Editor’s Preface

* 2013, American Academy

The Continued of Neurology.

Evolution of Epilepsy
Since the publication of that in a future revision of
the last is- the revision, the ubiqui-
sue devoted to Epilepsy, tous seizure ‘‘semiology’’
our understanding of the will simply become sei-
pathophysiology, neuro- zure ‘‘symptomatology.’’
physiology, genetics, imag- Next, Drs Rama
ing, and medical and Maganti and Paul Rutecki
surgical management of discuss EEGs and epi-
seizures and epilepsy syn- lepsy monitoring. In their
dromes has significantly concise and thorough
evolved. In this issue of overview of the role of
, Guest Edi- EEG in epilepsy diagno-
tors Gregory D. Cascino, MD, sis, the authors provide
FAAN, and Erik K. St. Louis, practical illustrative ex-
MD, FAAN, have gathered
In this issue of amples of ictal and non-
an expert and institutionally , Guest ictal EEG patterns as well
diverse faculty to help us Editors Gregory D. as benign variants. In the
incorporate the current Cascino, MD, FAAN, next article, Dr Fernando
state of the art of diagnosis Cendes discusses the
and management of epi-
and Erik K. St. Louis, role of neuroimaging in
lepsy into our practices. MD, FAAN, have patients with epilepsy,
This issue begins with gathered an expert including particularly in-
a discussion by Drs Anne and institutionally structive examples of im-
Berg and John Millichap aging of malformations
about the International
diverse faculty to of cortical development
League Against Epilepsy help us incorporate (causes of epilepsy that are
2010 Revised Classifica- the current state of increasingly recognized as
tion of Seizures and Epi- the art of diagnosis important to all neurolo-
lepsy. The modernized gists, whether treating
classification system takes
and management children or adults).
into account the newest of epilepsy into Next, Drs Jacqueline
information about causes our practices. French and Deana
of epileptic syndromesV Gazzola review princi-
eg, ‘‘idiopathic,’’ ‘‘symptomatic,’’ and ples of antiepileptic drug (AED) treat-
‘‘cryptogenic’’ are replaced by ‘‘genetic,’’ ment, providing their expert opinion
‘‘structural/metabolic,’’ and ‘‘unknown’’ on strategies for AED selection and, if
in the new system. This new classification necessary, drug combinations. Their
scheme even seems to present a more article is complemented by the subse-
intuitive terminologyVeg, the reintro- quent article by Drs Tracy Glauser and
duction of the term ‘‘focal seizures’’ Tobias Loddenkemper, who tackle the
instead of ‘‘partial seizures,’’ and ‘‘with management of childhood epilepsy.
impairment of consciousness’’ instead This article will even be of interest to
of ‘‘complex partial.’’ We can only hope those of us whose practice is confined
Continuum (Minneap Minn) 2013;19(3):569–570 www.ContinuumJournal.com 569

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 Editor’s Preface
to adults, especially given their exten-
sive table-based summary and overview
of AEDs used in patients of all ages.
In the next review, Drs Leslie
Rudzinski and Kimford Meador dis-
cuss the neuropsychological (both
cognitive and psychiatric) comorbidities
in patients with epilepsyVsymptoms
that are increasingly recognized as af-
fecting our epilepsy patients’ qualities of
life. Next, Dr Page Pennell thoroughly
reviews the issues specific to women
with epilepsy, including the most cur-
rent information relevant to AED treat-
ment and pregnancy. Dr Selim Benbadis
then discusses the diagnosis and treat-
ment of nonepileptic behavioral dis-
orders (psychogenic nonepileptic
events or episodes), emphasizing the
importanceVand practical difficultyVin
accessing appropriate mental health
referral and follow-up for these patients.
Drs John Miller and Shahin
Hakimian then review the contempo-
rary surgical treatments of epilepsy,
emphasizing recognition and early re-
ferral of appropriate surgical candi-
dates by the treating neurologist.
This is followed by a discussion by Drs
Christopher DeGeorgio and Scott Krahl
on neurostimulation for drug-resistant
epilepsy, including a discussion of the
only currently US Food and Drug
AdministrationYapproved device (vagus
nerve stimulation) and other devices on
the horizon. Next, Drs Mackenzie
Cervenka and Eric Kossoff provide a
thorough and practical review of vari-
ous dietary treatment options, and their
benefits and risks, for intractable epi-
lepsy. Finally, Drs Lawrence Hirsch and
Nicolas Gaspard present the current
state of the art in the diagnosis and
management of both convulsive and
nonconvulsive status epilepticus.
In this issue’s Ethical Perspectives
section, Drs Courtney Wusthoff and
Donald Olson discuss and analyze the
ethical challenges that arise when con-
570 www.ContinuumJournal.com
Copyright © American Academy of Neurology. Unauthorized reproduction of this article is prohibited.
sidering genetic testing of a child with
epilepsy. In the Practice section, Dr L.
James Willmore discusses the process of
informed decision sharing and docu-
mentation in regard to AED choice as
well as the issues involved in drug
monitoring, and Dr Jeffrey Buchhalter
discusses diagnostic coding in epilepsy.
As with every issue,
there are ample opportunities for CME.
Reading the material, answering the
Multiple-Choice Questions crafted by
Drs Ronnie Bergen and Adam Kelly,
and reviewing the explanatory discus-
sions will assess and enhance your
knowledge of the material, and you
will be able to earn up to 10 AMA PRA
Category 1 CME Creditsi. An alterna-
tive opportunity allows you to obtain
up to 12 AMA PRA Category 1 CME
Credits specifically approved by the
American Board of Psychiatry and Neu-
rology (ABPN) for self-assessment by
completing and submitting the Self-
Assessment Pretest before reading the
material and completing the post-
reading Multiple-Choice Questions.
The Patient Management Problem, writ-
ten by Drs Cascino and St. Louis, de-
scribes the case of a 21-year-old woman
from her first witnessed seizure to her
progression to medically refractory epi-
lepsy. By following her case and an-
swering multiple-choice questions
corresponding to important diagnostic
and therapeutic decision points along
her course (reinforcing many of the
issues addressed throughout the issue),
you will have the opportunity to earn up
to 2 AMA PRA Category 1 CME Credits.
I thank Drs Cascino and St. Louis and
their expert team of authors for provid-
ing us with such clear and practical
information that we can use to provide
the most contemporary diagnostic and
management approaches to our patients
with epilepsy.
VSteven L. Lewis, MD, FAAN
Editor-in-Chief
June 2013