(Press-News.org) An expert task force has created a new definition for epilepsy that refines the scope of patients diagnosed with this brain disease. The study published in Epilepsia, a journal published by Wiley on behalf of the International League Against Epilepsy (ILAE), provides a greater level of detail to diagnose epilepsy by including individuals with two unprovoked seizures, and those with one unprovoked seizure and other factors that increase risk of seizure recurrence.
The 2005 report by the ILAE task force defined an epileptic seizure as "a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain" and epilepsy as "a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures, and by the neurobiologic, cognitive, psychological, and social consequences of this condition. The definition of epilepsy requires the occurrence of at least one epileptic seizure."
"Why change the definition of epilepsy?" asks task force lead author Dr. Robert Fisher from Stanford University School of Medicine. "The 2005 definition does not allow a patient to outgrow epilepsy, nor does it take into account some clinicians' views that epilepsy is present after a first unprovoked seizure when there is a high risk for another. The task force recommendation resolves these issues with the new, more practical, definition of epilepsy that is aimed at clinicians. However, some researchers might use criteria similar to those of the older definition to facilitate comparison with prior studies."
The task force suggests that epilepsy is a disease of the brain defined as:
1. At least two unprovoked (or reflex) seizures occurring more than 24 hours apart; or
2. One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years; or
3. Diagnosis of an epilepsy syndrome.
"The burden of determining recurrence risk does not fall on the clinician. If information is not available on recurrence risk after a first seizure, then the definition defaults to the old definition," adds Dr. Fisher. According to the article epilepsy is "resolved" in individuals who are past the applicable age of an age-dependent epilepsy syndrome, or those that have been free of seizures for the last 10 years and off anti-epileptic drugs (AEDs) for 5 years or more. The authors note that, the meaning of "resolved" is not identical to that of "remission" or "cure."
"The published definitions were supported with factual data, but in some cases medical evidence did not exist and the task force used a "consensus" approach for these definitions," explains Drs. Gary Mathern and Astrid Nehlig, Editors-in-Chief of Epilepsia. In these instances, the editors are asking readers' opinions adding, "We encourage you to go to http://surveys.verticalresponse.com/a/show/1539433/ea840f4206/0 to share your feedback regarding the new definition of epilepsy."
INFORMATION:
This study is published in Epilepsia. Media wishing to receive a PDF of this article may contact sciencenewsroom@wiley.com.
Full citation: "A Practical Clinical Definition of Epilepsy." Robert S. Fisher, Carlos Acevedo, Alexis Arzimanoglou, Alicia Bogacz, J. Helen Cross, Christian E. Elger, Jerome Engel Jr, Lars Forsgren, Jacqueline A. French, Mike Glynn, Dale C. Hesdorffer, B.-I. Lee, Gary W. Mathern, Solomon L. Moshé, Emilio Perucca, Ingrid E. Scheffer, Torbjörn Tomson, Masako Watanabe, and Samuel Wiebe. Epilepsia; Published Online: April 14, 2014 (DOI: 10.1111/epi.12550).
URL Upon Publication: http://doi.wiley.com/10.1111/epi.12550
Editorial "From the Editors: Names Count—The New Operational Definition of Epilepsy and Epilepsia's Poll." Gary Mathern and Astrid Nehlig. Epilepsia; Published Online: April 14, 2014 (DOI: 10.1111/epi.12589).
URL Upon Publication: http://doi.wiley.com/10.1111/epi.12589
Author Contact: Media wishing to speak with Dr. Fisher may contact Michelle Brandt with Stanford University at mbrandt@stanford.edu. To speak with Dr. Mathern, please contact contact Amy Albin with UCLA at AAlbin@mednet.ucla.edu.
About the Journal
Epilepsia is the leading, most authoritative source for current clinical and research results on all aspects of epilepsy. As the journal of the International League Against Epilepsy, subscribers every month will review scientific evidence and clinical methodology in: clinical neurology, neurophysiology, molecular biology, neuroimaging, neurochemistry, neurosurgery, pharmacology, neuroepidemiology, and therapeutic trials. For more information, please visit http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1528-1167.
About the International League Against Epilepsy
The International League Against Epilepsy (ILAE) is the world's preeminent association of physicians and health professionals working toward a world where no person's life is limited by epilepsy. Since 1909 the ILAE has provided educational and research resources that are essential in understanding, diagnosing and treating persons with epilepsy. The ILAE supports health professionals, patients, and their care providers, governments, and the general public worldwide by advancing knowledge of epilepsy.
About Wiley
Wiley is a global provider of content-enabled solutions that improve outcomes in research, education, and professional practice. Our core businesses produce scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising; professional books, subscription products, certification and training services and online applications; and education content and services including integrated online teaching and learning resources for undergraduate and graduate students and lifelong learners.
Founded in 1807, John Wiley & Sons, Inc. (NYSE: JWa, JWb), has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company's website can be accessed at http://www.wiley.com.
New clinical definition for epilepsy improves diagnosis accuracy
2014-04-14
ELSE PRESS RELEASES FROM THIS DATE:
Women who gain too much or too little weight during pregnancy at risk for having an overweight child
2014-04-14
OAKLAND, Calif. — Gaining both too much or too little weight during pregnancy appears to increase the risk of having an overweight or obese child, according to a Kaiser Permanente study published today in the American Journal of Obstetrics and Gynecology.
In one of the largest studies to examine current Institute of Medicine recommendations regarding pregnancy weight gain in relation to childhood obesity, researchers reviewed the electronic health records of 4,145 racially diverse female members of Kaiser Permanente in Northern California who had completed a health survey ...
Study supports detrimental effects of television viewing on sleep in young children
2014-04-14
A study following more than 1,800 children from ages 6 months to nearly 8 years found a small but consistent association between increased television viewing and shorter sleep duration. The presence of a television in the room where a child sleeps also was associated with less sleep, particularly in minority children. Investigators from MassGeneral Hospital for Children (MGHfC) and Harvard School of Public Health (HSPH) report their results – the first to examine the connection between television and sleep duration over several years – in the May issue of Pediatrics. ...
Reduction in HPV in young women in England seen, following national immunization program
2014-04-14
Each year around 2,000-2,500 women are diagnosed with cervical cancer in England, the most common cancer in women under 35. Infection with high-risk human papillomavirus (HR HPV) types 16 and 18 is responsible for around 70-80% of cervical cancers. A study conducted by Public Health England and presented today at the Society for General Microbiology's Annual Conference shows a reduction in these two HR HPV types – which are included in the HPV vaccines used – in sexually active young women in England.
Between 2010 and 2012, over 4000 samples were collected from young ...
Gene linked to pediatric kidney cancer suggests new strategies for kidney regeneration
2014-04-14
BOSTON (April 14, 2014)—Nearly one-third of cases of Wilms tumor, a pediatric cancer of the kidney, are linked to a gene called Lin28, according to research from Boston Children's Hospital. Mice engineered to express Lin28 in their kidneys developed Wilms tumor, which regressed when Lin28 was withdrawn, indicating that strategies aimed at blocking or deactivating the gene hold therapeutic promise for children with Wilms. Studies in the mouse model further suggest that controlled expression of Lin28 can promote kidney development and therefore may hold clues to regeneration ...
Mechanism, and possible treatment, for immune suppression in liver disease uncovered
2014-04-13
The mechanism which underlies the susceptibility of liver disease patients to life-threatening infection has been uncovered by Wellcome Trust-funded medical scientists, who have also suggested a possible treatment to reverse immune suppression in these patients.
Liver disease, or cirrhosis, is currently the fifth leading cause of death in the UK. Cirrhosis patients are more than five times more likely to pick up infections in hospital than patients with other chronic conditions, due to reduced immunity which is a well-recognised feature of the disease.
In a study published ...
How a Silly Putty ingredient could advance stem cell therapies
2014-04-13
ANN ARBOR—The sponginess of the environment where human embryonic stem cells are growing affects the type of specialized cells they eventually become, a University of Michigan study shows.
The researchers coaxed human embryonic stem cells to turn into working spinal cord cells more efficiently by growing the cells on a soft, utrafine carpet made of a key ingredient in Silly Putty. Their study is published online at Nature Materials on April 13.
This research is the first to directly link physical, as opposed to chemical, signals to human embryonic stem cell differentiation. ...
Fish from acidic ocean waters less able to smell predators
2014-04-13
VIDEO:
Scientists collected fish from the coral reefs shown here and found that fish from the more acidic waters of the bubble reefs were less likely to detect the odor of...
Click here for more information.
Fish living on coral reefs where carbon dioxide seeps from the ocean floor were less able to detect predator odor than fish from normal coral reefs, according to a new study.
The study confirms laboratory experiments showing that the behavior of reef fishes can be seriously ...
Hereditary trauma
2014-04-13
The phenomenon has long been known in psychology: traumatic experiences can induce behavioural disorders that are passed down from one generation to the next. It is only recently that scientists have begun to understand the physiological processes underlying hereditary trauma. "There are diseases such as bipolar disorder, that run in families but can't be traced back to a particular gene", explains Isabelle Mansuy, professor at ETH Zurich and the University of Zurich. With her research group at the Brain Research Institute of the University of Zurich, she has been studying ...
Glasses strong as steel: A fast way to find the best
2014-04-13
Scientists at Yale University have devised a dramatically faster way of identifying and characterizing complex alloys known as bulk metallic glasses (BMGs), a versatile type of pliable glass that's stronger than steel.
Using traditional methods, it usually takes a full day to identify a single metal alloy appropriate for making BMGs. The new method allows researchers to screen about 3,000 alloys per day and simultaneously ascertain certain properties, such as melting temperature and malleability.
"Instead of fishing with a single hook, we're throwing a big net," said ...
Virus-fighting genes linked to mutations in cancer
2014-04-13
Researchers have found a major piece of genetic evidence that confirms the role of a group of virus-fighting genes in cancer development.
Our understanding of the biological processes that cause cancer is limited. UV light and smoking are two well-understood cancer-causing processes. Exposure to either of these processes causes distinguishable patterns of genetic damage, or 'signatures', on the genome that can lead to cancer. All cancer-causing processes leave their own distinct imprint or signature, on the genomes of cancer cells.
The APOBEC family of genes control ...