Clinical Practice Guidelines for Epilepsy 2018

Table of Contents

Colophon

List of Authors

Publication of Clinical Practice Guidelines for Neurological Diseases

Revision of the Clinical Practice Guidelines for Epilepsy

PDF

Part I Clinical Practice Guidelines for Epilepsy 2018

CQ1-1  What is epilepsy?

CQ1-2  What are the key clinical features to be included in history taking for epilepsy diagnosis?

CQ1-3  How are epileptic seizure types, epilepsies, epilepsy syndromes, and related seizure disorders classified?

CQ1-4  Which diseases should be differentiated from epilepsy in adults?

CQ1-5  Which diseases should be differentiated from epilepsy in children?

CQ1-6  What are the practical procedures for the diagnosis of epilepsy?

CQ2-1  How useful is EEG for the diagnosis of epilepsy?

CQ2-2  What is the significance of EEG examination in the treatment of epilepsy?

CQ2-3  What is the significance of long-term video-EEG monitoring in clinical practice of epilepsy?

CQ2-4  What are the essential neuroimaging studies for clinical practice of epilepsy?

CQ2-5  What are the useful functional neuroimaging studies for presurgical evaluation of epilepsy?

CQ3-1  Should drug therapy be started after the first epileptic seizure?

CQ3-2  What are the recommended drugs for new-onset partial epilepsy?

CQ3-3  What are the recommended drugs for new-onset generalized epilepsy?

CQ3-4  Which antiepileptic drugs should be avoided for generalized epilepsies?

CQ3-5  What are the recommended drugs for patients with a risk of psychiatric symptoms?

CQ3-6  What are the recommended drugs when complicated with medical diseases?

CQ3-7  What are the recommended drugs for elderly-onset epilepsy?

CQ3-8  What are the combined drugs that require special caution for epilepsy patients?

CQ3-9  What are the precautions when switching from the original antiepileptic drugs to generic drugs?

CQ4-1  Which epilepsy syndromes with childhood or adolescent onset have high prevalence?

CQ4-2  What examinations are recommended for the first unprovoked seizure in children and adolescents?

CQ4-3  For unprovoked seizures in children and adolescents, is the long-term prognosis worse if treatment would start after the second seizure

CQ4-4  How to make a diagnosis of juvenile myoclonic epilepsy?

CQ4-5  What are the first-line drugs for childhood- or adolescence-onset epilepsy with undetermined seizure type (partial or generalized)?

CQ4-6  If seizures recur in those treated with valproate for childhood/adolescent generalized seizure or carbamazepine for childhood/adolescent partial seizures, even when their drug concentrations are in the therapeutic ranges, which drugs should be the next candidates?

CQ5-1  What is the definition of drug-resistant epilepsy?

CQ5-2  What are the true drug-resistant epilepsies in adults?

CQ5-3  What are the drug-resistant epilepsies in children?

CQ5-4  What is pseudo-resistant epilepsy?

CQ5-5  How to manage drug-resistant epilepsies?

CQ5-6  What are the intellectual prognosis and social prognosis of drug-resistant epilepsy?

CQ6-1  What are the drug options for idiopathic partial epilepsy?

CQ6-2  What are the drug options for childhood absence epilepsy?

CQ6-3  What are the drug options for Lennox-Gastaut syndrome?

CQ6-4  What are the drug options for juvenile myoclonic epilepsy?

CQ6-5  What are the drug options for epilepsy with generalized tonic-clonic seizures alone (epilepsy with grand mal on awakening)?

CQ7-1  What are the adverse effects of antiepileptic drugs?

CQ8-1  What is the definition of status epilepticus?

CQ8-2  Which drugs are used for convulsive status epilepticus?

CQ8-2-(1) What treatment should be given when intravenous line has not yet been established?

CQ8-2-(2) What are the drugs for stage 1 status epilepticus?

CQ8-2-(3) How effective is intravenous fosphenytoin for status epilepticus?

CQ8-2-(4) How effective is intravenous phenobarbital for status epilepticus?

CQ8-2-(5) How effective is midazolam for status epilepticus?

CQ8-2-(6) How effective is intravenous levetiracetam for status epilepticus?

CQ8-3  How effective is general anesthesia for refractory status epilepticus?

CQ8-4  Does EEG monitoring during status epilepticus have clinical significance?

CQ9-1  Which kinds of epilepsies (syndromes) are indications for surgical treatment?

CQ9-2  Is temporal lobe resection effective for drug-resistant temporal lobe epilepsy?

CQ9-3  What are the indications for chronic intracranial EEG (long-term intracranial EEG) in presurgical evaluation?

CQ9-4  How to determine the timing of considering surgical treatment?

CQ9-5  Is surgical treatment effective even for drug-resistant epilepsies in children?

CQ9-6  What is the risk of psychiatric symptoms after epilepsy surgery?

CQ9-2  Should temporal lobe resection be added to drug therapy in drug-resistant temporal lobe epilepsy?

CQ10-1 Is vagus nerve stimulation therapy effective for drug resistant epilepsy?

CQ10-3 Is intracranial electrical stimulation therapy with implanted electrodes effective for epilepsy?

CQ10-1 Should vagus nerve stimulation therapy be added to drug therapies for drug-resistant temporal lobe epilepsy?

CQ10-2 When conducting vagus nerve stimulation for drug-resistant epilepsy, which intensity of stimulation (high or low) should we use?

CQ11-1 How many years after seizure remission should treatment termination be considered?

CQ11-2 Does the risk of seizure recurrence differ depending on seizure type, epilepsy type, or epilepsy syndrome?

CQ11-3 Is there an optimal dose reduction speed of antiepileptic drugs?

CQ11-4 What are the poor prognostic factors in treatment termination?

CQ11-5 Should driving be avoided during dose reduction of antiepileptic drug?

CQ12-1 When should serum concentrations of antiepileptic drugs be monitored?

CQ12-2 Serum concentration monitoring is useful for which drugs?

CQ12-3 Is serum concentration monitoring a requisite in the treatment of patients with hepatic or renal dysfunction?

CQ12-4 What are the drugs that interact with antiepileptic drugs?

CQ13-1 What kind of advice and information should be provided regarding pregnancy and childbirth for women with epilepsy?

CQ13-2 What is to be noted for antiepileptic medication in women at childbearing age?

CQ13-3 Is folic acid supplementation needed?

CQ13-4 Is it useful to monitor serum concentrations of antiepileptic drugs during pregnancy?

CQ13-5 Are women with epilepsy more likely to have complications during pregnancy?

CQ13-6 Can women with epilepsy have a natural delivery? How are seizures treated during delivery?

CQ13-7 Can women taking antiepileptic drugs breastfeed a baby?

CQ14-1 How are psychogenic nonepileptic seizures differentiated from epileptic seizures?

CQ14-2 How are psychogenic nonepileptic seizures treated?

CQ15-1 What kinds of psychoses accompany epilepsy and what are their treatments?

CQ15-2 How to manage depression and suicide-related behaviors associated with epilepsy?

CQ16-1 What is the definition of acute symptomatic seizure?

CQ16-2 What are the causes of acute symptomatic seizures?

CQ16-3 How to manage patients with acute symptomatic seizures?

CQ16-4 What kinds of examination are needed for acute symptomatic seizures?

CQ16-5 How to treat acute symptomatic seizures?

CQ16-6 How to diagnose and treat anti-NMDA receptor encephalitis?

CQ17-1 Relation between epilepsy and genetics

CQ17-2 Current situation of genetic research and genetic testing for epilepsy

CQ18-1 What kinds of advice should be given to patients?

CQ18-2 How to give advice on driver’s license?

Part II Systematic Review DigestPDF

CQ9-2  Should temporal lobe resection be added to drug therapy in drug-resistant temporal lobe epilepsy?

CQ10-1 Should vagus nerve stimulation therapy be added to drug therapies for drug-resistant temporal lobe epilepsy?

CQ10-2 When conducting vagus nerve stimulation for drug resistant epilepsy, which intensity of stimulation (high or low) should we use?