Medical management of epileptic seizures: challenges and solutions

Anand K Sarma,1 Nabil Khandker,1 Lisa Kurczewski,2 Gretchen M Brophy2 1Department of Neurology, 2Departments of Pharmacotherapy & Outcomes Science and Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA Abstract: Epilepsy is one of the most common neurologic illnesses. This c...

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Autores principales:	Sarma AK, Khandker N, Kurczewski L, Brophy GM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Epilepsy pregnancy HIV/AIDS psychiatric pseudo-seizures management. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/42aea4b61d5f4bb59fd24e94c538f470
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spelling	oai:doaj.org-article:42aea4b61d5f4bb59fd24e94c538f4702021-12-02T01:16:13ZMedical management of epileptic seizures: challenges and solutions1178-2021https://doaj.org/article/42aea4b61d5f4bb59fd24e94c538f4702016-02-01T00:00:00Zhttps://www.dovepress.com/medical-management-of-epileptic-seizures-challenges-and-solutions-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Anand K Sarma,1 Nabil Khandker,1 Lisa Kurczewski,2 Gretchen M Brophy2 1Department of Neurology, 2Departments of Pharmacotherapy & Outcomes Science and Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA Abstract: Epilepsy is one of the most common neurologic illnesses. This condition afflicts 2.9 million adults and children in the US, leading to an economic impact amounting to $15.5 billion. Despite the significant burden epilepsy places on the population, it is not very well understood. As this understanding continues to evolve, it is important for clinicians to stay up to date with the latest advances to provide the best care for patients. In the last 20 years, the US Food and Drug Administration has approved 15 new antiepileptic drugs (AEDs), with many more currently in development. Other advances have been achieved in terms of diagnostic modalities like electroencephalography technology, treatment devices like vagal nerve and deep-brain stimulators, novel alternate routes of drug administration, and improvement in surgical techniques. Specific patient populations, such as the pregnant, elderly, those with HIV/AIDS, and those with psychiatric illness, present their own unique challenges, with AED side effects, drug interactions, and medical–psychiatric comorbidities adding to the conundrum. The purpose of this article is to review the latest literature guiding the management of acute epileptic seizures, focusing on the current challenges across different practice settings, and it discusses studies in various patient populations, including the pregnant, geriatric, those with HIV/AIDS, comatose, psychiatric, and “pseudoseizure” patients, and offers possible evidence-based solutions or the expert opinion of the authors. Also included is information on newer AEDs, routes of administration, and significant AED-related drug-interaction tables. This review has tried to address only some of these issues that any practitioner who deals with the acute management of seizures may encounter. The document also highlights the numerous avenues for new research that would help practitioners optimize epilepsy management. Keywords: epilepsy, pregnancy, HIV/AIDS, psychiatric, pseudoseizures, managementSarma AKKhandker NKurczewski LBrophy GMDove Medical PressarticleEpilepsypregnancyHIV/AIDSpsychiatricpseudo-seizuresmanagement.Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2016, Iss Issue 1, Pp 467-485 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Epilepsy pregnancy HIV/AIDS psychiatric pseudo-seizures management. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Epilepsy pregnancy HIV/AIDS psychiatric pseudo-seizures management. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Sarma AK Khandker N Kurczewski L Brophy GM Medical management of epileptic seizures: challenges and solutions
description	Anand K Sarma,1 Nabil Khandker,1 Lisa Kurczewski,2 Gretchen M Brophy2 1Department of Neurology, 2Departments of Pharmacotherapy & Outcomes Science and Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA Abstract: Epilepsy is one of the most common neurologic illnesses. This condition afflicts 2.9 million adults and children in the US, leading to an economic impact amounting to $15.5 billion. Despite the significant burden epilepsy places on the population, it is not very well understood. As this understanding continues to evolve, it is important for clinicians to stay up to date with the latest advances to provide the best care for patients. In the last 20 years, the US Food and Drug Administration has approved 15 new antiepileptic drugs (AEDs), with many more currently in development. Other advances have been achieved in terms of diagnostic modalities like electroencephalography technology, treatment devices like vagal nerve and deep-brain stimulators, novel alternate routes of drug administration, and improvement in surgical techniques. Specific patient populations, such as the pregnant, elderly, those with HIV/AIDS, and those with psychiatric illness, present their own unique challenges, with AED side effects, drug interactions, and medical–psychiatric comorbidities adding to the conundrum. The purpose of this article is to review the latest literature guiding the management of acute epileptic seizures, focusing on the current challenges across different practice settings, and it discusses studies in various patient populations, including the pregnant, geriatric, those with HIV/AIDS, comatose, psychiatric, and “pseudoseizure” patients, and offers possible evidence-based solutions or the expert opinion of the authors. Also included is information on newer AEDs, routes of administration, and significant AED-related drug-interaction tables. This review has tried to address only some of these issues that any practitioner who deals with the acute management of seizures may encounter. The document also highlights the numerous avenues for new research that would help practitioners optimize epilepsy management. Keywords: epilepsy, pregnancy, HIV/AIDS, psychiatric, pseudoseizures, management
format	article
author	Sarma AK Khandker N Kurczewski L Brophy GM
author_facet	Sarma AK Khandker N Kurczewski L Brophy GM
author_sort	Sarma AK
title	Medical management of epileptic seizures: challenges and solutions
title_short	Medical management of epileptic seizures: challenges and solutions
title_full	Medical management of epileptic seizures: challenges and solutions
title_fullStr	Medical management of epileptic seizures: challenges and solutions
title_full_unstemmed	Medical management of epileptic seizures: challenges and solutions
title_sort	medical management of epileptic seizures: challenges and solutions
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/42aea4b61d5f4bb59fd24e94c538f470
work_keys_str_mv	AT sarmaak medicalmanagementofepilepticseizureschallengesandsolutions AT khandkern medicalmanagementofepilepticseizureschallengesandsolutions AT kurczewskil medicalmanagementofepilepticseizureschallengesandsolutions AT brophygm medicalmanagementofepilepticseizureschallengesandsolutions
_version_	1718403194708557824

Medical management of epileptic seizures: challenges and solutions

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