Neurostimulation For Epilepsy

Neurostimulation for Epilepsy: Advances, Applications, and Opportunities comprehensively reviews the diverse array of neurostimulation technologies currently in use and in development for the treatment of epilepsy. The book covers basic mechanisms of neurostimulation, technical characteristics of approved and investigational neurostimulation devices, clinical applications and programming considerations of these devices, and progress toward next-generation device technology. Leading experts in the field provide a contemporary appraisal of neurostimulation in epilepsy, one that highlights recent advances, outlines unanswered questions, and proposes future directions. Neurostimulation for Epilepsy: Advances, Applications, and Opportunities will be of high interest to clinical, basic, and translational researchers seeking to understand leading-edge applications of neurostimulation in epilepsy and to clinicians managing patients with epilepsy who are treated with implanted and external neurostimulation devices. This book will also be of interest to trainees, to physicians in other areas of neurology where neurostimulation is employed, such as Pain and Movement Disorders, and to general medical practitioners, neurobiologists, and engineers. Explains fundamental principles of neurostimulation in accessible terms Details technical characteristics and engineering considerations of neurostimulation devices Describes strengths and limitations of approved and investigational neurostimulation devices Overviews clinical applications of neurostimulation, including device selection and programming Highlights the patient experience with neurostimulation, with an emphasis on quality of life Provides a roadmap for the development of next-generation devices

H.H. Jasper, A.A. Ward, A. Pope and H.H. Merritt, chair of the Public Health Service Advisory Committee on the Epilepsies, National Institutes of Health, published the first volume on Basic Mechanisms of the Epilepsies (BME) in 1969. Their ultimate goal was to search for a "better understanding of the epilepsies and seek more rational methods of their prevention and treatment." Since then, basic and clinical researchers in epilepsy have gathered together every decade and a half with these goals in mind -- assessing where epilepsy research has been, what it has accomplished, and where it should go. In 1999, the third volume of BME was named in honor of H.H. Jasper. In line with the enormous expansion in the understanding of basic epilepsy mechanisms over the past four decades, this fourth edition of Jasper's BME is the most ambitious yet. In 90 chapters, the book considers the role of interactions between neurons, synapses, and glia in the initiation, spread and arrest of seizures. It examines mechanisms of excitability, synchronization, seizure susceptibility, and ultimately epileptogenesis. It provides a framework for expanding the epilepsy genome and understanding the complex heredity responsible for common epilepsies as it explores disease mechanisms of ion channelopathies and developmental epilepsy genes. It considers the mechanisms of conditions of epilepsy comorbidities. And, for the first time, this 4th edition describes the current efforts to translate the discoveries in epilepsy disease mechanisms into new therapeutic strategies. This book, considered the 'bible' of basic epilepsy research, is essential for the student, the clinician scientist and all research scientists who conduct laboratory-based experimental epilepsy research using cellular, brain slice and animal models, as well as for those interested in related disciplines of neuronal oscillations, network plasticity, and signaling in brain strucutres that include the cortex, hippocampus, and thalamus. In keeping with the 1969 goals, the book is now of practical importance to the clinical neurologist and epileptologist as the progress of research in molecular genetics and modern efforts to design antiepileptic drugs, cures and repairs in the epilepsies converge and impact clinical care.

Deep brain stimulation for seizures has been applied to cerebellum, caudate, locus coeruleus, subthalamic nucleus, mammillary bodies, centromedian thalamus, anterior nucleus of thalamus, hippocampus and amygdala, hippocampal commissure, corpus callosum, neocortex, and occasionally to other sites. Animal and clinical studies have primarily investigated seizure prevention and, to a lessersmaller extent, seizure interruption. No studies have yet shown stimulation able to cure epilepsy. A wide variety of stimulation parameters have been employed in multiple different combinations of frequencies, amplitudes, and durations. Literature review identifies at least 52 clinical studies of brain stimulation for epilepsy in 817 patients. Two studies were large, randomized, and controlled, one in the anterior nucleus of thalamus and another at the cortical or hippocampal seizure focus; both of these studies showed efficacy and tolerability of stimulation. Many questions remain. We do not know the mechanisms, the best stimulation parameters, the best patient population, or how to predict benefit in advance. We do not know why benefit of neurostimulation for epilepsy seems to increase over time or whether there are long-term deleterious effects. All of these questions may be answerable with a combination of laboratory research and clinical experience.

This second edition presents a timely and practical discussion of vagal nerve stimulation in a clear and well-illustrated format. It provides a clinical approach to the treatment of patients with medically-intractable seizures, as well as for those with depression (a new indication since the publication of first edition). The book's focus has made

Could neurostimulation be a management option for yourpatients? Neurostimulation techniques present real management options forpatients with a range of neurologic and psychiatric disorders, suchas movement disorders, pain and depression. They should be activelyconsidered when conventional medical approaches have failed or areinappropriate. But for many clinicians, these new methods pose manyquestions. What are the available modalities? How do they work?Which patients might benefit from them? How do I explain theprocesses to patients? How do I monitor my patient’s progressafter implantation? Neurostimulation provides a concise, easy-to-read fusion ofthe clinical applications of implanted neurostimulators. Itdemystifies selection and referral criteria, maximizing therapy,programming the implanted neuromodulators, monitoring progress andtroubleshooting problems associated with neurostimulation. Written by an international cast of experts,Neurostimulation, sets the stage for you to provide realclinical benefit to your patients who might receive, or are alreadyusing, neurostimulators.

As the population ages, technology improves, intensive care medicine expands and neurocritical care advances, the use of EEG monitoring in the critically ill is becoming increasingly important. This atlas is a comprehensive yet accessible introduction to the uses of EEG monitoring in the critical care setting. It includes basic EEG patterns seen in encephalopathy, both specific and non-specific, nonconvulsive seizures, periodic EEG patterns, and controversial patterns on the ictal–interictal continuum. Confusing artefacts, including ones that mimic seizures, are shown and explained, and the new standardized nomenclature for these patterns is included. The Atlas of EEG in Critical Care explains the principles of technique and interpretation of recordings and discusses the techniques of data management, and 'trending' central to long-term monitoring. It demonstrates applications in multi-modal monitoring, correlating with new techniques such as microdialysis, and features superb illustrations of commonly observed neurologic events, including seizures, hemorrhagic stroke and ischaemia. This atlas is written for practitioners, fellows and residents in critical care medicine, neurology, epilepsy and clinical neurophysiology, and is essential reading for anyone getting involved in EEG monitoring in the intensive care unit.

The extensively updated third edition of Pediatric Epilepsy: Diagnosis and Therapy continues to be the definitive volume on the diagnosis, treatment, classification, and management of the childhood epilepsies. Written by nearly 100 international leaders in the field, this new edition progresses logically with major sections on the basic mechanisms of the disease, classification, epidemiology, etiology, diagnosis, and age-related syndromes of epilepsy. The core of the new third edition is its completely updated section on antiepileptic drugs, including an in-depth discussion of dosage considerations, drug toxicity, teratogenicity, and drug interactions, with recommendations for optimal combinations when multiple drug therapy is required. Features unique to the third edition include: Expanded section on the basic science and mechanism of epilepsy Completely updated drug chapters, including newly released drugs and those in development Expanded chapters on vagus nerve stimulation and surgical treatment Expanded section on co-morbidities The third edition includes 21 new chapters, including discussions of: epileptic channelopathies; epileptogenic cerebral cortical malformation; epilepsy genes; etiologies and workup; evidence-based medicine issues related to drug selection; Levetiracetam; Sulthiame; Pregabalin; herbal medications; basic and advanced imaging; immunotherapy issues; vagus nerve stimulation therapy; cognitive and psychiatric co-morbidities and educational placement; and psychosocial aspects of epilepsy.

Treatment-resistant major depression and bipolar disorder are highly prevalent and disabling conditions associated with substantial morbidity and mortality. Providing a concise view of the current definitions, assessment and evidence-based management of such disorders, this work reviews novel therapeutic targets, which may enhance the future therapeutic armamentarium of clinicians.