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Seizures and Epilepsies (2023)

This video is intended to serve as an overview of seizures and epilepsies for medical students. Students will learn the differential diagnosis of transient neurological dysfunction, how to identify and classify a seizure, how to localize seizure focus based on presenting signs/symptoms (for focal seizures), how to estimate risk of seizure recurrence and the requirements to diagnose epilepsy. The video will then proceed to review antiseizure drug treatments and the treatments of status epilepticus, as well as risks/benefits of epilepsy surgery. 00:00 - Intro 00:49 - OBJECTIVES 03:01 - CASE 05:32 - DEFINING A SEIZURE 07:50 - Anatomy of a seizure 10:28 - SEIZURE CLASSIFICATION 16:21 - LOCALIZATION of seizure focus 23:21 - DIAGNOSTIC TESTING 25:39 - Brain imaging 30:05 - EEG 33:28 - Sensitivity, specificity of EEG 35:12 - EPILEPSY 38:19 - Epilepsy syndromes 43:46 - PHARMACOLOGICAL TREATMENTS for epilepsy 47:28 - Antiseizure medication side-effects 53:06 - Antiseizure drug table 56:25 - Choice of antiseizure drugs: Practice 01:06:37 - Management of CONVULSIVE STATUS EPILEPTICUS 01:08:27 - Pharmacological treatment of status 01:13:44 - Causes of status epilepticus 01:16:19 - SURGICAL TREATMENTS for epilepsy 01:18:05 - Benefits of epilepsy surgery 01:20:08 - Ideal candidate for epilepsy surgery 01:21:03 - Neuromodulation 01:22:55 - SUMMARY and the approach Created, produced and narrated by: Helen Han MD Assistant Professor Division of Epilepsy Igor Rybinnik MD Associate Professor Neurology Clerkship Director Division of Stroke and Critical Care Content experts: Bradley Kamitaki MD, Shelly Rishty MD, Ram Mani MD Division of Epilepsy Department of Neurology Rutgers Robert Wood Johnson Medical School Images, videos adapted from: - Tinea soleum - Teresa Zgoda, Rochester Institute of Technology - Astrocytoma - Gaillard F, rID 49912 - Cavernoma - Haouimi A, rID 72043 - Focal Cortical Dysplasia - Alkenawy M, rID 77002 - Chowdhury FA, et al. Pract Neurol 2021;21:481–491 - Kandel ER, et al. Principles of Neural Science 5th Edition. McGraw Hill, 2012. - Bradshaw MJ, et al. Neurol Neuroimmunol Neuroinflamm 2021;8:e1084 - Neonatal Hypoxic Ischemic Encephalopathy - Mahmoud Yacout Alabd, rID: 41406 - Schmidt D, Schachter SC. BMJ 2014;348:g2546 - Absence Seizure courtesy of Epilepsy Action (epilepsy.org.uk) - Absence seizure courtesy of I.M.S. - Infantile Spasms Awareness - Epilepsy Foundation of Metropolitan New York - MR-Guided Stereotactic Laser Amygdalohippocampotomy - Willie JT, et al. Neurosurgery . 2014 Jun;74(6):569-84 - Myoclonic Seizure courtesy of Nancy Davie - Understanding Infantile Spasms by Dr John Bodensteiner (Child Neurology Society) - NeuroPace RNS System Patient Manual. 2021 NeuroPace, Inc - Deep Brain Stimulation illustration adapted from Okun MS. NEJM 2012:367;16 - Schenck C, Mahowald M. REM Sleep Behavior Disorder (RBD). University of Minnesota, 1986. References: - Fisher RS, et al. Epilepsia, 2014;55(4):475-482 - Fisher RS, et al. Epilepsia 2017;58(4):522-30 - Scheffer RS, et al. Epilepsia 2017;58(4):512-21 - Chowdhury FA, et al. Pract Neurol 2021;21:481–491 - Neligan A, et al. Cochrane Database of Systematic Reviews 2023;1:CD013847. - Brigo F, Marson A. Continuum 2022;28(2):483–499. - Kwan P, Brodie MJ. Epilepsia 2001;42(10):1255-60 - Chen Z, Brodie MJ, Liew D, Kwan P. JAMA Neurol 2018;75(3):279-286 - Brophy GM, et al. Neurocrit Care 2012;17(1):3-23. - Trinka E, et al. Epilepsia 2015;56(10):1515. - Brigo F, et al. Epilepsy Behav 2015;49:325-336 - Kapur J, et al. NEJM 2019;381:2103-2113 - Engel J, et al. JAMA 2012;307(9):922-30 - Wiebe S, et al. N Engl J Med 2001;345(5):311-18 - Dwivedi R, et al. N Engl J Med 2017;377:1639-47 Music, Sounds: - Waititi, Taika. 2022. "Thor Love and Thunder" [Film] - Screaming Goats sound - HondEpic, "Goodbye" from "Arcane" (Epic Instrumental Cover) - Peter Hollens, "This is Me" from "The Greatest Showman" (Cover) - The Tower of Light - Beginnings (Intro). Auto-generated by YouTube. DISCLAIMER: Please note that this material was simplified for educational purposes. For patient management, please review your clinical society's guidelines and engage expert consultation where appropriate. Also, the opinions of the presenters do not necessarily reflect those of Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, RWJBarnabus Health, or Rutgers University as a whole.