomatic 16, 25, 125
focal 24
syndrome 18, 20, 20t, 21, 22, 67, 110, 110t
febrile infection-related 10, 11, 90
identification of 110
self-limiting focal 21t
specific 26
temporal lobe 59, 64, 68, 80
therapy resistance in 122
treatment of 6, 41
types of 80
with complex inheritance 69
Epileptic syndrome 11, 31, 42, 80t
Epileptiform discharges, absence of 112
Epileptogenic lesions 83t
Erythrocyte sedimentation rate 34
Escitalopram 61
Eslicarbazepine 101
Ethosuximide 102
European Association of Epilepsy Centers 5
European Forum on Epilepsy Research 6
Everolimus 72
Exercise, role of 151
Extratemporal resection 131
Ezogabine 72
F
Falling disease 1
Fallot's tetralogy 49
Father of medicine 1
Fatigue 92, 102
paresthesias 102
Febrile
delirium 10
episode 13
myoclonus 10
seizures 79, 14, 15, 23, 56
development of 8
first 12
majority of 11
plus 68, 70
syndrome 8, 25
treatment of 11
Felbamate 101, 102
Fenfluramine 72
Fetal
heart rate 49
hypoxia 49
Fever 10
causes of 10
infections 8
low-grade 12
Fluid attenuated inversion recovery 34, 82
Fluoxetine 61
Folic acid 8
Fosphenytoin 12, 92
Functional magnetic resonance imaging 84f
G
Gabapentin 43, 100, 104
Gait problems 111
Galen's theory 2
Gamma-aminobutyric acid 8, 96
Ganglioglioma 24, 83
Gastroenteritis 8
Gastrointestinal
irritation 102
malformations 49
Gator1 complex 72
Genetic 8
epilepsy 16, 31, 70, 71, 74fc, 118
syndromes 70t
etiology 19
factors 8
generalized epilepsy 110
testing 11
Genomic imprinting, disorder of 73
Ginkgo biloba 43
Glaucoma 102
Gliosis 111
Global Campaign Against Epilepsy 5
Glucose
transporter deficiency 71, 72
syndrome 27
Glucuronidation, hepatic 51
Glutamic acid decarboxylase 96
Granulomas 34
cysticercal 32
neurocysticercal 34t
tuberculous 34t
Growth hormone deficiency 26
Gum hyperplasia 102
H
Hamartoma, hypothalamic 19, 25
Hans Berger 3
Hashimoto's encephalopathy 37
Head
injury 56
trauma 36
Headache 102
Hearing 73
loss, sensorineural 69
Heart 73
disease, structural 41
Hemiconvulsion-hemiplegia epilepsy 19
Hemiparesis, transient 9
Hemispherectomy 131
Hemispherotomy 131
Hemogram 43
Hemorrhage 49
postpartum 49
Henri Jean Pascal Gastaut 4
Hepatic failure 102
Hepatotoxicity 13, 93, 102
Herpes
encephalitis 32
simplex 55
Hippocrates 2
Hirsutism 102
Histone modifications 71
Holter monitoring 30
Hospital Anxiety and Depression Scale 141
Human immunodeficiency virus 32, 36
Hydronephrosis 49
Hyperammonemia 13, 73, 92, 102
Hyperekplexia 17
Hyperglycemia 32, 41, 42
Hypernatremia 32, 41
Hyperphagia 64, 65
Hypersexuality 64
Hypertensive disorders 49
Hyperthermia 64
Hypnic jerks 41
Hypocalcemia 30, 32, 34, 41, 42, 44, 54, 56, 73
Hypohidrosis 102
Hypometabolism, severe 84f
Hyponatremia 32, 34, 41, 42, 56, 102
Hypospadias 49
Hypotension 92
orthostatic 41
Hypothermia, therapeutic 93
Hypothyroidism 26, 42
Hypoxia, maternal 49
Hypsarrhythmia 80
I
Immunization 8
Immunoglobulin 37
Indian Academy of Neurology 160
Indian Epilepsy Association 6, 146, 158160
activities of 160
birth of 159
Infantile spasm 18, 26, 69
Infections 34, 111
extracranial 8
Infertility 48
Insomnia 102
Intensive care unit 96
Interictal epileptiform discharges 78
Intermittent therapy 13
indications for 13
International 1020 Montage System 79f
International Bureau for Epilepsy 158
International Classification of Epileptic Seizures and Epilepsies 5
International Epilepsy Day 161
International League Against Epilepsy 4, 18, 67, 116, 158
Classification of Seizure Types Basic Version 108f
Classification of Seizures and Epilepsies 107
Framework for Classification of Epilepsies 108f
International Neuropsychiatric Interview Plus 60
Intoxication 90
Intracranial infection, acute 7
Intrauterine
device 51
growth retardation 9
Iron 8
J
Japanese encephalitis 55
Jitteriness 17
John Hughlings Jackson 2
K
Kapha 1
Kernig's signs 10
Ketamine 93
Ketogenic diet 72, 93, 128
Kidney 73
Klüver-Bucy syndrome 64
L
Lacosamide 12, 33, 92, 105, 125, 126
Lactic acidosis 70
Lafora's disease 69, 85, 90
Lamotrigine 33, 43, 48, 72, 100102, 125, 126
Landau-Kleffner syndrome 26
Language impairment 26
Laser intermittent thermal ablation treatment 133
Learning disability 111
Lennox-Gastaut syndrome 3, 4, 26, 69, 80, 90, 104
Lesionectomy 131
Lethargy 102
Leukopenia 102
Levetiracetam 12, 33, 43, 92, 100102, 125, 126
Levodopa 43
Limbic encephalitis 23
Liver 73
enzymes, elevated 92
failure 42, 105
function tests 43
Lorazepam 90, 95f
Lumbar puncture 11, 96
Lymphadenopathy 102
M
Magnetic resonance imaging 11, 77, 81, 83t, 84f, 85f, 99, 112, 127, 130
Magnetoencephalography 126, 127, 130
Malaria 90
Malformations
arteriovenous 32
major congenital 49
Manganese 8
Marriage, low rates of 48
Masturbation 17, 64
Mean spectral intensity 152
Memantine 72
Memory disorders 65
Mendelian inheritance 69
Meningeal irritation, signs of 10
Meningioma 36
Meningitis 10
bacterial 56
cryptococcal 36
Menstrual irregularities 48
Mental
disorders, statistical manual of 59
retardation 27
stress 48
Metabolism
hepatic 45
inborn error of 73
several inborn errors of 23
Metastatic lesions 36
Methylation 71
Micturition syncope 55
Midazolam 88, 91, 93
Midline craniofacial anomalies 49
Migraine 17, 18
complicated 30
Miscarriages 49
Mitochondrial
disease 69
inheritance 69, 70
syndromes 85
Mood
disorders 26
symptoms 64
Morbus Divus 2
Morbus Sacer 2
Motor disabilities 111
Motor vehicle Act 146
Movement disorders 30, 111
Multifocal paraneoplastic disorders 23
Multiorgan involvement 34, 73
Multiple subpial transections 28, 132
Muscle 73
biopsy 77
oligodendrocyte glycoprotein 37
tone and power, assessment of 10
Myoclonic disease, severe 69
Myoclonus 92
Myopathy sensory ataxia 70
N
Narcolepsy 41
National Epilepsy Day 161
National Institute of Mental Health and Neurosciences 152
Neonatal epilepsy, benign familial 69, 70
Neonatal intensive care unit 9
Nerve 73
Nervous system malformations 49
Neural tube defects 49
Neurocysticercosis 34, 35f
Neuroleptics 43
Neurological disorder, chronic 58
Neurological Society of India 6
Neuromyelitis optica 37
Neuronal ceroid lipofuscinosis 85
adult-onset 32
Neurons, epileptic 4
Neuropsychiatric disorder, developmental 25
Neurostimulation 133
responsive 133
Neurosyphilis 32, 36
Neurotuberculosis 34
Nimesulide 14
N-methyl-D-aspartate 23, 96
Nonepileptic attack 30
disorder 54, 56, 56t
Nonmendelian inheritance 69
Norepinephrine-dopamine reuptake inhibitors 61
O
Obsessive compulsive disorder 65
Ocular hypertelorism 49
Oligodendroglioma 36
Orbitofrontal lesions 65
Osteomalacia 102
Otitis media 8
Oxcarbamazepine 125, 126
Oxcarbazepine 33, 100102
P
Panayiotopoulos syndrome 21, 90
Pancreatitis 92
Panic attacks 55
Papilledema 10
Paracetamol oral 13, 15
Parenchymal hemorrhagic lesions 36
Paresthesias 92
Parkinson's disease 55
Paroxysmal torticollis, benign 17
Paroxysmal vertigo, benign 17
Patent ductus arteriosus 49
Pediatric neurologic disorders 16
Pentobarbital 93
Perampanel 105
Persons with epilepsy 1, 58, 115, 129, 145, 146, 148, 152, 156, 158
Phenobarbital 50, 101, 105
Phenobarbitone 12, 13, 92, 100, 102, 116, 125, 126
Phenylephrine 32, 56
Phenytoin 5, 44, 50, 92, 94f, 100103, 116, 125, 126
intravenous 12
Phosphorus metabolism 41
Pitta 1
Pleitropy 67
Pneumonia 8
Polycystic ovary syndrome 26
Polymicrogyria 24
Polypharmacy 45
Porphyria 105
Positron emission tomography 5, 77, 83, 84f, 126, 127
Premature birth 8
Presyncope 30
Prevention Task Force of International League Against Epilepsy 143
Primidone 49, 104
Propofol 93
Protein binding 45
Pseudocrisis 18
Pseudoseizures 124
Psychiatric
comorbidities 26
conditions 111
Psychic blindness 64
Psychogenic crises 17
Psychosis 26, 6163, 102
chronic interictal 63
in persons with epilepsy 61
interictal 65
postictal 62
prevalence of 61
Public Awareness Programs 161
Pyridoxine 27, 72, 93
Q
Quinidine 72
Quinolones 32, 56
R
Radiofrequency thermocoagulation 133
Radiosurgery 132
Randomized controlled trials 46
Rapamycin inhibitors, mammalian target of 72
Rapid eye movement 41
Rasmussen syndrome 19
Rectal preparation 12, 14
Regression, developmental 73
Renal agenesis 49
Renal failure 104
Renal function tests 43
Renal stones 102
Respiratory rate, monitor for 91
Restless legs syndrome 41
Retigabine 101
Ribonucleic acids 71
noncoding 71
Rolandic epilepsy 80
Rolandic seizure 18
S
Sandifer syndrome 17, 18
Sclerosis
hippocampal 19, 82, 111
mesial temporal 24, 3133, 95f, 129, 131
multiple 37
tuberous 72
Sedation 102
Seizures 3, 811, 17, 19, 48, 54, 55, 55t, 69, 88, 107, 138
absence 11, 18
acute 44
repetitive 88
and epilepsy, first unprovoked 43
atonic 11
characteristics 10
cluster 88
complex
febrile 9, 9t, 59
partial 79f
convulsive 163
differential diagnoses of 41b
disorders 145
drug induced 34
duration of 10
during pregnancy, recurrence of 48
early-onset 36
epileptic 30, 115, 117
focal 18, 19, 31
frequency 52
generalized 16, 19, 109
hysterical 54
isolated 34, 88
migrating partial 72
myoclonic 11, 18
neonatal 73
nonepileptic psychogenic 41
occipital lobe 18
paradoxical worsening of 92
poststroke 34, 36
post-traumatic 34, 36
prolonged febrile 11
provoked 42, 56b
psychogenic 54
nonepileptic 124
reduction 28
re-emergence of 49
sensory 41
simple febrile 9, 9t
temporal lobe 18
types 18, 2022
classification of 19b
identification of 107
typical febrile 68
Selective serotonin-norepinephrine reuptake inhibitors 61
Selenium 8
Sertraline 61
Sexual maturation-related issues 26
Single-photon emission computed tomography 77, 83, 126
Skin 77
rash 102
Sleep
apnea 41
benign epileptiform transients of 112
deprivation of 145
positive occipital sharp transients of 112
myoclonus, venign 17, 18
disorders 17, 18, 30, 41, 111
Sodium
channel blocker 72
valproate 5, 32, 49, 116, 125, 126
Somnolence 92
Spasm, march of 2
Spasmus nutans 17
Status epilepticus 10, 16, 18, 27, 41, 45, 8890
afebrile 12
classification of 89
convulsive 88, 91fc
De novo 90
epidemiology of 89
etiology of 90b
evaluation of 97fc
febrile 9, 10, 14
first-line antiepileptic drugs in 92t
management of 90
medical management of 90
new onset refractory 90
nonconvulsive 18, 88, 91fc, 96
refractory 93
second-line antiepileptic drugs in 92t
Stereotactic techniques 132
Steroids, high-dose 37
Stevens-Johnson syndrome 102
Stiripentol 72
Stokes-Adams syndrome 55
Stroke 56, 89, 90, 111
like episodes 70
Supportive therapy 141
Surgically remediable syndromes 129
Syncope 17, 18, 30, 43, 54, 55, 55t
common types of 55b
convulsive 30
Systemic lupus erythematosus 32
T
Tachyarrhythmia 55
Taenia solium 34, 144
Teratogenesis, cognitive 50
Testis, undescended 49
Tetracyclic antidepressants, use of 61
Theophylline 43
Thiazides 43
Thrombocytopenia 92, 102
transient 92
Thyroiditis, autoimmune 37
Thyrotoxicosis 41
Tiagabine 101
Tics 17
Todd's paresis 9
Tonic spasms 18
Tonic upward gaze, benign paroxysmal 17
Tonic-clonic seizure 18
generalized 11, 18, 31, 44, 49, 110, 116
Topiramate 33, 51, 92, 100102, 104, 125, 126
TORCH infections, congenital 111
Toxoplasmosis 36
Tramadol 32
Transcranial magnetic stimulation 93
Trauma 111
Tremor 102
Tricyclic antidepressants, use of 61
Tuberculoma, right parietal 35f
Tuberculosis 32, 34
granuloma 34
Tumors 32, 36, 111
low-grade 36
Typhoid 54
U
Unverricht-Lundborg disease 69, 70
Upper respiratory infection 8
Uremia 42
Urinary ketones 73
Urinary tract infection 8, 42
V
Vagal nerve stimulation 28, 127, 133
Valproate 12, 13, 33, 92, 100, 101, 105
Valproic acid 43, 44, 102
Vasculitis 32
Vasovagal syncope 30, 41
Venereal Disease Research Laboratory 38
Venlafaxine 61
Ventricular septal defect 49
Vertigo 92, 102
Video electroencephalography 85, 127
Vigabatrin 101, 104
Viral infections 8
Visual agnosia 64
Vitamin
B12 8
D supplements 44
W
Weight
gain 102
loss 102
West's syndrome 80, 104
Wilder Graves Penfield 4
William Gordon Lennox 3
William Richard Gowers 3
Women with epilepsy 48
Women, epilepsy and pregnancy 48
World Health Organization 5
X
X-linked disorders 70
Y
Yoga, role of 151
Z
Zinc 8
Zonisamide 3, 102, 105, 125, 126
×
Chapter Notes

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Handbook on Epilepsy for Physicians
In pursuit of good care of people with Epilepsy
With Compliments from:
Indian Epilepsy Association Bangalore Chapter
Handbook on Epilepsy for Physicians
Editors PV Rai Senior Neurologist/Epileptologist Former Associate Medical Director Swiss Epilepsy Center Zurich, Switzerland HV Srinivas Senior Consultant Neurologist, Sagar Hospital and Agadi Hospital, Bengaluru Former Associate Professor Department of Neurology NIMHANS, Bengaluru, Karnataka, India P Satishchandra Advisor and Senior Consultant Department of Neurology/Epileptology Apollo Hospitals, Bengaluru Hon. Professor University of Liverpool, UK Former Director Vice-Chancellor and Ex-Senior Professor Department of Neurology National Institute of Mental Health and Neurosciences (NIMHANS) Bengaluru, Karnataka, India GT Subhas Senior Consultant Neurologist/Epileptologist Former Dean/Director Bangalore Medical College and Research Institute Professor and Head Department of Neurology BMCRI, Bengaluru, Karnataka, India Foreword Bhim S Singhal
Jaypee Brothers Medical Publishers (P) Ltd
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© 2019, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book.
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Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
Handbook on Epilepsy for Physicians
First Edition: 2019
9789389188004
Printed at
Late Dr KS Mani
Founder Member of Indian Epilepsy Association
National Body and Bangalore Chapter
“Father of Indian Epileptology”
Contributors Foreword
I am honored to write the foreword for the book “Handbook on Epilepsy for Physicians”, brought out by Indian Epilepsy Association (IEA) Bangalore Chapter. Epilepsy is a common neurological problem seen in day-to-day practice of primary care physicians. Epilepsy can be diagnosed clinically and managed easily in about 70–80% of patients. However, due to paucity of adequate training and knowledge, this eminently treatable condition is often misdiagnosed and not managed correctly. This book addresses several such issues and is handy for the Physicians to quickly refer and make a proper diagnosis and manage.
I should compliment the four distinguished editors for this multi-authored book. They have invited specialists with expertise in the field of epilepsy and having a large practical experience in managing persons with epilepsy to write the various chapters. Each section is devoted to one aspect of epilepsy, which includes diagnosis, investigations, and appropriate management.
The book also dwells into difficult to treat epilepsy/drug-resistant epilepsy, which accounts for about 20–25% of all epilepsies. Investigation of such a case along with the indications for surgery has been well brought out. For readers who would like to have some advanced information, the role of genetics and personalized treatment has been touched upon.
Indian Epilepsy Association Bangalore Chapter has been in the forefront of public education to dispel the myths and misunderstanding about epilepsy. For more than 10 years, members of the Association have been addressing regularly students in schools, colleges, and various social organizations. In addition, street plays are being performed regularly for more than 10 years, by amateur artists to spread the right message to rural and semiurban population. These are conducted in busy places such as bus stand, railway station, schools, and weekly fairs. It is heartening to note that the book also covers several social aspects of epilepsy, which the medical doctors should be aware of to educate their patients and their family members.
This comprehensive “Handbook on Epilepsy for Physicians” should be extremely useful for all those who care for persons with epilepsy including family physicians, internists, pediatricians, neurologists, and psychiatrists.
Bhim S Singhal
Director of Neurology
Bombay Hospital Institute of Medical Sciences
Mumbai, Maharashtra, India
Preface
For the past four to five decades, there has been significant advancement in the diagnosis and treatment for people living with epilepsy (PWE). This is the result of some major developments in the field of neurology and neurosciences, which have resulted in the establishment of a specialization—Epileptology. The progress in epileptology can be traced mainly to three to four major areas such as: (1) the classification of epileptic seizures and epilepsies—by the International League against Epilepsy (ILAE), (2) the development of newer antiepileptic drugs (AEDs), (3) the advancement in the field of medical technology—in particular electroencephalography (EEG) with different forms of application—neuroradiological investigations with computed tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET), etc. Further progress is the result of extensive scientific and social programs carried out by the two organizations—ILAE and International Bureau for Epilepsy (IBE) through their worldwide chapters.
Because of these advancements, epilepsy, which was for ages considered as “incurable”, has become an eminently treatable neurological condition with over 70% PWE almost certain to achieve the status of freedom from seizures. Having a variety AEDs available in the market, with proper selection, a single drug can lead to seizure freedom in about 70%. Where drugs do not help, in a small number of people, neurosurgery can make a person free of seizures. Under this positive scenario of epilepsy treatment, the reality is very much different particularly in developing countries including India. A large number of PWE mostly in the rural areas do not get even the basic drug treatment and continue to have seizures, although some of the effective “standard” drugs have become cost-effective and affordable for all sections of society.
Epilepsy is very much a clinical condition. The diagnosis of epilepsy is made on the basis of identification of seizures and the circumstances, which lead to their manifestation. With ongoing Continuing Medical Education (CME) program around the year, every physician should be able to diagnose and treat a PWE in nearly 70% of cases, except in cases of some complicated epilepsies, where neurological consultation may be needed. Managing a PWE at the level of primary healthcare/general medical practice is of utmost importance in view of the present medical and social situation in India. The number of neurologists available in the country is insufficient for the management of huge population of around 10–12 million of PWE in India. With this in our mind, the Indian Epilepsy Association (IEA) Bangalore Chapter has planned to have simple but comprehensive “Handbook on Epilepsy for Physicians”. We hope that this will guide our physicians in day-to-day practice in managing their patients. This is a multi-author book and the authors chosen for this task are highly proficient in their field of work related to epileptology. Thanks to their contribution, the book provides expert and latest information regarding various aspects of epilepsy.
Attempts have been made to present important aspects of epilepsy as separate chapters, so that the readers can select these chapters according to their particular needs. Examples, febrile seizures, new onset epilepsy, epilepsy syndromes in children, epilepsy in the elderly, seizures but not epilepsy, epilepsy and pregnancy, to name only a few of the chapters. The authors have done commendable work in synthesizing their ideas, taking much time, in spite of their busy professional schedule for which we express our gratitude to them.
The book would not have seen the light of the day at this stage of publication but for the incessant work of Dr HV Srinivas in doing maximum amount of the editorial work, in spite of his busy professional activity. He has dedicated weeks and months of his private time for bringing out a neurological book on epilepsy for physicians. We express our sincere thank profusely.
We wish to dedicate this book to our Indian Epilepsy Association founder Professor KS Mani who is known as “Father of Indian Epileptology”. We are thankful to Professor BS Singhal for kindly writing the Foreword for this book. We also thank the Jaypee Brothers Medical Publishers (P) Ltd., New Delhi and their Bengaluru office for bringing out the book in a beautiful form.
Rai PV
Srinivas HV
Satishchandra P
Subhas GT
Acknowledgements
The book is a brainchild of Dr PV Rai, President of Indian Epilepsy Association Bangalore Chapter, who mooted the idea of bring out multi-authored book on behalf of Indian Epilepsy Association (IEA) Bangalore Chapter, which would be of help to Primary Care Physicians dealing with epilepsy.
Sincere thanks to all the contributors from IEA Bangalore Chapter who spared their time willingly to contribute to this book.
Our thanks to Dr BS Singhal for graciously accepting to write the Foreword.
The Editors wish to express their hearty thanks to Dr HV Srinivas for his untiring work of editing, organizing, and “endless” correspondence with Authors and Publishers.
We thank Ms Meena Chandramohan for diligently copyediting the book.
We thank our Secretary Ms Theresa Pinto for typing several drafts ungrudgingly before it took the final shape.
Finally, we are thankful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head) and Ms Nedup Denka Bhutia (Development Editor) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for giving a go-ahead at the very beginning and helping us in every way possible to bring out this book.