Epileptologist

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An epileptologist is a neurologist who specializes in the treatment of epilepsy. [1] Epileptologists are experts in epileptic seizures and seizure disorders, anticonvulsants, and special situations involving seizures, such as cases in which all treatment intended to stop seizures has failed and epilepsy (especially poorly controlled epilepsy) in pregnant women. [2] [3] Some epileptologists specialize in treatment of epilepsy in children. [4]

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The training required for expertise in epilepsy generally involves a residency in neurology or pediatric neurology followed by a fellowship in clinical neurophysiology or epilepsy. The American Board of Psychiatry and Neurology first held subspecialty certifications in epilepsy after a vote in 2010 with ACGME-accredited fellowships appearing in the mid-2010s. Accredited fellowships are one year in duration and focus on training in EEG, surgical planning, and the clinical treatment of epilepsy.

An epileptologist is not necessary for the treatment of all seizure disorders, and is generally only consulted if seizures do not stop, despite treatment from a regular physician or neurologist. [5]

Origin of the field

The field of epileptology was first created early in the 20th century. William P. Spratling is identified as the first epileptologist. He is said to have coined the term in 1904. [6]

Related Research Articles

Epilepsy Group of neurological disorders causing seizures

Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrical activity in the brain. These episodes can result in physical injuries, either directly such as broken bones or through causing accidents. In epilepsy, seizures tend to recur and may have no immediate underlying cause. Isolated seizures that are provoked by a specific cause such as poisoning are not deemed to represent epilepsy. People with epilepsy may be treated differently in various areas of the world and experience varying degrees of social stigma due to the scary nature of their symptoms.

Neurology Medical specialty dealing with disorders of the nervous system

Neurology is a branch of medicine dealing with disorders of the nervous system. Neurology deals with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal cord and the peripheral nerves. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system.

Neurosurgery Medical specialty of disorders which affect any portion of the nervous system

Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peripheral nervous system.

A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly mental issues. Sometimes a psychiatrist works within a multi-disciplinary team, which may comprise clinical psychologists, social workers, occupational therapists, and nursing staff. Psychiatrists have broad training in a bio-psycho-social approach to the assessment and management of mental illness.

Seizure Period of symptoms due to excessive or synchronous neuronal brain activity

An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much of the body with loss of consciousness, to shaking movements involving only part of the body with variable levels of consciousness, to a subtle momentary loss of awareness. Most of the time these episodes last less than two minutes and it takes some time to return to normal. Loss of bladder control may occur.

Clinical neurophysiology is a medical specialty that studies the central and peripheral nervous systems through the recording of bioelectrical activity, whether spontaneous or stimulated. It encompasses both research regarding the pathophysiology along with clinical methods used to diagnose diseases involving both central and peripheral nervous systems. Examinations in the clinical neurophysiology field are not limited to tests conducted in a laboratory. It is thought of as an extension of a neurologic consultation. Tests that are conducted are concerned with measuring the electrical functions of the brain, spinal cord, and nerves in the limbs and muscles. It can give the precise definition of site, the type and degree of the lesion, along with revealing the abnormalities that are in question. Due to these abilities, clinical neurophysiology is used to mainly help diagnose diseases rather than treat them.

The Wada test, also known as the intracarotid sodium amobarbital procedure (ISAP), establishes cerebral language and memory representation of each hemisphere.

Ruben Kuzniecky

Ruben Kuzniecky, M.D. is Vice-chair academic affairs and professor of neurology at Northwell Health specializing in the field of epilepsy, epilepsy surgery and neuro-imaging.

Psychogenic non-epileptic seizure Type of neurological disorder

Psychogenic non-epileptic seizures (PNES) are events resembling an epileptic seizure, but without the characteristic electrical discharges associated with epilepsy. PNES fall under the category of disorders known as functional neurological disorders (FND), also known as conversion disorders. A more recent term to describe these events is dissociative non-epileptic seizures. These are typically treated by psychologists or psychiatrists. PNES has previously been called pseudoseizures, psychogenic seizures, and hysterical seizures, but these terms have fallen out of favor.

William Gordon Lennox was an American neurologist and epileptologist who was a pioneer in the use of electroencephalography (EEG) for the diagnosis and treatment of epilepsy. He graduated from Colorado College and Harvard Medical School.

Frederick Andermann

Frederick Andermann, was a Canadian neurologist and epileptologist.

Epilepsy and driving is a personal and safety issue. A person with a seizure disorder that causes lapses in consciousness may be putting the public at risk from their operation of a motor vehicle. Not only can a seizure itself cause an accident, but anticonvulsants often have side effects that include drowsiness. People with epilepsy are more likely to be involved in a traffic accident than people who do not have the condition, although reports range from minimally more likely up to seven times more likely.

Generally, seizures are observed in patients who do not have epilepsy. There are many causes of seizures. Organ failure, medication and medication withdrawal, cancer, imbalance of electrolytes, hypertensive encephalopathy, may be some of its potential causes. The factors that lead to a seizure are often complex and it may not be possible to determine what causes a particular seizure, what causes it to happen at a particular time, or how often seizures occur.

Epilepsy is a disorder in which nerve cell activity in the brain is disturbed, causing seizures.During a seizure, a person experiences abnormal behavior, symptoms, and sensations, sometimes including loss of consciousness. There are few symptoms between seizures. A seizure is a single occurrence, whereas epilepsy is a neurological condition characterized by two or more unprovoked seizures. Epilepsy is the most common childhood brain disorder in the United States. Nearly 3 million people have been diagnosed with this disease, while 450,000 of them are under the age of 17. Two thirds of the child population will overcome the side effects, including seizures, through treatment during adolescence. Some treatments include surgery, medication and therapy, surgery however is only done if the child has drug resistant epilepsy.

The Mischer Neuroscience Institute is a combined research and education effort between the Vivian L. Smith Department of Neurosurgery and the Department of Neurology at McGovern Medical School at UTHealth Houston and Memorial Hermann Hospital. Located in Houston, the Institute draws patients from around the world for specialized treatment of diseases of the brain and spine. It was the first center in Texas and one of only a few institutions in the country to fully integrate neurology, neurosurgery, neuroradiology, neuro-oncology, spine surgery, pain medicine and neurorehabilitation.

People with epilepsy may be classified into different syndromes based on specific clinical features. These features include the age at which seizures begin, the seizure types, and EEG findings, among others. Identifying an epilepsy syndrome is useful as it helps determine the underlying causes as well as deciding what anti-seizure medication should be tried. Epilepsy syndromes are more commonly diagnosed in infants and children. Some examples of epilepsy syndromes include benign rolandic epilepsy, childhood absence epilepsy and juvenile myoclonic epilepsy. Severe syndromes with diffuse brain dysfunction caused, at least partly, by some aspect of epilepsy, are also referred to as epileptic encephalopathies. These are associated with frequent seizures that are resistant to treatment and severe cognitive dysfunction, for instance Lennox-Gastaut syndrome and West syndrome.

John M. Freeman American physician

John Mark Freeman was an American pediatric neurologist specializing in epilepsy. He is known for bringing two long-abandoned treatments for pediatric epilepsy back into popular use. One, the ketogenic diet, is a carefully managed, high-fat diet plan that reduces the incidence of seizures in children during and after its use, and the other, the hemispherectomy, is a drastic surgical procedure in which part or all of one highly seizure-prone hemisphere of the brain is removed to alleviate severe epilepsy.

A neonatal seizure is a seizure in a baby younger than age 4-weeks that is identifiable by an electrical recording of the brain. It is an occurrence of abnormal, paroxysmal, and persistent ictal rhythm with an amplitude of 2 microvolts in the electroencephalogram, detected in infants younger than 4 weeks. These may be manifested in form of stiffening or jerking of limbs or trunk. Sometimes random eye movements, cycling movements of legs, tonic eyeball movements, and lip-smacking movements may be observed. Alteration in heart rate, blood pressure, respiration, salivation, pupillary dilation, and other associated paroxysmal changes in the autonomic nervous system of infants may be caused due to these seizures. Often these changes are observed along with the observance of other clinical symptoms. A neonatal seizure may or may not be epileptic. Some of them may be provoked by stimulation or suppressed by restraining them.

A functional neurologic disorder or functional neurological disorder (FND) is a condition in which patients experience neurological symptoms such as weakness, movement disorders, sensory symptoms and blackouts. Symptoms of functional neurological disorders are clinically recognisable, but are not categorically associated with a definable organic disease. The intended contrast is with an organic brain syndrome, where a physiological cause can be identified. Subsets of functional neurological disorders include functional neurological symptom disorder (FNsD), conversion disorder, and psychogenic movement disorder/non-epileptic seizures. Neurological symptoms which are unexplained by organic disease are common in neurological services, accounting for up to one third of outpatient neurology clinic attendances, and associated with as much self-reported disability and distress as those caused by organic neurological disorders. The diagnosis is made based on positive signs and symptoms in the history and examination during consultation of a neurologist. Physiotherapy is particularly helpful for patients with motor symptoms and tailored cognitive behavioural therapy has the best evidence in patients with dissociative (non-epileptic) attacks.

Musicogenic epilepsy is a form of reflex epilepsy with seizures elicited by special stimuli.

References

  1. Wilner, A.N. (2008). Epilepsy 199 Answers: A Doctor Responds To His Patients Questions. Demos Medical Publishing. ISBN   9781932603354.
  2. Devinsky, O. (2008). Epilepsy: Patient and Family Guide. Demos Medical Publishing, LLC. ISBN   9781934559918.
  3. Schachter, S.C.; Schomer, D.L. (1997). The Comprehensive Evaluation and Treatment of Epilepsy: A Practical Guide. Elsevier Science. ISBN   9780080529462.
  4. Lüders, H.; Comair, Y.G. (2001). Epilepsy Surgery. Lippincott Williams & Wilkins. ISBN   9780781714426.
  5. Gumnit, R.J. (1995). Your Child and Epilepsy. Demos Medical Publishing LLC. ISBN   9780939957767.
  6. Chillemi, S. (2005). Live Learn, and Be Happy with Epilepsy. Lulu Enterprises Incorporated. ISBN   9781411630086.