New PDF release: Handbook of Epilepsy (Lippincott Williams & Wilkins Handbook

By Thomas R. Browne

Completely up to date for its Fourth variation, this best-selling pocket reference is a realistic point-of-care advisor to the prognosis and administration of epilepsy. In an easy-to-use define structure, the e-book offers whole, clinically centred info on seizure type, epilepsies with varied a while of onset, situation-related epilepsy, prognosis and differential prognosis, and all on hand drugs, together with dosages, unintended effects, and drug interactions. This edition's up to date insurance of drug treatment comprises present American Academy of Neurology guidance, new medicinal drugs, newly licensed symptoms, new info on pharmacokinetics, and result of six registries of antiepileptic medicinal drugs in being pregnant. New info at the genetics and molecular biology of a number of epilepsy syndromes is usually integrated.

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Additional info for Handbook of Epilepsy (Lippincott Williams & Wilkins Handbook Series)

Sample text

Management and Prognosis See Chapters 6 and 7. B. Myoclonic Seizures 1. Definition Myoclonic seizures are characterized by sudden, brief (less than 350 µsec), shocklike contractions that may be generalized or confined to the face and trunk, or to one or more extremities, or even to individual muscles or groups of muscles. Myoclonic seizures result in short bursts of synchronized electromyographic (EMG) activity, which often involves simultaneous activation of agonist and antagonist muscles. The contractions of muscles are quicker than the contractions of clonic seizures.

If standing, the patient typically falls to the ground. The duration of these seizures is longer than myoclonic seizures. The EMG activity is dramatically increased in tonic seizures. Conversely, atonic seizures consist of the sudden loss of muscle tone. The loss of muscle tone may be confined to a group of muscles, such as the neck, resulting in a head drop, or it may involve all trunk muscles, leading to a fall to the ground. 2. Seizure Phenomena Tonic seizures frequently begin with a tonic contraction of the neck muscles, leading to fixation of the head in an erect position, widely opened eyes, and jaw clenching or mouth opening.

A versive movement, usually away from the side of ictal onset, may precede secondary generalization. The tonic posturing may be preceded by sensory symptoms in an extremity. Supplementary motor seizures occur frequently, and for a patient to experience five to ten episodes per day is not rare. Many seizures occur during sleep. Commonly, these seizures are medically intractable. 2. Cingulate Cingulate seizure patterns are complex partial with complex motor gestural automatisms at onset. Autonomic signs are common, as are changes in mood and affect.

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