Universität zu Köln

Bast, Thomas, Bauer, Juergen, Berkenfeld, Ralf, Elger, Christian E., Hamer, Hajo, Malter, Michael, Mayer, Thomas, von Podewils, Felix, Runge, Uwe, Schmidt, Dieter, Steinhoff, Bernhard, Baumgartner, Christoph, von Oertzen, Tim J., Kramer, Gunter, Seeck, Margitta, Beyenburg, Stefan and Vatter, Hartmut (2017). First Epileptic Seizure and Epilepsy in Adulthood. Aktuelle Neurol., 44 (9). S. 603 - 637. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-9428

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Abstract

Background The manuscript is a current and significantly expanded version of the 2012 German Society of Neurology (DGN) Guidelines for the First Epileptic Seizure and Epilepsy in Adulthood. The goal of these guidelines is to summarize the present situation with regard to diagnostics and therapy along with the available scientific literature and thereby improve the diagnostic and therapeutic procedures and contribute towards their standardization. The guidelines pertain exclusively to those epilepsies in adulthood. Children's epilepsies will not be included, nor will status epilepticus or seizures resulting from an immune-mediated disease of the brain as these types of epilepsies already have their own set of DGN guidelines. Methodology The guideline committee is comprised of neurology experts possessing special expertise in the area of epilepsy, as well as clinicians and independent physicians. In addition to the German Society of Neurology (DGN), the German Society of Neurosurgery (DGNC), the Austrian Chapter of the International League Against Epilepsy, the Swiss League Against Epilepsy as well as the Luxemburg Society of Neurology also participated. Special care was taken to also include younger members on the editorial board. Literature that has been published since the 2012 edition was issued has been examined and incorporated in the current edition. The methodology utilized for guideline development is in accordance with standardized consensus techniques like a modified Delphi process (submission of previously produced text or tables, multi-step written questioning techniques, feedback process, participant information about the group responses, discussion of all comments and, if appropriate, the subsequent revisions; group members are able to examine a comparison of their statements). The consensus process corresponds to the rules of the Association of the Scientific Medical Societies in Germany (AWMF) and the DGN in order to address conflicts of interests. Results The most important new feature is the development of a new epilepsy definition. A substantially new aspect of this definition is the question of whether or not epilepsy can be resolved. Also included is a new version of the classification for seizures and epilepsies which essentially corresponds to the 1989 version. The most important therapeutic development since the 2012 edition has been the significant expansion of the anticonvulsive medication spectrum. New medications have been approved (Perampanel, Brivaracetam) or have extended their approval (Zonisamide, Lacosamide, Eslicarbazepine acetate). The administration of Valproic Acid to women and children is being viewed ever more critically. The guidelines explain, in detail, the problems related to treating women with epilepsy. In addition to drug therapy, operative therapies and stimulation procedures are also covered. Psycho-social aspects, driving ability, education, vocation as well as the problems that arise when discontinuing medication after years of seizure freedom are more extensively discussed. Also, new sections on mortality, first-aid measures, and acute symptomatic seizures have been added. A single chapter has been devoted to pharmacokinetics and addresses the interactive potential of anti-epileptic drugs with other medications as well as the possible influence on vitamin and hormone levels. In particular, therapies for malignant diseases can be critically influenced by interactions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bast, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauer, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Berkenfeld, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Elger, Christian E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamer, Hajo UNSPECIFIED UNSPECIFIED UNSPECIFIED Malter, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Mayer, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED von Podewils, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Runge, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Steinhoff, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Baumgartner, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED von Oertzen, Tim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kramer, Gunter UNSPECIFIED UNSPECIFIED UNSPECIFIED Seeck, Margitta UNSPECIFIED UNSPECIFIED UNSPECIFIED Beyenburg, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Vatter, Hartmut UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-212348
DOI:	10.1055/s-0043-116312
Journal or Publication Title:	Aktuelle Neurol.
Volume:	44
Number:	9
Page Range:	S. 603 - 637
Date:	2017
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1438-9428
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TEMPORAL-LOBE EPILEPSY; QUALITY-STANDARDS-SUBCOMMITTEE; NEWLY-DIAGNOSED EPILEPSY; VAGUS NERVE-STIMULATION; TECHNOLOGY-ASSESSMENT SUBCOMMITTEE; CONTROLLED-RELEASE CARBAMAZEPINE; JUVENILE MYOCLONIC EPILEPSY; DRUG-RESISTANT EPILEPSY; LENNOX-GASTAUT SYNDROME; UPDATE MANAGEMENT ISSUES Multiple languages Clinical Neurology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21234