Seizures and Epilepsy

Jerome Engel, Jr., MD, PhD, is Director of the Seizure Disorder Center, and The Jonathan Sinay Distinguished Professor of Neurology, Neurobiology, and Psychiatry and Biobehavioral Sciences at UCLA. He is past president of the American Clinical Neurophysiology Society, the American Epilepsy Society, and the International League against Epilepsy, and is past co-chair of the Global Campaign against Epilepsy. His bibliography lists over 1,000 publications and over 30 books, and he is principal investigator on three research grants from the National Institute of Neurological Disorders and Stroke. He has received numerous awards and honors, including a Fulbright Scholarship, a Guggenheim Fellowship, and a Javits Award.

PART I: INTRODUCTION ; Chapter 1 ; TERMINOLOGY AND CLASSIFICATIONS ; TERMINOLOGY ; Epileptic Seizures ; Definition ; Discussion ; Epilepsy Disorders ; Definition ; Discussion ; Epileptic and Epilepsy ; Definition ; Discussion ; Ictal, Postictal, and Interictal ; Definitions ; Discussion ; Epileptogenesis and Epileptogenicity ; Definition ; Discussion ; Epileptic Spike Focus, Epileptic Lesion, and Epileptogenic Zone or Region ; Definition ; Discussion ; Control, Cure, and Drug Resistance ; Definition ; Discussion ; Antiepileptogenesis, Prevention, and Disease Modification ; Definition ; Discussion ; Nonepileptic Seizures ; Definition ; Discussion ; CLASSIFICATIONS ; Older Classifications of Epileptic Seizure ; International Classification of Epileptic Seizures ; Other Seizure Classifications ; Older Classifications of the Epilepsies ; The 1970 International Classification ; The WHO Classifications ; The 1985 and 1989 International Classifications ; Recent Efforts to Revise the International Classifications ; Practical Considerations ; SUMMARY AND CONCLUSIONS ; Chapter 2 ; PERSPECTIVES ; EPILEPSY THEN-HISTORICAL PERSPECTIVE ; Medical History ; Ancient and Medieval Periods ; The Modern Era ; Epilepsy and Religion ; Epilepsy and Genius ; EPILEPSY NOW-EPIDEMIOLOGICAL PERSPECTIVE ; Definitions of Incidence and Prevalence ; Methodological Considerations ; Estimations of Incidence and Prevalence ; Global Burden of Disease ; SUMMARY AND CONCLUSIONS ; PART II: PATHOPHYSIOLOGY ; Chapter 3 ; MECHANISMS OF NEURONAL EXCITATION AND SYNCHRONIZATION ; THE NEURON ; The Excitable Membrane and Its Microenvironment ; Voltage gated Channels ; Membrane Physiology ; Intracellular Processes ; Structure-Function Relationship of Neuronal Elements ; Interneuronal Connections ; Chemical Synapses ; Electrotonic Synapses ; Nonsynaptic Communication ; Glial Influences ; NEURONAL NETWORKS ; Intrinsic Organization of Ammon's Horn ; Intrinsic Organization of the Neocortex ; Subcortical and Interhemispheric Connections ; PHYLOGENY AND ONTOGENY ; Species Differences ; Cortical Development ; Maturational Effects on Excitability ; SYSTEMIC INFLUENCES ; NEURONAL BASIS OF EEG ACTIVITY ; METHODOLOGICAL DEVELOPMENTS ; SUMMARY AND CONCLUSIONS ; Chapter 4 ; BASIC MECHANISMS OF SEIZURES AND EPILEPSY ; EXPERIMENTAL MODELS OF SEIZURES AND EPILEPSY ; Acute Models ; In Vivo Models of Focal Seizures ; In Vivo Models of Generalized Seizures ; In Vitro Studies of Acute Seizures ; Chronic Models ; In Vivo Models of Epilepsy with Focal Seizures ; Lesion and insult models ; Models in the developing brain ; Secondary epileptogenesis ; In Vivo Models of Epilepsy with Generalized Seizures ; In Vitro Studies of Chronic Epilepsy ; STUDIES OF HUMAN EPILEPSY ; Electrophysiological Investigations ; Investigations Using Brain Imaging Techniques ; Microanatomical Investigations ; Biochemical and Molecular Investigations ; MOLECULAR GENETIC INVESTIGATIONS ; Gene Discovery ; Acquired Genetic Disturbances ; POSSIBLE MECHANISMS OF HUMAN EPILEPTIC PHENOMENA ; Epileptogenesis ; Interictal State ; Ictogenesis ; Ictus ; Ictal Termination ; Postictal Period ; Possible Consequences of Epileptic Seizures ; SUMMARY AND CONCLUSIONS ; Chapter 5 ; CAUSES OF HUMAN EPILEPSY ; NONSPECIFIC PREDISPOSING FACTORS ; Genetic Factors ; Environmental Factors ; Dynamic Aspects of Threshold ; SPECIFIC EPILEPTOGENIC DISTURBANCES ; Genetic Causes of Epilepsy Disorders ; Genetic Epilepsies ; Genetic Disorders Associated with Epilepsy ; Acquired Causes of Epilepsy Disorders ; Anoxia and Trauma ; Cerebrovascular Disorders ; Brain Tumors ; Infections Diseases ; Inflammation and Immune-Mediated Disorders ; Malformations of Cortical Development ; Toxic and Metabolic Disturbances ; Hippocampal Sclerosis ; PRECIPITATING FACTORS ; Nonspecific Precipitating Factors ; Specific Precipitating Factors ; SUMMARY AND CONCLUSIONS ; PART III: PHENOMENOLOGY ; Chapter 6 ; EPILEPTIC SEIZURES ; NEUROBIOLOGICAL CONSIDERATIONS FOR THE DIAGNOSIS OF EPILEPTIC ; SEIZURE TYPES ; Anatomic Substrates ; Pathophysiological Mechanisms ; Pharmacological Considerations ; TYPES OF EPILEPTIC SEIZURES ; Definitions ; FOCAL SEIZURES ; Neocortical Seizures ; Mechanisms ; Phenomenology ; Motor Signs ; Sensory Symptoms ; EEG ; Clinical Considerations ; Limbic Seizures ; Mechanisms ; Phenomenology ; Limbic Sensory Symptoms ; Autonomic Symptoms and Signs ; Psychic Symptoms ; Automatisms ; EEG ; Clinical Considerations ; Focal Seizures Evolving Into Secondarily Generalized Seizures ; Mechanisms ; Phenomenology ; Clinical Considerations ; GENERALIZED SEIZURES ; Tonic-Clonic Seizures ; Mechanisms ; Phenomenology ; EEG ; Clinical Considerations ; Typical Absence Seizures ; Mechanisms ; Phenomenology ; EEG ; Clinical Considerations ; Atypical Absence Seizures ; Mechanisms ; Phenomenology ; EEG ; Clinical Considerations ; Myoclonic Absences ; Eyelid Myoclonia ; Myoclonic Seizures ; Mechanisms ; Phenomenology ; EEG ; Clinical Considerations ; Myoclonic Atonic Seizures ; Myoclonic Tonic Seizures ; Clonic Seizures ; Mechanisms ; Phenomenology ; EEG ; Clinical Considerations ; Tonic Seizures ; Mechanisms ; Phenomenology ; EEG ; Clinical Considerations ; Atonic Seizures ; Mechanisms ; Phenomenology ; EEG ; Clinical Considerations ; UNCLASSIFIED SEIZURES ; Epileptic Spasms ; Reflex Seizures ; Neonatal Seizures ; MYOCLONUS ; SUMMARY AND CONCLUSIONS ; Chapter 7 ; EPILEPSY SYNDROMES ; NEONATAL PERIOD ; Benign Familial Neonatal Epilepsy (BFNE) ; Early Myoclonic Epilepsy (EME) ; Ohtahara Syndrome (OS) ; INFANCY ; Epilepsy of Infancy with Migrating Focal Seizures (MPSI) ; West Syndrome (WS) ; Clinical Description ; Epidemiology ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; Myoclonic Epilepsy in Infancy (MEI) ; Benign Infantile Epilepsy (BIE) and Benign Familial Infantile Epilepsy (BFIE) ; Dravet Syndrome (DS) ; Myoclonic Encephalopathy in Non-progressive Disorders ; CHILDHOOD ; Febrile Seizures Plus (FS+) ; Panayiotopoulos Syndrome (PS) ; Epilepsy with Myoclonic-Atonic Seizures (EMAS) ; Benign Epilepsy with Centrotemporal Spikes (BECTS) ; Clinical Description ; Epidemiology ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; Autosomal-Dominant Nocturnal Frontal Lobe Epilepsy (ADNFLE) ; Late Childhood Occipital Epilepsy (Gastaut Type) ; Epilepsy with Myoclonic Absences (EMA) ; Lennox-Gastaut Syndrome (LGS) ; Clinical Description ; Epidemiology ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; Epileptic Encephalopathy with Continuous Spike and Wave During Sleep (CSWS) ; Landau-Kleffner Syndrome (LKS) ; Childhood Absence Epilepsy (CAE) ; Clinical Description ; Epidemiology ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; ADOLESCENCE-ADULT ; Juvenile Absence Epilepsy (JAE) ; Juvenile Myoclonic Epilepsy (JME) ; Clinical Description ; Epidemiology ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; Epilepsy with Generalized Tonic-Clonic Seizures Alone ; Progressive Myoclonus Epilepsies (PME) ; Autosomal-Dominant Epilepsy with Auditory Features (ADEAF) ; Other Familial Temporal Lobe Epilepsies ; LESS SPECIFIC AGE RELATIONSHIP ; Familial Focal Epilepsy with Variable Foci ; Reflex Epilepsies ; DISTINCTIVE CONSTELLATIONS ; Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (MTLE with HS) ; Clinical Description ; Epidemiology ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; Rasmussen Syndrome (RS) ; Gelastic Seizures with Hypothalamic Hamartoma ; Hemiconvulsion-Hemiplegia Epilepsy (HHE) ; CONDITIONS WITH EPILEPTIC SEIZURES THAT ARE TRADITIONALLY NOT DIAGNOSED AS A FORM OF EPILEPSY PER SE ; Benign Neonatal Seizures (BNS) ; Febrile Seizures (FS) ; Clinical Description ; Epidemiology ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; Reactive Seizures ; Neonatal Seizures Due to Structural and Metabolic Disorders ; Clinical Description ; Epidemiology ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; MYOCLONIC SYNDROMES ; SUMMARY AND CONCLUSIONS ; Chapter 8 ; EPILEPTOGENESIS ; THE DEVELOPMENT OF EPILEPSY ; Phenomenology ; Character of the Lesion ; Location of the Lesion ; Genetic Factors ; Practical Considerations ; Prophylaxis for Early Seizures ; Prophylaxis for Chronic Epilepsy ; THE PROGRESSIVE NATURE OF EPILEPSY ; Secondary Epileptogenesis ; Clinical Evidence for Progression ; Practical Considerations ; EPILEPTIC SEIZURES AND BRAIN DEVELOPMENT ; Epileptic Susceptibility of the Immature Brain ; Evolution of Epileptic Syndromes ; Migration of the Interictal EEG Spike ; Practical Considerations ; SUMMARY AND CONCLUSIONS ; Chapter 9 ; PERIICTAL PHENOMENA ; ICTAL INITIATION ; Mechanisms ; Clinical Considerations ; Reflex Seizures ; Genetic Reflex Epilepsies ; Reflex Epilepsies Due to Structural Lesions ; Simple vs. Complex Reflex Epilepsies ; Reflex Myoclonus ; Abortive Stimuli ; SLEEP-WAKE CYCLES AND CHRONOBIOLOGY ; METABOLIC AND TOXIC INFLUENCES ; PSYCHOLOGICAL STRESS ; POSTICTAL SYMPTOMS ; Mechanisms ; Clinical Considerations ; Specific Postictal Cerebral Dysfunction ; Nonspecific Postictal Cerebral Dysfunction ; Noncerebral Postictal Dysfunction ; MORTALITY ; Comorbidity ; Sudden unexpected death ; Drowning ; SUMMARY AND CONCLUSIONS ; Chapter 10 ; STATUS EPILEPTICUS ; GENERALIZED CONVULSIVE STATUS EPILEPTICUS ; Clinical Description ; Tonic-Clonic Status Epilepticus ; Other Forms of Generalized Convulsive Status Epilepticus ; Incidence ; Etiology ; Treatment ; Lorazepam ; Diazepam ; Fosphenytoin ; Phenobarbital ; Paraldehyde ; Other drugs ; General Anesthesia ; EEG Monitoring, Ventilation, and Follow-Up ; Prognosis ; ABSENCE STATUS EPILEPTICUS ; Clinical Description ; Incidence ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; EPILEPSIA PARTIALIS CONTINUA ; Clinical Description ; Incidence ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; FOCAL DYSCOGNITIVE (COMPLEX PARTIAL) STATUS EPILEPTICUS ; Clinical Description ; Incidence ; Etiology ; Differential Diagnosis ; Treatment ; Prognosis ; SUBTLE STATUS EPILEPTICUS ; FEBRILE STATUS EPILEPTICUS ; NEONATAL STATUS EPILEPTICUS ; EPILEPTIC BRAIN DAMAGE ; SUMMARY AND CONCLUSIONS ; Chapter 11 ; CHRONIC BEHAVIORAL DISTURBANCES ; EPIDEMIOLOGY OF PSYCHIATRIC COMORBIDITY IN EPILEPSY ; PHENOMENOLOGY OF BEHAVIORAL DISTURBANCES IN EPILEPSY ; Ictal and Peri-ictal Behavior ; Psychosocial Adaptation ; Neurological, Intellectual, and Cognitive Function ; Personality ; Mood and Affect ; Anxiety ; Attention Deficit Hyperactivity Disorder (ADHD) ; Psychosis ; Classification of Neuropsychiatric Disorders in Epilepsy ; MECHANISMS OF INTERICTAL BEHAVIORAL DISTURBANCES IN EPILEPSY ; Psychosocial Factors-The Predicament ; Neuropathological Factors ; Effects of Treatment ; Epilepsy-Induced Neurobiological Factors ; SUMMARY AND CONCLUSIONS ; PART IV: MANAGEMENT ; Chapter 12 ; DIAGNOSTIC EVALUATION ; HISTORY ; Seizure History ; Aura or Prodrome ; Clinical Seizures ; Postictal Period ; Precipitating Factors and Pattern ; Frequency ; Age of Onset ; Progression of Symptoms ; ANTISEIZURE DRUG HISTORY ; Past Medical History ; Family History ; Psychosocial History ; PHYSICAL EXAMINATION ; General Physical Examination ; Neurological Examination ; Epileptic Seizure Observation ; LABORATORY EXAMINATION ; Clinical Laboratory Tests ; Electroencephalography ; When to Use EEG ; Special EEG Approaches ; Additional Electrodes ; Physiological Activation Procedures ; Pharmacological Activation Procedures ; Video-EEG Monitoring (VEM) ; Computer-Enhanced EEG ; Evoked Potentials ; Magnetoencephalography ; Transcranial Magnetic Stimulation (TMS) ; Structural Neuroimaging ; Magnetic Resonance Imaging (MRI) ; X-Ray Computed Tomography (CT) ; Radiographs ; Functional Neuroimaging ; Positron Emission Tomography (PET) ; Single Photon Emission Computed Tomography (SPECT) ; Functional Magnetic Resonance Imaging (fMRI) ; Magnetic Resonance Spectroscopy (MRS) ; Rectilinear Radionuclide Brain Scanning ; PSYCHOLOGICAL EVALUATION ; BIOMARKERS ; SUMMARY AND CONCLUSIONS ; Chapter 13 ; DIFFERENTIAL DIAGNOSIS ; DIFFERENTIAL DIAGNOSIS OF NONEPILEPTIC PAROXYSMAL EVENTS ; Systemic Disturbances ; Syncope ; Breath Holding ; Hyperventilation ; Toxic and Metabolic Disturbances ; Abdominal Epilepsy ; Neurologic Disturbances ; Cerebrovascular Disorders ; Sleep Disorders ; Motor Disorders ; Sensory Disorders ; Psychogenic Disturbances ; Psychogenic Nonepileptic Seizures (PNES) ; Intermittent Explosive Disorders ; Dissociative States ; Daydreaming ; Psychoses and Other Nonpsychotic Psychiatric Conditions ; DIFFERENTIAL DIAGNOSIS OF REACTIVE (ACUTE SYMPTOMATIC, PROVOKED) EPILEPTIC SEIZURES ; Alcohol Withdrawal Seizures ; Recurrent Reactive Seizures ; DIFFERENTIAL DIAGNOSIS OF CHRONIC EPILEPSY ; THE USE OF THE EEG IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY ; Avoiding an Inappropriate Diagnosis of Epilepsy ; EEG Contributions to a Positive Diagnosis of Epilepsy ; EEG Contributions to Diagnosis of the Type of Epilepsy ; THE USE OF FUNCTIONAL IMAGING IN THE DIFFERENTIAL DIAGNOSIS OF EPILEPSY ; SUMMARY AND CONCLUSIONS ; Chapter 14 ; GENERAL PRINCIPLES OF TREATMENT ; PHARMACOLOGICAL TREATMENT ; Pharmacological Principles ; Absorption ; Protein Binding ; Distribution ; Elimination ; Half-Life ; Zero-Order Kinetics ; Pharmacodynamic Actions ; Dose Planning ; Approach to Monotherapy and Polytherapy ; Clinical Factors Influencing Drug Efficacy ; Adverse Side Effects ; Dose-Dependent Adverse Side Effects ; Hypersensitive and Chronic Adverse Side Effects ; Drug Monitoring ; Choosing the Appropriate Drug ; Discontinuation of Medication ; Special Considerations ; Age ; Pregnancy ; Comorbidity ; Surgery ; Psychiatric Conditions ; Alcohol and Sedative Drug Withdrawal ; MEDICALLY REFRACTORY SEIZURES ; ALTERNATIVE THERAPY ; PSYCHOSOCIAL CONSIDERATIONS ; THE USE OF EEG IN ASSESSING TREATMENT ; MANAGEMENT AFTER A SINGLE SEIZURE ; EMERGENCY TREATMENT ; SUMMARY AND CONCLUSIONS ; Chapter 15 ; ANTISEIZURE DRUGS ; STANDARD OLDER DRUGS ; Phenobarbital (PB) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Phenytoin (PHT) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Primidone (PRM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Ethosuximide (ESM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Benzodiazepines ; Diazepam (DZP) ; Clonazepam (CLN) ; Lorazepam (LZP) ; Clobazam (CLB) ; Carbamazepine (CBZ) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Valproic Acid (VPA) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; NEWER DRUGS ; Eslicarbazepine Acetate (ESL) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Ezogabine (EZG) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Felbamate (FBM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Gabapentin (GBP) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Lacosamide (LCM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Lamotrigine (LTG) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Leviteracetam (LEV) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Oxcarbazepine (OXC) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Pregabalin (PGN) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Rufinamide (RUF) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Tiagabine (TGB) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Topiramate (TPM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Vigabatrin (VGB) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Zonisamide (ZON) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; SPECIAL AND RARELY USED DRUGS ; Acetazolamide ; ACTH and Adrenocorticosteroids ; Barbiturates ; Methylphenobarbital ; Metharbital ; Benzodiazepines ; Clorazepate ; Midazolam ; Nitrazepam ; Bromides ; Hydantoins ; Fosphenytoin ; Mephenytoin ; Ethotoin ; Oxazolidinediones ; Trimethadione ; Paramethadione ; Paraldehyde ; Phenacemide ; Piracetam ; Progabide ; Propofol ; Stiripentol ; Succinimides ; Methsuximide ; Phensuximide ; Sulthiame ; NEW DRUG DEVELOPMENT ; Identification of New Compounds ; Preclinical Evluation ; Clincial Evaluation ; DRUGS UNDER INVESTIGATION ; Drugs in Phase III Trials ; Brivaracetam ; Ganaxolone ; Perampanel ; Drugs in Preclincal Development ; 2-Deoxy-D-Glucose ; Huperzine A ; ICA105665 ; T2000 ; Tonabersat ; Valproic Acid Derivatives ; YKP3089 ; VX-765 ; SUMMARY AND CONCLUSIONS ; Chapter 15 ; ANTISEIZURE DRUGS ; STANDARD OLDER DRUGS ; Phenobarbital (PB) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Phenytoin (PHT) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Primidone (PRM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Ethosuximide (ESM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Benzodiazepines ; Diazepam (DZP) ; Clonazepam (CLN) ; Lorazepam (LZP) ; Clobazam (CLB) ; Carbamazepine (CBZ) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Valproic Acid (VPA) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; NEWER DRUGS ; Eslicarbazepine Acetate (ESL) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Ezogabine (EZG) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Felbamate (FBM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Gabapentin (GBP) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Lacosamide (LCM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Lamotrigine (LTG) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Leviteracetam (LEV) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Oxcarbazepine (OXC) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Pregabalin (PGN) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Rufinamide (RUF) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Tiagabine (TGB) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Topiramate (TPM) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Vigabatrin (VGB) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; Zonisamide (ZON) ; Mechanisms of Action ; Pharmacokinetics ; Toxicity ; Drug Interactions ; Indications ; Administration ; SPECIAL AND RARELY USED DRUGS ; Acetazolamide ; ACTH and Adrenocorticosteroids ; Barbiturates ; Methylphenobarbital ; Metharbital ; Benzodiazepines ; Clorazepate ; Midazolam ; Nitrazepam ; Bromides ; Hydantoins ; Fosphenytoin ; Mephenytoin ; Ethotoin ; Oxazolidinediones ; Trimethadione ; Paramethadione ; Paraldehyde ; Phenacemide ; Piracetam ; Progabide ; Propofol ; Stiripentol ; Succinimides ; Methsuximide ; Phensuximide ; Sulthiame ; NEW DRUG DEVELOPMENT ; Identification of New Compounds ; Preclinical Evluation ; Clincial Evaluation ; DRUGS UNDER INVESTIGATION ; Drugs in Phase III Trials ; Brivaracetam ; Ganaxolone ; Perampanel ; Drugs in Preclincal Development ; 2-Deoxy-D-Glucose ; Huperzine A ; ICA105665 ; T2000 ; Tonabersat ; Valproic Acid Derivatives ; YKP3089 ; VX-765 ; SUMMARY AND CONCLUSIONS ; Chapter 16 ; NONPHARMACOLOGICAL THERAPY OF SEIZURES ; SURGICAL THERAPY ; Historical Perspectives ; Surgical Therapy Continues to Be Underutilized ; Misconceptions about Surgical Candidates ; Arguments for Early Surgical Intervention ; Surgically Remediable Epilepsy Syndromes ; Therapeutic Surgical Procedures ; Standardized Resections ; Tailored Resections ; Disconnection Surgery ; Ablative Surgery ; Stimulation ; Surgical Protocols ; Strategy ; Candidate Selection ; Phase I ; Phase II ; Phase III ; Outcome ; Outcome with Respect to Seizures ; Quality of Life ; Cognitive, Psychiatric, and Social Outcomes ; Surgical Complications ; Development of New Centers ; VAGUS NERVE STIMULATION (VNS) ; HORMONE THERAPY ; IMMUNE THERAPY ; COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) ; Diet ; Ketogenic Diet ; Dietary Supplements ; Amino Acits ; Vitamins ; Minerals ; Food Sensitivity ; Traditional and Folk Medicine ; Behavioral Therapies ; Treatment of the Reflex Epilepsies ; Abortive Sensory Stimulation ; EEG Biofeedback ; Psychological Treatments ; Physical Interventions ; Nonallopathic Medical Systems ; SUMMARY AND CONCLUSIONS ; Chapter 17 ; SOCIAL MANAGEMENT ; STIGMA ; QUALITY OF LIFE ; ACTIVITIES OF DAILY LIVING ; Driving ; Practical Criteria for Restrictions on Driving ; Driver's License Regulations ; Participation in Sports ; Alcohol and Drugs ; Specific Hazards ; FAMILY ; The Child with Epilepsy ; The Parent with Epilepsy ; SCHOOL ; EMPLOYMENT ; LEGAL RIGHTS ; INSURANCE ; FINANCIAL AID ; RESOURCES ; HEALTH CARE DISPARITIES ; SUMMARY AND CONCLUSIONS