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Research into the neuropsychiatry of epilepsy has become a central focus of interest in the last five years. Comorbidity of epilepsy with behavioral problems is now recognized widely, and the neuroscientific basis for such comorbidity is an active area of investigation. With an expanded international team of authors, this fully revised new edition builds on the strengths of its predecessor, examining in detail the subtleties of behavioral changes in patients with seizure disorders and offering both a diagnostic and a management perspective. New chapters cover genetic disorders, the effects of epilepsy on social behavior as viewed through theory of mind, a discussion of the precuneus, the importance and nature of peri-ictal psychiatric symptoms, depression and the interictal dysphoric disorder, and the relationship between antiepileptic drugs and suicide. This new edition is a must for anyone involved in diagnosing or managing epilepsy.
This introduction presents an overview of the concepts discussed in this book The Neuropsychiatry of Epilepsy. In the intervening years, there has been a clear appreciation in biological psychiatry of the neurobiological bases of psychopathologies as major depressive disorder, obsessive-compulsive disorder and other anxiety-related conditions, and there has been further development of psychotropic and anticonvulsant drugs (AEDs). The second edition starts with epidemiology, which has become a prominent discipline in research attempting to disentangle the extent and variety of psychiatric comorbidities in epilepsy. The clinical presentations and the wide spectrum of peri-ictal disorders are then discussed. Depression in epilepsy may not be quite like depression in the absence of epilepsy, the neuroanatomy giving a special stamp on the phenomenology. The book concludes with a discussion on the brain mechanisms of consciousness as may be revealed through investigations of patients with seizure disorders.
Postictal psychiatric phenomena are relatively frequent in patients with treatment-resistant epilepsy. This chapter reviews the most relevant clinical aspects of peri-ictal symptomatology. Ictal panic is one of the most frequently misdiagnosed symptoms in medical practice, as it is often diagnosed as a panic attack. Postictal psychiatric phenomena may be the expression of isolated psychiatric symptoms; clusters of postictal psychiatric symptoms (PPS) mimicking a depressive, anxiety or psychotic episode; postictal exacerbation in severity of interictal psychiatric symptoms and persistence of interictal symptoms into the postictal period. In contrast to postictal symptoms of depression (PSD) or PDE, postictal psychotic episodes (PIPE) can be readily prevented and treated. Prevention of PIPE is possible in patients who are found to have bilateral ictal foci in the course of a video-EEG or who are known to develop PIPE after a cluster of seizures.
The paroxysmal disorders present neurologists and other medical professionals with diagnostic problems across a range of disorders, including multiple sclerosis, migraine and epilepsy. This new English language edition of a compendium of the paroxysmal disorders, originally published in German as Paroxysmale Störugen in der Neurologie, is an informative and practical resource for clinicians, which provides invaluable help with differential diagnosis and management. Fully updated throughout, this new edition comprehensively covers the entire spectrum of the paroxysmal disorders, including sudden falls, headache, vertigo attacks, memory loss, visual disturbances, seizures and anxiety. Each chapter is practice oriented, covering definitions, etiology, epidemiology, diagnosis, examination techniques and therapy. Detailed guidelines for gathering case-histories, essential for accurate diagnosis, are also provided. Important reading for clinicians, professionals and academic researchers working in neurology, psychiatry, epilepsy, internal medicine and ENT.
Michael Trimble and Bettina Schmitz have assembled a multi-national team of experts to review the most recent findings and explore the interface between epilepsy and behaviour disorders. They begin by looking at the classifications available and examine how adequate they are for defining the subtleties of behavioural changes in patients with neurological disorders. Coverage is broad-ranging, from related cognitive problems, the biological underpinnings and pseudoseizures, to clinical aspects and treatment issues. There has been a great deal of research in this area over recent years, but limited published reviews. This timely book covers the practical implications of ongoing research, and offers both a diagnostic and management perspective. It will be essential reading for all professionals engaged in the treatment of epileptic patients.
This chapter focuses on the most frequent vertigo syndromes. Characteristic symptoms of Benign paroxysmal positioning vertigo (BPPV) include brief, in part, severe attacks of rotatory vertigo with and without nausea, which are caused by rapid changes in head If the typical positioning nystagmus can be elicited without any additional central signs and symptoms. Menière's disease is typically a combination of abruptly occurring attacks with vestibular and/or cochlear symptoms, fluctuating, slowly progressive hearing loss and, in the course of time, tinnitus. Vertigo and nausea are reduced by antivertiginous drugs used in other acute disorders of labyrinthine function, for example, dimenhydrinate 100 mg as suppository or benzodiazepine. The differential diagnosis of perilymph fistulas includes the following illnesses: BPPV, positional vertigo of central origin, Menière's disease, vestibular paroxysmia, somatoform phobic postural vertigo, labyrinthine trauma and bilateral vestibulopathy. Differentiating vestibular migraine from transient ischemic attacks, Menière's disease or vestibular paroxysmia can occasionally be difficult.
How much violence can a society expect its members to accept? A comparison between the language theories of Julia Kristeva and Jacques Lacan is the starting point for answering this question. A look at the early stages of language acquisition exposes the sacrificial logic of patriarchal society. Are those forces that restrict the individual to be conceived in a martial imagery of castration or is it possible that an existing society critically questions those points of socialization that leave their members in a state of homelessness? The following considerations should help to distinguish between unavoidable and avoidable forms of violence.
