Epilepsy diagnosis

Because alcohol intoxication may be simulated by many pathologic conditions, including diabetic acidosis, the postconvulsive depression of epilepsy, uremia, head injuries, and poisonings by any other central nervous depressant and some stimulants (280), a diagnosis of acute alcoholism should not be made casually chemical testing of blood, urine, or expired air is always desirable. 

Epilepsy is a heterogeneous group of syndromes characterized by abnormal, rhythmic electrical activity of the brain or parts of the brain. The term epilepsy is reserved for chronic diseases, while a single, isolated seizure does not justify the diagnosis of epilepsy. 

Mr. Parks, age 32 years, has recently received a diagnosis of epilepsy. He has been taking the anticonvulsant carbamazepine, but his seizures are not yet under control. Mr. Parks asks you how long it will take to cure his epilepsy. Determine how you would respond to Mr. Parks. 

National Institute for Clinical Excellence. The Epilepsies The Diagnosis and Management of the Epilepsies in Children and Adults in Primary and Secondary Care http //www.nice.org.uk/ pdf/CG020NICEguideline.pdf. Accessed December 20, 2005. 

Scottish Intercollegiate Guidelines Network. Diagnosis and Management of Epilepsy in Adults http //www.sign.ac.uk/pdf/sign70.pdf. Accessed December 20,2005. 

Suggested Alternatives for Differential Diagnosis Encephalitis, Herpes Simplex, tetanus, Guillain-Barre syndrome, poliomyelitis, transverse myelitis, cerebrovascular accident, psychosis, intracranial mass, epilepsy, atropine poisoning, and Creutzfeldt-Jacob disease. 

EEG is very useful in the diagnosis of various seizure disorders, but the EEG may be normal in some patients who still have the clinical diagnosis of epilepsy. 

Data from Fought Pharmacokinetic considerations in prescribing antiepileptic drugs. Epilepsia 2001 42(Suppl 4) 19-23 Leppik IE. Contemporary Diagnosis and Management of the Patient with Epilepsy, 6th ed. Newton, PA Handbooks in Health Care, 2006.02-149 and Bourgeois BED. Pharmacokinetics and pharmacodynamics of antiepiieptic drugs. In WyllieE. ed. The Treatment of Epilepsy, 4th ed. Philadelphia Lippincott Williams 8 Wilkins, 2006 656-669. 

Data from French JA, Kanner AM, Bautista J, et al Efficacy and tolerability of the new antiepileptic drugs I. Treatment of new onset epilepsy. Neurology 2004 62 1252-1260 French JA, Kanner AM, Bautista J, et al. Efficacy and tolerability of the new antiepileptic drugs II. Treatment of refractory epilepsy. Neurology 2004 62 1261-1273 and LeppiklE Contemporary Diagnosis and Management of the Patient with Epilepsy, 6th ed. Newton, PA Elandbooks in Health Care, 2006 92-149. 

A native of England, Roy Bolbery, forty-two when interviewed, was ill throughout his childhood in London. At age six he had a severe adverse reaction to penicillin. His sleep frequently was interrupted by night terrors. And during the day he would suddenly feel ill for no apparent reason. The outcome of many medical tests was a diagnosis of mild epilepsy. His sister died in childhood of leukemia. His father suffered with tuberculosis. 

GAMT deficiency has been known for more than 10 years now and several affected patients have been reported [6]. The severity of clinical symptoms varies widely. Affected patients show developmental delay with absence of active speech and, in older patients, autism with self injury. More severely affected patients present with severe extrapyramidal symptoms and intractable epilepsy. Biochemical diagnosis can be made by analysis of GA in the plasma or urine. 

It is well established that mitochondrial function defects are not severe until the proportion of mutant mtDNA reaches a high level, which forms the basis of the concept of the threshold effect. In skeletal muscle, the level of the A3243G mutation is related to the severity of strokelike episodes, epilepsy, and dementia in patients with MELAS syndrome (C6, H14, PI). Similarly, the level of the A8344G mutation is correlated with the degree of cerebellar ataxia and myoclonus in patients with MERRF syndrome (C6). Thus, molecular genetic analysis of mtDNA mutations in muscle biopsies usually provides more definitive diagnosis of... 

Many patients taking the same drug for years are doing so for the best reason, i.e. firm diagnosis for which effective therapy is available, such as epilepsy, diabetes, hypertension, but some are not. 

Swartz BE, Brown C, Mandelkem MA, Khonsari A, Patell A, Thomas K, Torgersen D, Delgado-Escueta AV, Walsh GO (2002) The use of 2-deoxy-2-[18F]fluoro-D-glucose (FDG-PET) positron emission tomography in the routine diagnosis of epilepsy. Mol Imaging Biol 4 245-252. 

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