Part,  Chapter, Paragraph

  1   II,     5.  5.Int|              not readily available.~ ~Epilepsy: The prevalence of epilepsy
  2   II,     5.  5.Int|           Epilepsy: The prevalence of epilepsy in the EU varies between
  3   II,     5.  5.Int|            incidence and mortality of epilepsy are declining. The estimated
  4   II,     5.  5.Int|     adolescents in Europe with active epilepsy is 0.9 million (prevalence
  5   II,     5.  5.Int|           Approximately 20-30% of the epilepsy population have more than
  6   II,     5.  5.  3|        conducted by Fombonne mentions epilepsy as the most frequent co-morbid
  7   II,     5.  5.  3|                              5.5.3.4. Epilepsy~ ~
  8   II,     5.  5.  3|               3.4.1. Introduction~ ~ ~Epilepsy is a chronic clinical disorder
  9   II,     5.  5.  3|               worldwide distribution. Epilepsy is a symptom complex arising
 10   II,     5.  5.  3|            cardinal manifestations of epilepsy are the epileptic seizures,
 11   II,     5.  5.  3|       epileptic process. Incidence of epilepsy is expected to increase
 12   II,     5.  5.  3|              the European population. Epilepsy is linked to educational
 13   II,     5.  5.  3|            the stigma associated with epilepsy~ ~While all people with
 14   II,     5.  5.  3|                 While all people with epilepsy experience seizures, not
 15   II,     5.  5.  3|        individuals with seizures have epilepsy. Epileptic seizures may
 16   II,     5.  5.  3|              acute phase has elapsed. Epilepsy in remission with treatment
 17   II,     5.  5.  3|              AEDs)(Commission, 1993). Epilepsy in remission without treatment (
 18   II,     5.  5.  3|             to the so-called inactive epilepsy. In contrast, epilepsy is
 19   II,     5.  5.  3|       inactive epilepsy. In contrast, epilepsy is the occurrence of two
 20   II,     5.  5.  3|         seizures may have “potentialepilepsy, seizure recurrence can
 21   II,     5.  5.  3|     epidemiological indexes. Although epilepsy is, by definition, a chronic
 22   II,     5.  5.  3|               Forsgren, 2004). Active epilepsy is defined as having at
 23   II,     5.  5.  3|        Commission, 1993). Intractable epilepsy still requires a standard
 24   II,     5.  5.  3|             cohort of childhood-onset epilepsy (Berg et al, 2001), intractability
 25   II,     5.  5.  3|           sources~ ~The patients with epilepsy enrolled in the epidemiological
 26   II,     5.  5.  3|         representative of the general epilepsy population. Thus, multiple
 27   II,     5.  5.  3|        conducted on all patients with epilepsy or in patients in different
 28   II,     5.  5.  3|       existing on the epidemiology of epilepsy was largely obtained from
 29   II,     5.  5.  3|             majority of patients with epilepsy no cause can be found and
 30   II,     5.  5.  3|             differential diagnosis of epilepsy encompasses a number of
 31   II,     5.  5.  3|           prevalence and mortality of epilepsy are fairly homogeneous across
 32   II,     5.  5.  3|           distributed.~ ~Incidence of epilepsy and seizures~Thirteen incidence
 33   II,     5.  5.  3|                while the incidence of epilepsy ranges from 24 to 57 per
 34   II,     5.  5.  3|               5.5.3.4.1. Incidence of epilepsy in Europe~ ~Table 5.5.3.
 35   II,     5.  5.  3|            Incidence (per 100,000) of epilepsy in Europe, by age~ ~With
 36   II,     5.  5.  3|               1995), the incidence of epilepsy and unprovoked seizures
 37   II,     5.  5.  3|             different distribution of epilepsy in men and women can be
 38   II,     5.  5.  3|             on the temporal trends of epilepsy in Europe. No overall trends
 39   II,     5.  5.  3|       age-specific incidence rates of epilepsy tended to decrease in the
 40   II,     5.  5.  3|               decreasing incidence of epilepsy in children, the introduction
 41   II,     5.  5.  3|               increasing incidence of epilepsy in the elderly has been
 42   II,     5.  5.  3|               unprovoked seizures and epilepsy was prospectively studied
 43   II,     5.  5.  3|               per year). Undetermined epilepsy (without unequivocal evidence
 44   II,     5.  5.  3|      cryptogenic localization-related epilepsy in 16% (8.8 per 100,000
 45   II,     5.  5.  3|      symptomatic localization-related epilepsy in 15% (8.4 per 100,000
 46   II,     5.  5.  3|            and idiopathic generalized epilepsy in 6% (3.4 per 100,000 per
 47   II,     5.  5.  3|             purposes.~ ~Prevalence of epilepsy~There are numerous studies
 48   II,     5.  5.  3|          studies on the prevalence of epilepsy in Europe (Forsgren et al,
 49   II,     5.  5.  3|          overall prevalence of active epilepsy ranges from 3.2 to 7.8 per
 50   II,     5.  5.  3|              incidence, prevalence of epilepsy tends to prevail in men.
 51   II,     5.  5.  3|               3. Prevalence of active epilepsy in Europe~Modified from
 52   II,     5.  5.  3|             different distribution of epilepsy syndromes in children and
 53   II,     5.  5.  3|          incidence, the prevalence of epilepsy syndromes has been calculated
 54   II,     5.  5.  3|           follows: idiopathic partial epilepsy with centro-temporal spikes
 55   II,     5.  5.  3| centro-temporal spikes 5-17%, absence epilepsy 6-8%, juvenile myoclonic
 56   II,     5.  5.  3|              6-8%, juvenile myoclonic epilepsy 1-5%, West syndrome 0.5-
 57   II,     5.  5.  3|               affect the frequency of epilepsy reports. In a study made
 58   II,     5.  5.  3|             between the prevalence of epilepsy and social deprivation,
 59   II,     5.  5.  3|             The mortality rate due to epilepsy ranges from 1 to 8 per 100,
 60   II,     5.  5.  3|         patients with childhood-onset epilepsy followed up for 35 years,
 61   II,     5.  5.  3|           past 100 years, the SMR for epilepsy in Europe was found to range
 62   II,     5.  5.  3|        incidence cohorts, the SMR for epilepsy ranges from 1.6 to 5.3 in
 63   II,     5.  5.  3|               studies of mortality in epilepsy~Modified from Shackleton
 64   II,     5.  5.  3|              source.~ ~ ~Aetiology of epilepsy is one of the strongest
 65   II,     5.  5.  3|            predictors of mortality in epilepsy. Patients with symptomatic
 66   II,     5.  5.  3|             Patients with symptomatic epilepsy have a two- to six-fold
 67   II,     5.  5.  3|               seizures and refractory epilepsy mostly account for the increased
 68   II,     5.  5.  3|          mortality in childhood-onset epilepsy. Mortality is greater in
 69   II,     5.  5.  3|             idiopathic or cryptogenic epilepsy in remission, mortality
 70   II,     5.  5.  3|               patients with childhood epilepsy followed into adulthood (
 71   II,     5.  5.  3|           between SMR and duration of epilepsy during the first 10 to 14
 72   II,     5.  5.  3|          Sander, 2004). Patients with epilepsy are reported to be at higher
 73   II,     5.  5.  3|        analysis. Patients with severe epilepsy have a fivefold and patients
 74   II,     5.  5.  3|           patients with temporal lobe epilepsy a 25-fold increased risk
 75   II,     5.  5.  3|           patients with temporal lobe epilepsy undergoing surgical treatment (
 76   II,     5.  5.  3|              suicide in patients with epilepsy. While seizure-related mortality
 77   II,     5.  5.  3|        mortality is rare in new onset epilepsy, in patients with chronic
 78   II,     5.  5.  3|              in patients with chronic epilepsy most deaths appear to be
 79   II,     5.  5.  3|       previously healthy patient with epilepsy in whom no cause of death
 80   II,     5.  5.  3|               with chronic refractory epilepsy, generalized tonic-clonic
 81   II,     5.  5.  3|   community-based series of childhood epilepsy (Callenbach et al, 2001).
 82   II,     5.  5.  3|                In patients undergoing epilepsy surgery, the SMR was found
 83   II,     5.  5.  3|          comorbidity in patients with epilepsy (Gaitatzis et al, 2004).
 84   II,     5.  5.  3|              was 86% in patients with epilepsy and 75% in controls (p<0.
 85   II,     5.  5.  3|             Patients with and without epilepsy were compared. Several somatic
 86   II,     5.  5.  3|            more common in people with epilepsy than in non-epileptic controls,
 87   II,     5.  5.  3|                Prognosis~Treatment of epilepsy is generally started at
 88   II,     5.  5.  3|        long-term prognosis of treated epilepsy reported a 69% cumulative
 89   II,     5.  5.  3|         patients with childhood-onset epilepsy, 64% of cases were in 5-
 90   II,     5.  5.  3|             Sillanpaa et al, 1998).~ ~Epilepsy and learning ability~About
 91   II,     5.  5.  3|               25-50% of children with epilepsy experience some degree of
 92   II,     5.  5.  3|             Wight found children with epilepsy of average intelligence
 93   II,     5.  5.  3|           showed 53% of children with epilepsy attending mainstream schools
 94   II,     5.  5.  3|             that 27% of children with epilepsy did not complete basic or
 95   II,     5.  5.  3|            education in patients with epilepsy and non-epileptic controls.
 96   II,     5.  5.  3|              for having children with epilepsy in their classes (Pazzaglia
 97   II,     5.  5.  3|             there is no evidence that epilepsy education of teachers has
 98   II,     5.  5.  3|              teachers has improved.~ ~Epilepsy and employment~People with
 99   II,     5.  5.  3|            and employment~People with epilepsy experience difficulties
100   II,     5.  5.  3|               higher in patients with epilepsy than in the general population (
101   II,     5.  5.  3|              However, most studies on epilepsy and employment have been
102   II,     5.  5.  3|              adopted in patients with epilepsy. However, recent studies
103   II,     5.  5.  3|          attitude towards people with epilepsy (Jacoby et al, 2004). In
104   II,     5.  5.  3|      idiopathic or remote symptomatic epilepsy from several Western and
105   II,     5.  5.  3|         accident rates in people with epilepsy (Van den Broek and Beghi,
106   II,     5.  5.  3|               Intervention studies on epilepsy and vocational rehabilitation
107   II,     5.  5.  3|                Smeets et al, 2007).~ ~Epilepsy and driving~In the European
108   II,     5.  5.  3|              for patients with active epilepsy (seizures during sleep or
109   II,     5.  5.  3|              5.5.3.4.5). The issue of epilepsy and driving varies depending
110   II,     5.  5.  3|                mandatory reporting of epilepsy may have negative implications
111   II,     5.  5.  3|              National legislations on epilepsy and driving in Europe~ ~__ __~
112   II,     5.  5.  3|             reasons for patients with epilepsy Although one gets the impression
113   II,     5.  5.  3|       attitude of the society towards epilepsy, patients with epilepsy
114   II,     5.  5.  3|               epilepsy, patients with epilepsy still face relevant problems
115   II,     5.  5.  3|             European Working Group on Epilepsy and Driving (SEWGED) has
116   II,     5.  5.  3|               experts in the field of epilepsy, collected all the available
117   II,     5.  5.  3|            universal understanding of epilepsy”. This statement aims at
118   II,     5.  5.  3|        current scientific position on epilepsy and recommends a set of
119   II,     5.  5.  3|         policy for hiring people with epilepsy and considers that job restrictions
120   II,     5.  5.  3|            programmes for people with epilepsy achieve better results than
121   II,     5.  5.  3|             in promoting education on epilepsy towards patients, their
122   II,     5.  5.  3|             involved society members. Epilepsy and any other disabling
123   II,     5.  5.  3|            removing prejudice against epilepsy and stigma.~A number of
124   II,     5.  5.  3|           regarding the management of epilepsy have been developed in several
125   II,     5.  5.  3|            diagnosis and treatment of epilepsy, these instruments can be
126   II,     5.  5.  3|              situations.~Consortia of epilepsy centres and other specialized
127   II,     5.  5.  3|                In Italy, a network of epilepsy centres was founded in the
128   II,     5.  5.  3|             of European comprehensive epilepsy programs.~ ~
129   II,     5.  5.  3|           incidence and prevalence of epilepsy in countries with no population-based
130   II,     5.  5.  3|       age-specific incidence rates of epilepsy in the younger and older
131   II,     5.  5.  3|     geographic and temporal trends of epilepsy in children and in the elderly
132   II,     5.  5.  3|        recurrent unprovoked seizures (epilepsy). Cohorts of patients with
133   II,     5.  5.  3|              patients at high risk of epilepsy.~The variability of the
134   II,     5.  5.  3|              driving in patients with epilepsy and the scarce attention
135   II,     5.  5.  3|               to the heterogeneity of epilepsy syndromes must change. Harmonization
136   II,     5.  5.  3|     educational issues, children with epilepsy should be admitted into
137   II,     5.  5.  3|               recognizing that, where epilepsy is not a single complication,
138   II,     5.  5.  3|               educating children with epilepsy should be an integral part
139   II,     5.  5.  3|           provision for children with epilepsy. Increased knowledge about
140   II,     5.  5.  3|             Increased knowledge about epilepsy amongst school children
141   II,     5.  5.  3|              of care to patients with epilepsy to reduce the risk of seizure
142   II,     5.  5.  3|            diagnosis and treatment of epilepsy should be disseminated into
143   II,     5.  5.  3|           comprehensive management of epilepsy in well-defined geographic
144   II,     5.  5.  3|               networks should include epilepsy centres and centres for
145   II,     5.  5.  3|            centres for the surgery of epilepsy. Using the available web
146   II,     5.  5.  3|         Anonymous (2003): Living with epilepsy. Employment. Epilepsia 44 (
147   II,     5.  5.  3|            1987): The suicide rate of epilepsy. Acta Psychiatrica Scandinavica
148   II,     5.  5.  3|           correlates of employment in epilepsy. Epilepsia 21:235-242.~Beghi
149   II,     5.  5.  3|            accidents in patients with epilepsy: results of a European cohort
150   II,     5.  5.  3|          Beghi E (2004): Aetiology of epilepsy. In: The Treatment of Epilepsy (
151   II,     5.  5.  3|        epilepsy. In: The Treatment of Epilepsy (2nd edition) (Edited by:
152   II,     5.  5.  3|            Beghi E, Sander JW (2005): Epilepsy and driving. Regulations
153   II,     5.  5.  3|               Prevalence of childhood epilepsy in Estonia. Epilepsia 40:
154   II,     5.  5.  3|            development of intractable epilepsy in children: a prospective
155   II,     5.  5.  3|              Black AB, Lay NY (1997): Epilepsy and driving in South-Australia –
156   II,     5.  5.  3|               PG (1978): Incidence of epilepsy in children: a follow-up
157   II,     5.  5.  3|       Mortality risk in children with epilepsy: the Dutch study of epilepsy
158   II,     5.  5.  3|          epilepsy: the Dutch study of epilepsy in childhood. Pediatrics
159   II,     5.  5.  3|           Goodridge DM, et al (1995): Epilepsy in a population of 6000
160   II,     5.  5.  3|          International League Against Epilepsy (1989): Proposal for revised
161   II,     5.  5.  3|          International League Against Epilepsy (1993): Guidelines for epidemiologic
162   II,     5.  5.  3|              epidemiologic studies on epilepsy. Epilepsia 34:592-596.~Employment
163   II,     5.  5.  3|              International Bureau for Epilepsy (1989): Employing people
164   II,     5.  5.  3|                 Employing people with epilepsy: principles for good practice.
165   II,     5.  5.  3|               Prevalence of childhood epilepsy in Kaunas, Lithuania. Brain
166   II,     5.  5.  3|       classification, and severity of epilepsy and epileptic syndromes
167   II,     5.  5.  3|               1282.~Fisher RS (2000): Epilepsy from the patient’s perspective:
168   II,     5.  5.  3|               community-based survey. Epilepsy Behav 1:S9-S14.~Forsgren
169   II,     5.  5.  3|         Epidemiology and prognosis of epilepsy and its treatment. In: The
170   II,     5.  5.  3|       treatment. In: The Treatment of Epilepsy (2nd edition). (Edited by:
171   II,     5.  5.  3|            2005): The epidemiology of epilepsy in Europe – a systematic
172   II,     5.  5.  3|                 Program evaluation in epilepsy rehabilitation. Epilepsia
173   II,     5.  5.  3|               2004): The mortality of epilepsy revisited. Epileptic Disord
174   II,     5.  5.  3|    epidemiology of the comorbidity of epilepsy in the general population.
175   II,     5.  5.  3|     Prevalence and characteristics of epilepsy in the Aeolian islands.
176   II,     5.  5.  3|          study of public attitudes to epilepsy in the United Kingdom and
177   II,     5.  5.  3|            Mortality in patients with epilepsyCurr Opin Neurol 17:141-
178   II,     5.  5.  3|               of incidence studies of epilepsy and unprovoked seizures.
179   II,     5.  5.  3|         dynamics of drug treatment in epilepsy: an observational study
180   II,     5.  5.  3|           cohort with newly diagnosed epilepsy followed up prospectively
181   II,     5.  5.  3|             BS (1985): Mortality from epilepsy. International patterns
182   II,     5.  5.  3|         deprivation and prevalence of epilepsy and associated health usage.
183   II,     5.  5.  3|                1995): Sudden death in epilepsy : a study of incidence in
184   II,     5.  5.  3|      incidence in a young cohort with epilepsy and learning difficulty.
185   II,     5.  5.  3|           relation to sudden death in epilepsy. J Neurol Neurosurg Psychiatry
186   II,     5.  5.  3|           Cause-specific mortality in epilepsy: a cohort study of more
187   II,     5.  5.  3|        patients once hospitalized for epilepsy. Epilepsia 38:1062-1068.~
188   II,     5.  5.  3|           Risk factors for suicide in epilepsy: a case control study. Epilepsia
189   II,     5.  5.  3|            population-based cohort of epilepsy surgery patients. Epilepsia
190   II,     5.  5.  3|             mortality associated with epilepsy, with particular reference
191   II,     5.  5.  3|               unprovoked seizures and epilepsy in Iceland and assessment
192   II,     5.  5.  3|         Iceland and assessment of the epilepsy syndrome classification:
193   II,     5.  5.  3|           grade school of pupils with epilepsy: an epidemiological study.
194   II,     5.  5.  3|                2002): Sudden death in epilepsy: a wake-up call for management.
195   II,     5.  5.  3|             Survival of patients with epilepsy: an estimate of the mortality
196   II,     5.  5.  3|             Li G (2004): Mortality in epilepsy: driving fatalities vs other
197   II,     5.  5.  3|             of death in patients with epilepsy. Neurology 63:1002-1007.~
198   II,     5.  5.  3|     Prevalence and characteristics of epilepsy in children in Northern
199   II,     5.  5.  3|              146.~Sillanpaa M (1992): Epilepsy in children: prevalence,
200   II,     5.  5.  3|         Vanhoutvin JPG, et al (2007): Epilepsy and employment: literature
201   II,     5.  5.  3|        employment: literature review. Epilepsy Behav 10:354-362.~Taylor
202   II,     5.  5.  3|             accidents in drivers with epilepsy. J Neurol Neurosurg Psychiatry
203   II,     5.  5.  3|              2000): Social aspects of epilepsy in the adult in seven European
204   II,     5.  5.  3|              PJ (1995): The impact of epilepsy on behavior and emotional
205   II,     5.  5.  3|            emotional development. In: Epilepsy in children and adolescents (
206   II,     5.  5.  3|               2004): Medical risks in epilepsy: a review with focus on
207   II,     5.  5.  3|       accidents and their prevention. Epilepsy Res 60:1-16.~Vaa T (2005):
208   II,     5.  5.  3|            Accidents in patients with epilepsy: types, circumstances and
209   II,     5.  5.  3|       classification, and severity of epilepsy in children in Western Norway.
210   II,     5.  5.  3|             810.~Zielinski JJ (1974): Epilepsy and mortality rate and cause
211   II,     5.  5.  3|              International Bureau for Epilepsy~ILAE~International League
212   II,     5.  5.  3|          International League Against Epilepsy~LICE~Lega Italiana contro
213   II,     5.  5.  3|             European Working Group on Epilepsy and Driving~SIGN~Scottish
214   II,     5.  5.  3|           Sudden Unexplained Death in Epilepsy~ ~
215   II,     8.  1.  3|        affected by mental problems or epilepsy; by about 30% of those affected
216   II,     8.  2.  1|          disabilities, not to mention epilepsy and mental health difficulties
217   II,     9        |          disease status. Diabetes and epilepsy are both associated with
218   II,     9        |        EUROCAT, 2004). In the case of epilepsy and diabetes, appropriate
219   II,     9.  1.  2|          disease status. Diabetes and epilepsy are both associated with
220   II,     9.  1.  2|        EUROCAT, 2004). In the case of epilepsy and diabetes, appropriate
221   II,     9.  3.  1|              not readily available.~ ~Epilepsy. The prevalence of epilepsy
222   II,     9.  3.  1|           Epilepsy. The prevalence of epilepsy in the EU varies between
223   II,     9.  3.  1|            incidence and mortality of epilepsy were declining. This trend
224   II,     9.  3.  1|          people in Europe with active epilepsy is 0.9 million children
225   II,     9.  3.  1|           Approximately 2030% of the epilepsy population have more than
226   II,     9.  3.  1|            2005): The epidemiology of epilepsy in Europe – a systematic
227  III,    10.  4.  2|                Nausea, neurotoxicity,~epilepsy, hallucinations,~various
228   IV,    11.  6.  2|              diseases (e.g. diabetes, epilepsy, transplantation, leprosy,
229  Key,   Ap5.  0.  0|               epidemics~epidermolysis~epilepsy~epithelium~epitope~epizootic~