Seizures and Status Epilepticus

Sebastian Pollandt, MD

Thomas Bleck, MD, MCCM

Seizures are an exceedingly common clinical problem encountered in the daily practice of many neurologists. Terminology and classification systems continue to evolve to reflect our current understanding of this complex disease. The goal of this issue is to provide an up-to-date overview of classification, diagnostic work-up, and management approaches for seizures and status epilepticus in both children and adults. The circumstances in which seizures occur are crucial to determine appropriate diagnostic investigations and therapeutic interventions. Many seizures occur in the context of an acute brain injury; these patients are often seen in emergency departments or intensive care units, and they may ultimately not go on to develop epilepsy. Dedicated reviews discuss the concept, work-up, and treatment of acute, provoked seizures in adult and pediatric patients. Children and adults who do suffer from epilepsy require complex considerations of a variety of factors beyond the prescription of antiseizure drugs to improve their quality of life. With individualized care, many patients in the epilepsy outpatient clinic do very well and are able to live a fulfilling life.

On the other end of the spectrum, status epilepticus often carries a high morbidity and mortality. It remains an enigmatic entity that has been challenging to define and treat effectively. Current knowledge, diagnostic modalities, and treatment approaches for patients in status epilepticus are reviewed for both adults and children.

Several new antiseizure drugs have been developed in recent years, and a separate review discusses principles of pharmacotherapy in detail. Novel therapeutic and diagnostic approaches including immunotherapies, advances in dietary treatments, as well as genetic testing are discussed. Major advances in neurosurgical care for patients with medically refractory seizures including responsive neurostimulation and deep brain stimulation are critically reviewed.

In summary, the care for patients with seizures and epilepsy is multifaceted and requires individualization of diagnostic evaluations and treatment plans with the goal to ultimately improve patient outcomes.

It has been a privilege to assemble this outstanding group of authors and we would like to thank them for their excellent contributions to this issue.

Publikationsverlauf

Artikel online veröffentlicht:
24. November 2020