User:Wadewitz/Epilepsy collaboration page

Article structure

Classification

• Engel J Jr. Report of the ILAE classification core group. Epilepsia. 2006 Sep;47(9):1558–68. PMID 16981873.
• Engel J Jr; International League Against Epilepsy (ILAE). A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology. Epilepsia. 2001 Jun;42(6):796–803. PMID 11422340.
• Fisher RS, van Emde Boas W, Blume W, Elger C, Genton P, Lee P, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005 Apr;46(4):470–2. PMID 15816939.
  • Beghi E, Berg A, Carpio A, Forsgren L, Hesdorffer DC, Hauser WA, et al. Comment on epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) [letter]. Epilepsia. 2005 Oct;46(10):1698–9; author reply 1701–2. PMID 16190948.
  • Gomez-Alonso J, Andrade C, Koukoulis A. On the definition of epileptic seizures and epilepsy [letter]. Epilepsia. 2005 Oct;46(10):1699–700; author reply 1701–2. PMID 16190949.
  • Ahmed SN. Epileptic seizures and epilepsy [letter]. Epilepsia. 2005 Oct;46(10):1700–1; author reply 1701–2. PMID 16190950.
• Lüders HO, Acharya J, Alexopoulos A, Baumgartner C, Bautista J, Burgess R, et al. Are epilepsy classifications based on epileptic syndromes and seizure types outdated? Epileptic Disord. 2006 Mar;8(1):81–5. PMID 16567333.

Seizure types

Main article: Seizure types

An epileptic seizure is "a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain".

There are three main types of seizures: partial, generalized, and unclassified. In terms of their origin within the brain, seizures may be described as either partial (focal) or generalized. Partial seizures only involve a localized part of the brain, whereas generalized seizures involve the the whole of both hemispheres. The term secondary generalisation may be used to describe a partial seizure that later spreads to the whole of the cortex and becomes generalized.

While most seizures can be neatly split into partial and generalized, some cannot. For example, a seizure that is generalized only within one hemisphere of the brain. Alternatively, there may be many focal points (multifocal seizures) that are distributed in a symmetrical or asymmetrical pattern.

• Partial seizures - Simple partial seizures, Complex partial seizures, Partial seizures evolving to secondarily generalized seizures

• Generalized seizures - Absence seizures (Older term: petit mal), Myoclonic seizures, Clonic seizures, Tonic seizures, Tonic-clonic seizures (Older term: grand mal), Atonic seizures

• Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. From the Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia. 1981 Aug;22(4):489–501 PMID 6790275.
• Dreifuss FE. The epilepsies: clinical implications of the international classification (PDF). Epilepsia. 1990;31 Suppl 3:S3–10. PMID 2226370.
• eMedicine: Seizures and Epilepsy: Overview and Classification (Not a source, but may be helpful to read).

Epilepsy syndromes

• Avoli M, Rogawski MA, Avanzini G. Generalized epileptic disorders: an update. Epilepsia. 2001 Apr;42(4):445-57. PMID 11440339.
  • Good review on generalised seizures
• Wheless JW, Kim HL. Adolescent seizures and epilepsy syndromes. Epilepsia. 2002;43 Suppl 3:33-52. Review. PMID 12060005.
• Camfield P, Camfield C. Epileptic syndromes in childhood: clinical features, outcomes, and treatment. Epilepsia. 2002;43 Suppl 3:27-32. PMID 12060004.
• Nordli DR Jr. Infantile seizures and epilepsy syndromes. Epilepsia. 2002;43 Suppl 3:11-6. PMID 12060002.
• Tharp BR. Neonatal seizures and syndromes. Epilepsia. 2002;43 Suppl 3:2-10. PMID 12060001.
• Mattson RH. Overview: idiopathic generalized epilepsies. Epilepsia. 2003;44 Suppl 2:2-6. PMID 12752455.

Causes

• Shostak S, Ottman R. Ethical, legal, and social dimensions of epilepsy genetics. Epilepsia. 2006 Oct;47(10):1595–602. PMID 17054679.
• Dulac O. Epileptic encephalopathy. Epilepsia. 2001;42 Suppl 3:23-6. PMID 11520318.
• Stommel EW, Seguin R, Thadani VM, Schwartzman JD, Gilbert K, Ryan KA, Tosteson TD, Kasper LH. Cryptogenic epilepsy: an infectious etiology? Epilepsia. 2001 Mar;42(3):436-8. PMID 11442166.
  • One for DO11.10?
• Ferreira LS, Zanardi VA, Scotoni AE, Li LM, Guerreiro MM. Childhood epilepsy due to neurocysticercosis: a comparative study. Epilepsia. 2001 Nov;42(11):1438-44. PMID 11879347.
  • Another for DO11.10?

Triggers

• Flickering light
• Thinking music
• Eating
• Praxis [Exercise?]
• Somatosensory [Explain]
• Proprioceptive [Explain]
• Reading
• Exposure to hot water
• Being startled

Mechanism

• DO11.10 has bravely volunteered to tack this subject.

Dump

• The chemistry of neurons, channels (sodium, calcium), GABA.
• The structure of how neurons link up and migrate to the appropriate part of the brain.
• The concept of a seizure threshold.
• The role of the corpus callosum in spreading a seizure between hemispheres.
• What we learn from animal models.
• A seizure is "excessive or synchronous neuronal activity in the brain". What makes it excessive (excite/inhibit)? Why does it become synchronous?
• How does a partial-onset seizure spread to become generalised? Why do some remain partial?
• How goes a general-onset seizure start without a focus?
• Why are absence seizures such an exception (they have their own drugs, to some extent, and are one of the idiopathic epilepsies).
• Are seizures damaging in themselves (controvesial)? Perhaps some more so than others (infantile spasms are one of the "catastrophic" epilepsy syndromes).
• Why are some epilepsies "benign"?
• What stops a seizure (self-limiting)? Why do some not stop (status)?

• Nair, Dileep R. "Epilepsy". Retrieved 2007-11-27.
• Temkin NR. Antiepileptogenesis and seizure prevention trials with antiepileptic drugs: meta-analysis of controlled trials. Epilepsia. 2001 Apr;42(4):515-24. PMID 11440347.
• Treiman DM. mechanisms in epilepsy. Epilepsia. 2001;42 Suppl 3:8-12. PMID 11520315.
  • Explains GABA
• Epilepsia September 2001 - Vol. 42 Issue s5 has lots on mechanism/genetics

Diagnosis

• Baumer JH; "Paediatric Accident and Emergency Research Group". Evidence based guideline for post-seizure management in children presenting acutely to secondary care. Arch Dis Child. 2004 Mar;89(3):278–80. PMID 14977713.

Treatment

Chronic

• Drugs are often first chosen based on the seizure type: partial-onset, generalised-onset, and absence seizures. Also, some rare epileptic syndromes have become associated with particular treatments (e.g., infantile spasms) and some drugs have achieved "orphan drug" status for certain epilepsies.
• Monotherapy, polytherapy. Approval for "adjunctive use" or "initial monotherapy".
• Difficult to arrange placebo-controlled trials for monotherapy. Alternative trial protocols are used.
• No cure (other than surgery), nor preventative (anti-epileptogenic).
• Most drugs have cognitive side effects, plus other effects.
• Problems with some drugs and pregnancy (esp. valproate).
• Modern drugs are more expensive but not necessarily any more effective. Supposed to be better tolerated, but few studies support this.
• Ketogentic diet is as effective as any modern anticonvulsant but is traditionally reserved for refractory epilepsy in children and is limited by resources to monitor the diet.
• Vagal nerve stimulator may help some but very rarely leads to seizure freedom. Can reduce seizure frequency but also (with use of a magnet switch) can be used to shorten a seizure in some people.
• Surgery is rationed and only those likely to benefit are chosen. However, it has pretty good success rates and is the only cure.
• Some surgery is palliative, not curative.

• Glauser T, Ben-Menachem E, Bourgeois B, Cnaan A, Chadwick D, Guerreiro C, et al. ILAE treatment guidelines: evidence-based analysis of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia. 2006 Jul;47(7):1094–120. PMID 16886973.
  • Shorvon S. We live in the age of the clinical guideline [Editorial]. Epilepsia. 2006 Jul;47(7):1091–3. PMID 16886972.
• Tudur Smith C, Marson AG, Chadwick DW, Williamson PR. Multiple treatment comparisons in epilepsy monotherapy trials (PDF). Trials. 2007 Nov 5;8(1):34 [Epub ahead of print]. PMID 17983480.
• Dunkley C, Cross JH. NICE guidelines and the epilepsies: how should practice change? Arch Dis Child. 2006 Jun;91(6):525–8. PMID 16714728.
• Wilby J, Kainth A, Hawkins N, Epstein D, McIntosh H, McDaid C, et al'. Clinical effectiveness, tolerability and cost-effectiveness of newer drugs for epilepsy in adults: a systematic review and economic evaluation (PDF). Health Technol Assess. 2005 Apr;9(15):1–157, iii–iv. PMID 15842952.
• Marson AG, Al-Kharusi AM, Alwaidh M, Appleton R, Baker GA, Chadwick DW, et al. The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial. Lancet. 2007 Mar 24;369(9566):1000–15. PMID 17382827.
• Marson AG, Al-Kharusi AM, Alwaidh M, Appleton R, Baker GA, Chadwick DW, et al. The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial. Lancet. 2007 Mar 24;369(9566):1016–26. PMID 17382828.
• Marson AG, Appleton R, Baker GA, Chadwick DW, Doughty J, Eaton B, et al. A randomised controlled trial examining the longer-term outcomes of standard versus new antiepileptic drugs. The SANAD trial (PDF). Health Technol Assess. 2007 Oct;11(37):1–154. PMID 17903391.
• Koren G, Nava-Ocampo AA, Moretti ME, Sussman R, Nulman I. Major malformations with valproic acid. Can Fam Physician. 2006 Apr;52:441–2, 444, 447. PMID 16639967.
• Leppik IE. Issues in the treatment of epilepsy. Epilepsia. 2001;42 Suppl 4:1-6. PMID 11564117.
  • Discusses general issues and then details lots of drugs and their issues.
• Kwan P, Brodie MJ. Effectiveness of first antiepileptic drug. Epilepsia. 2001 Oct;42(10):1255-60. PMID 11737159.
• Patsalos PN, Fröscher W, Pisani F, van Rijn CM. The importance of drug interactions in epilepsy therapy. Epilepsia. 2002 Apr;43(4):365-85. PMID 11952767.
• Brodie MJ, Dichter MA. Antiepileptic drugs. N Engl J Med. 1996 Jan 18;334(3):168-75. PMID 8531974.
• French JA, Schachter S. A workshop on antiepileptic drug monotherapy indications. Epilepsia. 2002;43 Suppl 10:3-27. PMID 12460242.
• Perucca E. Current trends in antiepileptic drug therapy. Epilepsia. 2003;44 Suppl 4:41-7. PMID 12823568.

Emergency

• Connock M, Frew E, Evans BW, Bryan S, Cummins C, Fry-Smith A, et al. The clinical effectiveness and cost-effectiveness of newer drugs for children with epilepsy. A systematic review (PDF). Health Technol Assess. 2006 Mar;10(7):iii, ix–118. PMID 16545206.
• Choudhery V, Townend W. Best evidence topic reports. Lorazepam or diazepam in paediatric status epilepticus. Emerg Med J. 2006 Jun;23(6):472–3. PMID 16714516.
• Walker M. Status epilepticus: an evidence based guide. BMJ. 2005 Sep 24;331(7518):673–7. PMID 16179702.

Surgery

• Téllez-Zenteno JF, Dhar R, Wiebe S. Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain. 2005 May;128(Pt 5):1188–98. Epub 2005 Mar 9. PMID 15758038.
• Maehara T, Shimizu H. Surgical outcome of corpus callosotomy in patients with drop attacks. Epilepsia. 2001 Jan;42(1):67-71. PMID 11207787.
  • First performed by Van Wagenen and Herren in 1940. Usually performed for drop attacks; 85% successful.
• Cross JH. Epilepsy surgery in childhood. Epilepsia. 2002;43 Suppl 3:65-70. PMID 12060008.
• Lhatoo SD, Solomon JK, McEvoy AW, Kitchen ND, Shorvon SD, Sander JW. A prospective study of the requirement for and the provision of epilepsy surgery in the United Kingdom. Epilepsia. 2003 May;44(5):673-6. PMID 12752466.

Prognosis

• Many childhood epilepsies disappear, esp. the idiopathic epilepsies.
• Some epilepsies are regarded as "benign".
• Some "catastrophic" epilepsies in infants have a terrible prognosis both for continued epilepsy and also mental function.
• The brain tends to become calmer as we reach adulthood, which can naturally reduce seizure frequency. (hand waving here).
• If someone becomes seizure-free on medication or post-surgery, then the medication may be gradually weaned and the epilepsy may have gone.
• Uncontrolled epilepsy results in an increased risk of early death.
• Sudden unexpected death in epilepsy (SUDEP).

• Kwan P, Sander JW. The natural history of epilepsy: an epidemiological view. J Neurol Neurosurg Psychiatry. 2004 Oct;75(10):1376–81. PMID 15377680.
• Lhatoo SD, Sander JW. Sudden unexpected death in epilepsy (PDF). Hong Kong Med J. 2002 Oct;8(5):354–8. PMID 12376713.
• Arroyo S, Brodie MJ, Avanzini G, Baumgartner C, Chiron C, Dulac O, French JA, Serratosa JM. Is refractory epilepsy preventable? Epilepsia. 2002 Apr;43(4):437-44. PMID 11952776.
• Sheth RD. Bone health in epilepsy. Epilepsia. 2002 Dec;43(12):1453-4. PMID 12460244.
• Sander JW. The natural history of epilepsy in the era of new antiepileptic drugs and surgical treatment. Epilepsia. 2003;44 Suppl 1:17-20. PMID 12558826.
• Epilepsia March 2001 - Vol. 42 Issue s1 has lots on Learning disabilities and Epilepsy.
• Kwan P, Brodie MJ. Refractory epilepsy: a progressive, intractable but preventable condition? (PDF). Seizure. 2002 Mar;11(2):77-84. PMID 11945093.
• Shackleton DP, Westendorp RG, Kasteleijn-Nolst Trenité DG, de Craen AJ, Vandenbroucke JP. Survival of patients with epilepsy: an estimate of the mortality risk. Epilepsia. 2002 Apr;43(4):445-50. PMID 11952777.
• Gaitatzis A, Johnson AL, Chadwick DW, Shorvon SD, Sander JW. Life expectancy in people with newly diagnosed epilepsy. Brain. 2004 Nov;127(Pt 11):2427-32. Epub 2004 Sep 15. PMID 15371287.

Epidemiology

• Udani V. Pediatric epilepsy – an Indian perspective. Indian J Pediatr. 2005 Apr;72(4):309–13. PMID 15876759.
• Sanchez RM, Jensen FE. Maturational aspects of epilepsy mechanisms and consequences for the immature brain. Epilepsia. 2001 May;42(5):577-85. PMID 11380563.
  • Explains why seizures are common in infancy and diminish.
• Krämer G. Epilepsy in the elderly: some clinical and pharmacotherapeutic aspects. Epilepsia. 2001;42 Suppl 3:55-9. PMID 11520326.

Society

• Discuss legal implications, stigma, disability rights. Issues regarding how society handles the person with epilepsy and individual seizures. Briefly mention issues regarding photosensitive epilepsy.

• Meinardi H, Scott RA, Reis R, Sander JW; ILAE Commission on the Developing World. The treatment gap in epilepsy: the current situation and ways forward. Epilepsia. 2001 Jan;42(1):136-49. PMID 11207798.
• Pal DK. Epilepsy control in the 21st century: leave no child behind. Epilepsia. 2003 Mar;44(3):273-5. PMID 12614380.
• Epilepsia April 2002 - Vol. 43 Issue s4 Economic burden.
• July 2002 - Vol. 43 Issue s6 Epilepsy in the World

History

I'll have a go at drafting this section. Any contributory sources or facts or questions are welcome. -- Colin.

Here's a quickly thrown-together bunch of paragraphs on the history of epilepsy. Some of it is sourced to the AES History. It is pretty rough at the moment.

Understanding

A set of law codes from ancient Babylon, known as the Code of Hammurabi and dating ca. 1760 BC, may contain the earliest written mention of epilepsy. Law 278 allows the return of a slave who develops epilepsy within a month of purchase. Later Babylonian scholars inscribed their medical knowledge into stone tablets know as the Sakikku (meaning All Diseases). This dates from the reign of the Babylonian king Adad-apla-iddina of the Second Dynasty of Isin--reckoned to be between 1067 and 1046 BC. Many types of seizures are described, each attributed to a certain demon or departed spirit and given a prognosis.

The earlised Chinese document to discuss epilepsy (specifically generalized convulsive seizures) comes from around 770-221 BC, in The Yellow Emperor's Classic of Internal Medicine, Huang Di Nei Ching.

Hippocrates, On the Sacred Disease. Was "so-called". Superfluity of phlegm.

Galen, in 375 AD distinguished two forms of epilepsy. idiopathic epilepsy originated in the brain; symptomatic epilepsy from elsewhere in the body.

The ILAE's 1981 classification of seizure types and the 1989 classification of epilepsies are landmarks in our ability to describe and analyse the disease.

Throughout the 1970s and 1980s, researchers developed new ways to test drugs and understand the basic mechanisms of epilepsy. These included in vitro techniques for studying neurons; chronic epilepsy models in animals; and the breeding of genetic strains of animals highly susceptible to developing epilepsies.

Electrophysiology

Luigi Galvani discovered animal electricity (1791), and founded electrophysiology. Richard Caton discovered electrical activity in the brain (1875). Vladimir Vladimirovich Pravdich-Neminsky first recorded EEG in animals (1912). N. Cybulsky and X. Jelenska-Macieszyna recorded an EEG during an induced seizure in a dog (1914). In 1929, Hans Berger recorded EEG in humans and later studied EEG changes in epilepsy. This technology was rapidly applied to the diagnosis and treatment of epilepsy, and transformed our understanding of the disease. It was now possible to locate a seizure focus prior to surgery. By 1966, closed-circuit television enabled the routine simultaneous recording of EEG and clinical seizures.

Treatments

Many remedies were tried for epilepsy; all were ineffective until the discovery of potassium bromide. Sir Charles Locock (obstetrician who delivered Queen Victoria's babies) learned that bromide caused impotence and had tried it successfully on some women troubled by "sexual excitement". He believed it might therefore help with epilepsy (which many at the time associated with masturbation). He reported his results at a meeting of the Royal Medical and Chirurgical Society in London in 1957. The treatment took a while to catch on, but from 1870s it was the mainstay of medicinal therapy. Unfortunately, bromide was only weakly effective and quite unpleasantly toxic in high doses.

In 1912, the German drug company Bayer launched a new sedative and hypnotic called Luminal (phenobarbital). A young doctor, Alfred Hauptmann, gave this barbiturate drug to his epilepsy patients as tranquiliser and discovered it reduced their epileptic attacks. Some patients became seizure free and once bromide was removed from their regime, many improved physically and mentally.Phenobarbital was the first really effective anticonvulsant and led to bromide's relegation to veterinary medicine. By 1918, phenobarbital was the dominant anticonvulsant, and remained so for 20 years. Its cheapness means that it remains the most widely used anticonvulsant in the developing world, though it is now considered only for second- or third-line use in more affluent countries.

In 1937, two Boston neurologists, Tracy Putnam and H. Houston Merritt, devised the first animal experiments for identifying promising anticonvulsants from candidate drugs. Of the 19 drugs they planned to test, the first proved the most effective: sodium diphenyl hydantoinate, commonly known as phenytoin and marketed as Dilantin. By 1938, favourable patient trials led to the introduction of this important drug to clinical practice. Unlike phenobarbital, it did not produce sedation at theraputic doses, and is still regarded as an effective and useful anticonvulsant.

While many seizure types were susceptible to the new drugs, absence seizures proved more difficult to treat. A new animal model of epilepsy, where seizures were induced by the drug pentamethylenetetrazol (Metrazol), was used to identify that the drug trimethadione could be effective. William G. Lennox tested the drug on patients in 1945 and it was introduced in 1946. In 1955, trimethadione was replaced by the less toxic ethosuximide (Zarontin).

First synthesized in 1882, valproic acid was believed to be a metabolically inert solvent for organic compounds. In 1962, French researcher Pierre Eymard serendipitously discovered valproic acid's antiseizure activity while using it as a vehicle for a number of other compounds that were being screened for anti-seizure activity. Clinical trials in 1964 led to adoption in Europe in the late 1960s but the US took until 1978. Valproic acid is effective for treating a number of generalized seizure types, including absence seizures.

Surgery for epilepsy began in earnest with Canadian neurosurgen Wilder Penfield in 1936. He and Herbert Jasper used EEG prior to surgery to identify the focus of the seizure and therefore the part to resect.

Brain imaging

Pneumoencephalography was used in the 1930s as a diagnostic procedure. It involved replacing the cerebrospinal fluid with air so that sufficient contrast could be achieved on x-ray. It was painful and stressful and only useful in a minority of cases. Huge improvement came in the early 1970s, when computerized tomography (CT) was invented. However, subtle changes to brain density were not picked up, and it wasn't until the 1980s that magnetic resonance imaging (MRI) enabled physicians to safely and precisely image the brain. MRI remains the definitive tool for identifying structural pathology in the brain.

Positron-emission tomography (PET) appeared in the late 1970s, and helped the investigation of epilepsy by highlighting areas of increased metabolic activity. Functional MRI (fMRI) is now also used for this purpose, and to identify vital brain regions that must be preserved during resective surgery.

Individuals: John Hughlings Jackson, Herbert Jasper, Wilder Penfield, H. Houston Merritt, William G. Lennox, Henri Gastaut.

• Hunt SJ, Morrow JI, Craig JJ. Are we failing those with 'The Falling Sickness'? Time to modernise the approach to epilepsy care. Ulster Med J. 2007 Jan;76(1):3–5. PMID 17288297.
• Pearce JM. Early accounts of epilepsy: a synopsis. J Neurol Neurosurg Psychiatry. 1998 May;64(5):679, 682. PMID 9598691.
• Pearce JM. Bromide, the first effective antiepileptic agent. J Neurol Neurosurg Psychiatry. 2002 Mar;72(3):412. PMID 11861713.
• Temkin O. The Falling Sickness: History of Epilepsy from the Greeks to the Beginnings of Modern Neurology. 2^nd Ed. Johns Hopkins University Press; 1994. ISBN 0801848490.
  • I have this book. It is so comprehensive, it is hard to know what to pick. It only covers up to the late 19th C. -- Colin.
• Goldensohn ES, Porter RJ, Schwartzkroin PA. The American Epilepsy Society: an historic perspective on 50 years of advances in research (PDF). Epilepsia. 1997 Jan;38(1):124–50. PMID 9024195.
• Eadie MJ. Cortical epileptogenesis-Hughlings Jackson and his predecessors. Epilepsia. 2007 Nov;48(11):2010-5. Epub 2007 Jun 11. PMID 17561950.
• Cascino GD. Advances in neuroimaging: surgical localization. Epilepsia. 2001 Jan;42(1):3-12. PMID 11207779.
  • Detail on John Hughlings Jackson + history of imaging.
• Sengoku A. The contribution of J. H. Jackson to present-day epileptology (PDF). Epilepsia. 2002;43 Suppl 9:6-8. PMID 12383272.
• Tyagi A, Delanty N. Herbal remedies, dietary supplements, and seizures. Epilepsia. 2003 Feb;44(2):228-35. PMID 12558579.

Research

• Kupferberg H. Animal models used in the screening of antiepileptic drugs. Epilepsia. 2001;42 Suppl 4:7-12. PMID 11564118.
• September 2003 - Vol. 44 Issue s7 Clinical trials.

Bibliography

Books

• Engel J, Pedley TA, Aicardi J, Dichter MA, Moshe S. Epilepsy: A Comprehensive Textbook. 2^nd ed. Lippincott Williams & Wilkins; 2007. ISBN 0781757770.
• Arzimanoglou A, Guerrini R, Aicardi J. Aicardi's Epilepsy in Children. 3^rd ed. Lippincott Williams & Wilkins; 2002. ISBN 0781726980.
• Shorvon S, Perucca E, Fish D, Dodson WE, editors. The Treatment of Epilepsy. 2^nd ed. Blackwell Science Ltd; 2004. ISBN 0632060468.
• Levy RH, Mattson RH, Meldrum BS , Perucca E. Antiepileptic Drugs. 5^th ed. Lippincott Williams & Wilkins; 2002. ISBN 0781723213.
• Panayiotopoulos CP. A Clinical Guide to Epileptic Syndromes and Their Treatment. 2^nd ed. London: Springer-Verlag; 2007. ISBN 1846286433.
• Roger J, Dravet C, Bureau M, Genton P, Tassinari CA, Wolf P, editors. Epileptic Syndromes in Infancy, Childhood and Adolescence. 4^th ed. John Libbey Eurotext; 2005. ISBN 2742005692.
• Bromfield EG, Cavazos JE, Sirven JI, editors. An Introduction to Epilepsy. Bethesda (MD): National Institute of Neurological Disorders and Stroke; 2006.
  • Shame the text has no inline citations, only a list of references for each chapter. -- Colin.

Journals

• Epilepsy Currents. American Epilepsy Society.

Epilepsy Currents is the journal of the AES. Freely available online to all readers.

• Epilepsia] is almost completely free from 1997 to 2006.
• Epilepsia September 2003 - Vol. 44 Issue s6 A goldmine. There are articles for every section we need.

Web sites

• Atlas: Epilepsy Care in the World. World Health Organisation. September 2005. ISBN 9241563036. (Available in chapter downloads from WHO's Global Epilepsy Campaign Website).

Probably the most useful resource for international facts and figures. The campaign website also contains reports from around the world, though it doesn't seem to have moved on since 2005.

• WHO Epilepsy Factsheets. World Health Organisation. February 2001.

Has a few interesting resources. The History and the Social Consequences factsheets look promising but basic.

• E-epilepsy The National Society for Epilepsy.

Has a large number of articles, literature reviews and other information pages for the professional. Some are reprints of work published in journals; others seem to be written for NSE.

• ILAE Task Force on Classification and Terminology. International League Against Epilepsy.

The authority on classification and terminology. Useful glossary and extensive information on seizure types and syndromes.

• eMedicine Neurology – Seizures and Epilepsy. eMedicine.

Loads of clinical overviews of various topics. Not as highly regarded as established peer-reviewed print journals.

Clinical guildelines

• NICE Clinical Guideline 20: Epilepsy. National Institute for Health and Clinical Excellence. October 2004.

Comprises a number of PDF documents that contain a wealth of UK-focused data and guidelines built on evidence-based-medicine.

• SIGN Guideline 81: Diagnosis and management of epilepsies in children and young people. Scottish Intercollegiate Guidelines Network. March 2005.

These Scottish guidelines, like the NICE equivalent for England & Wales, are thoroughly reviewed and evidence-based.

• SIGN Guideline 70: Diagnosis and management of epilepsy in adults. Scottish Intercollegiate Guidelines Network. October 2005. (Also available as HTML here.)

• AAN Practice Guidelines: Epilepsy. American Academy of Neurology.

A substantial number of guidelines with an American flavour. Often jointly supported by the American Epilepsy Society.