Challenges in epilepsy—The perspective of Norwegian epilepsy patients (original) (raw)
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Prevalence, Classification, and Severity of Epilepsy in Children in Western Norway
Epilepsia, 2000
Summary: Purpose: To determine prevalence of active epilepsy in school children in a defined area and assess the usefulness of International League Against Epilepsy classification of seizures and epileptic syndromes, with special emphasis on frequency, additional handicaps, and therapeutic problems of severe cases. Methods: The latest International League Against Epilepsy International Classification of Epileptic Seizures (ICES, 1981) and Epilepsies and Epileptic Syndromes (ICE, 1989) were used for determination of prevalence rates, seizure types, epilepsies and epileptic syndromes, and additional neurological deficits in all 6‐ to 12‐year‐old children with epilepsy in a Norwegian county. Children had neuropediatric and EEG examination, intelligence evaluation, and, when necessary, additional investigations. Results: Prevalence of active epilepsy on January 1, 1995, was 5.1 per 1,000. Main seizure type and epilepsy syndrome could be classified in 98% and 90% of patients, respectivel...
Validation of epilepsy diagnoses in the Danish National Hospital Register
Epilepsy Research, 2007
Purpose: To validate the diagnosis of epilepsy in the Danish National Hospital Register. Methods: We randomly selected 200 patients registered with epilepsy in the Danish National Hospital Register between 1977 and 2002 and validated the diagnosis according to the guidelines developed by the International League Against Epilepsy.
Epilepsia, 2003
To assess the needs and resources available in the provision of basic epilepsy care across Europe. A mailed questionnaire was used, the European Epilepsy Services inventory (EESI). The EESI was distributed to all 36 European chapters of the International League Against Epilepsy (ILAE), and answers were obtained from 32, a response rate of 89%. For the purpose of studying trends across Europe, the chapters were divided into a Western, an Eastern, a Central, and a Southern group. The survey results showed that there was a wide range in the number of physicians and specialists involved in epilepsy care across Europe, with a trend toward higher numbers of neurologists, pediatricians, and pediatric neurologists in Eastern Europe. Many different specialties were involved in epilepsy care, and many chapters reported differences in the provision of care across their countries, with less possibility for patients to see a specialist in the least provided areas, where most epilepsy patients we...
Epilepsy: some epidemiological aspects1
Psychological Medicine, 1979
The epilepsies have been subject to effective chemical control for a good half century longer than the functional psychoses. Phenobarbitone, which was preceded by over 50 years by bromides, came into use in 1913, dilantin in 1938. Perhaps this early advent of successful pharmacological control of the epilepsies, as compared with that of the functional psychoses, damped epidemiological research into the subject. We venture that there is less epidemiological knowledge about the distribution and aetiology of the epilepsies than about the psychoses. This neglect of the epidemiology of seizure disorders has left fallow a most intriguing psychiatric issue, namely, the association of temporal lobe epilepsy with psychiatric disorders, and with schizophrenia in particular. We shall concern ourselves here with the more general epidemiological background of the epilepsies. Anticonvulsants permit the control of seizures in 60-80% of epileptic patients (Rodin, 1972). After a 20-year follow-up, some 70 % of patients have been found free of seizures for 5 years (Annegers et al. 1979). Still, as a recent review in this journal suggested, long-term use of anticonvulsants may produce mental deterioration (Trimble & Reynolds, 1976). Experiments on preweanling and postweanling rats also suggest, alarmingly, that phenobarbitone given during the brain growth spurt, or even during the subsequent deceleration, retards brain growth and disturbs behaviour (Diaz et al. 1977; Diaz & Schain, 1977). In addition, many persons with seizures go undiagnosed and untreated or improperly medicated. A recent report has drawn attention to under-medication and overmedication that is widespread and substantial in certain institutionalized settings (Murphy & D'Souza, 1977). Primary prevention is surely what we must aim for in the long run-an aim which can only be achieved by a search for causes. This goal is ambitious. At present, about 70 % of seizures identified in population surveys are ascribed to unknown causes (Hauser, 1978). Even this figure is an underestimate, since the environmental and genetic 'causes' often cited are best treated as hypothetical rather than established. The search for causes begins with a quest for variations in the frequency of the disorder. Since 1950, at least 36 surveys-whether concerned exclusively with seizure disorders in particular or with neurological disorders in general-have been conducted in various settings around the world (see bibliography). Fourteen of these deal exclusively with infants and children. Worldwide, the reported incidence rates of the epilepsies for all ages combined range from 0-173 per 1000 in Niigata City, Japan (Sato, 1964) to 1 per 1000 in Australia (Crombie et al. 1960). Within England itself, the reported rates vary from 0-30 per 1000 in Carlisle (Brewis et al. 1966) to 0-73 per 1000 in 14 general practices in southeast England (