By Richard T. Johnson
As with earlier variants, this can be certain to develop into the best-selling inner medication 'Current remedy' publication. all through, well known pros current their very own reports within the administration of particular problems affecting the fearful procedure. analysis, epidemiology, and pathophysiology are mentioned merely once they have an effect on therapy ideas and judgements.
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Extra info for Current Therapy in Neurologic Disease
Other therapies may be successful at a much lower rate. Consider pyridoxine (to exclude pyridoxinedependent seizures, or as therapy), 100-150 mg/day; valproate; topiramate; and the ketogenic diet. If seizures remit and recur, verify that these are indeed infantile spasms rather than a new seizure type with focal EEG. A second course of ACTH may be effective for infantile spasm recurrence. New seizure types, instigated by the original disorder, may respond to appropriate anticonvulsant therapy. 25 TABLE 1 Risk of Experiencing a Febrile Seizure Factor General population Child in daycare Slow development Prolonged nursery stay (>28 days) Febrile seizure in first-degree relative (mother, father, sibling) Febrile seizure in two first-degree relatives Any two risk factors Risk of Febrile Seizure (%) 2 7 10 12 10 33 28 Adapted from Bethune P, Gordon K, Dooley J, et al: Which child will have a febrile seizure?
Even experienced epileptologists can be challenged when making the distinction between a first febrile seizure and a first seizure with fever. Recent work has shown that some patients with a combination of febrile and afebrile seizures, known as generalized epilepsy and febrile seizures plus (GEFS+) have mutations in voltage-gated sodium channel subunits. If there is a family history of febrile and afebrile seizures (particularly severe myoclonic epilepsy of infancy), referral can be made to research groups interested in the genetics of these conditions.
18 Narcolepsy The International Classification of Sleep Disorders. 2005, Westchester, IL: American Academy of Sleep Medicine. Hobson JA, Silvestri L: Parasomnias, Harvard Mental Health Lett 15:3-5, 1999. Kales A, Soldatos CR, Kales JD: Sleep disorders: insomnia, sleepwalking, night terrors, nightmares, and enuresis, Ann Intern Med 106:582-592, 1987. Kavey NB, Whyte J, Resor SR Jr, Gidro-Frank S: Somnambulism in adults, Neurology 40:749-752, 1990. Klackenberg G: Incidence of parasomnias in children in a general population, New York, 1987, Raven Press, 99-113.