From First Unprovoked Seizure to Newly Diagnosed Epilepsy

This new edition of the book series dedicated to “Progress in Epileptic Disorders” is the result of a recently held unique gathering of international experts that debated on the prognostic and therapeutic issues raised by the management of first unprovoked seizures and of newly diagnosed epilepsy.
Current knowledge on natural evolution of a first seizure, the role of co-morbid conditions, the impact of immediate versus delayed treatment and recent guidelines are thoroughly addressed. The new ideas and suggestions that emerge from this book offer challenging perspectives for both patient care and clinical as well as fundamental research.
The first section of the book includes an up to date review of epidemiological data, encompassing the natural evolution of single unprovoked seizures, risk factors for
recurrent seizures, and the potential for comorbid conditions such as depression, migraine, ADHD, and dysimmune metabolic disorders to promote the development of epilepsy. The impact of febrile convulsions on long-term brain hyperexcitability is also discussed.
The second section concentrates on therapeutic issues, concerning the management of single unprovoked seizures and newly diagnosed epilepsy. These include the impact of immediate versus deferred treatment and the choice of the most appropriate antiepileptic drug therapy.
Several methodological issues are addressed in parallel with the chapters, providing new insights into domains, such as the representativeness of the patient population in the studies under consideration, as well as the limitations and pitfalls of most randomised controlled trials. The value of these trials in the development of treatment guidelines is also discussed.
CONTENTS
I: Setting the scene
From first unprovoked seizure to newly diagnosed epilepsy: definitions and diagnostic issues at epilepsy onset
Commentary by Dorotée Kasteleijn Nolst Trenité: Provoked and unprovoked?
How restricted is the spectrum of epilepsies observed in prospective cohorts of first unprovoked seizure?
II: Back to the future
Natural evolution of first unprovoked epileptic seizure
Risk factors for developing epilepsy after a first unprovoked seizure
III: Epileptogenesis and disease progression: the example of febrile seizures
“Complex” febrile seizures and the epilepsy: information from an experimental model
Febrile seizures as a risk factor for the development of epilepsy: human data
IV: Novel approaches of medical risk factors for unprovoked seizures and cryptogenic epilepsy
Comorbidity of epilepsy and neuropsychiatric disorders: epidemiological considerations
Commentary by Andres M. Kanner
Epileptic seizures in the context of the dysimmune syndromes
V: From randomized controlled trials to patient-oriented decision making
From randomized controlled trials to patient-oriented therapy: methodology and clinical issues
Treatment of first unprovoked seizure
Treatment of newly diagnosed epilepsy
Bridging the gap between clinical guidelines and individualized patient treatment
VI: Future Challenges
What types of trials and studies do we need for early treatment of epilepsy?
From prediction of medical intractability to early surgical treatment