Hypersomnia
Hypersomnia is the cardinal symptom of sleep disorders characterized by excessive daytime sleepiness, often resulting in increased sleep time or involuntary dozing. While insufficient sleep is the most common cause…
NEUROLOGY
EEG Interpretation
A. The initial step in evaluating an electroencephalogram (EEG) is to identify the recording montage. The typical initial montage is bipolar—each electrode is compared to a single adjacent electrode rather…
Management of Comorbidities in Patients With Epilepsy
A. Depression, bipolar disorder, anxiety, and psychosis are all more common in patients with epilepsy. If patients have symptoms or a history of depression, antiepileptic drugs (AEDs) with adverse mood…
Status Epilepticus
Status epilepticus (SE) can be categorized into convulsive and nonconvulsive status epilepticus (NCSE). Generalized convulsive status epilepticus is the most commonly encountered form of status epilepticus and is defined as:…
Antiepileptic Drug Selection
In most cases, initial antiepileptic drug (AED) therapy is selected from a relatively short list of AEDs determined primarily by the suspected epilepsy syndrome, as previously described in Chapter 71….
Drug-Resistant Epilepsy
Most patients with epilepsy achieve seizure control with medications. However, about 30% of patients have drug-resistant epilepsy. Drug-resistant epilepsy, often known as medically intractable epilepsy, is defined as continued seizures…
Initial Treatment of Epilepsy
A. When choosing initial antiepileptic drug (AED) therapy for a patient with epilepsy, assess whether the suspected diagnosis is a focal or generalized epilepsy. In focal epilepsies, there is felt…
Evaluation of Adult With First Seizure
Evaluation of the patient with a first seizure is focused on determining (1) the risk of recurrence and whether antiepileptic drug (AED) therapy is warranted to reduce this risk, and…
Intracranial Hypotension
Intracranial hypotension, or low cerebrospinal fluid (CSF) pressure, should be suspected in a patient with a positional headache that worsens within 15 minutes of standing and improves with recumbency. The…
Trigeminal Neuralgia
Trigeminal neuralgia, also known as tic douloreux, manifests as recurrent attacks of abrupt, unilateral, severe stabbing (or electric-like) pain in the distribution of the trigeminal nerve. Typically, the mandibular or…
