First epileptic seizure and epilepsies in adulthood. Abridged version ofthe S2k guideline of the German Society for Neurology in cooperationwith the German Society for Epileptology

被引：0

作者：

Holtkamp, Martin ^{[1
,2
]}

May, Theodor W. ^{[3
]}

Berkenfeld, Ralf ^{[4
]}

Bien, Christian G. ^{[5
]}

Coban, Ingrid ^{[6
]}

Knake, Susanne ^{[7
]}

Michaelis, Rosa ^{[8
]}

Remi, Jan ^{[9
]}

Seeck, Margitta ^{[10
]}

Surges, Rainer ^{[11
]}

Weber, Yvonne ^{[12
]}

Baum, Petra ^{[13
]}

Baumgartner, Christoph ^{[14
]}

Beyenburg, Stefan ^{[15
]}

Brandt, Christian ^{[6
]}

Brodisch, Peter ^{[16
]}

Brueckner, Sabine ^{[17
]}

Chatzikonstantinou, Anastasios ^{[18
]}

Conrad, Stefan ^{[19
]}

Fauser, Susanne ^{[20
]}

Focke, Niels ^{[21
]}

Freiman, Thomas ^{[22
]}

Freitag, Hedwig ^{[23
]}

Fudali, Monika ^{[24
]}

Geiger-Riess, Mirijam ^{[25
]}

Greshake, Benedikt ^{[23
]}

Grimmer, Anja ^{[1
]}

Hebel, Jonas ^{[2
]}

Held, Lynna ^{[19
]}

Kaufmann, Elisabeth ^{[9
]}

Kerling, Frank ^{[26
]}

Kniess, Tobias ^{[27
]}

Kollmar, Rainer ^{[28
]}

Kraemer, Guenter ^{[29
]}

Kuersten, Kathrin ^{[30
]}

Laufs, Helmut ^{[31
]}

Luesebrink, Arne ^{[32
]}

Lutz, Martin ^{[17
]}

Moeddel, Gabriel ^{[33
]}

Mueffelmann, Birgitt ^{[6
]}

Noachtar, Soheyl ^{[9
]}

Roesche, Johannes ^{[34
]}

Rozinat, Klaus ^{[19
]}

Rueegg, Stephan ^{[35
]}

Schaefer, Ulrike ^{[36
]}

Schmidt, Pia Magdalena ^{[32
]}

Schmitt, Friedhelm C. ^{[37
]}

Schmitt, Joerg ^{[38
]}

Schneider, Ulf C. ^{[39
]}

Schulze-Bonhage, Andreas ^{[40
]}

机构：

[1] Evangel Krankenhaus Konigin Elisabeth Herzberge KE, Abt Epileptol, Inst Diagnost Epilepsien KFH, Epilepsie Zentrum Berlin Brandenburg, Berlin, Germany

[2] Charite Univ Med Berlin, Epilepsie Zentrum Berlin Brandenburg, Klin Neurol, Berlin, Germany

[3] Univ Bielefeld, Evangel Klinikum Bethel, Univ Klinikum OWL, Campus Bielefeld Bethel, Bielefeld, Germany

[4] Epileptol Schwerpunktpraxis Neukirchen Vluyn, Neukirchen Vluyn, Germany

[5] Univ Bielefeld, Krankenhaus Mara, Univ Klin Epileptol, Univ Klinikum OWL,Labor Krone, Campus Bielefeld Bethel, Bad Salzuflen, Germany

[6] Univ Bielefeld, Krankenhaus Mara, Univ Klin Epileptol, Univ Klinikum OWL, Campus Bielefeld Bethel, Bielefeld Bethel, Germany

[7] Univ Klinikum Marburg, Klin Neurol, Epilepsiezentrum Hessen, Marburg, Germany

[8] Ruhr Univ Bochum, Klin Neurol, Ruhr Epileptol, Knappschaftskrankenhaus Bochum,Univ Klinikum, Bochum, Germany

[9] LMU Klinikum, Neurol Klin & Poliklin, Munich, Germany

[10] Hop Univ Geneve, Dept Neurosci Clin, Unite EEG & Epilepsie, Geneva, Switzerland

[11] Univ Klinikum Bonn, Klin & Poliklin Epileptol, Bonn, Germany

[12] Univ Klinikum RWTH Aachen, Klin Neurol, Sekt Epileptol, Aachen, Germany

[13] Univ Klinikum Leipzig, Klinik & Poliklin Neurol, Leipzig, Germany

[14] Sigmund Freud Privat Univ, Klin Hietzing, Med Fak, Neurol Abt,Karl Landsteiner Inst Klin Epilepsie Fo, Vienna, Austria

[15] Ctr Hosp Luxembourg, Abt Neurol, Luxembourg, Luxembourg

[16] Diakonie Munchen, Epilepsie Beratung Netzwerk Epilepsie & Arbeit, Munich, Germany

[17] Epilepsiezentrum Kleinwachau, Radeberg, Germany

[18] Kliniken Schmieder Allensbach, Allensbach, Germany

[19] Deutsch Epilepsievereinigung Vertreter Patientinne, Berlin, Germany

[20] RKH Reg Kliniken Holding & Serv GmbH, Ludwigsburg, Germany

[21] Univ Med Gottingen, Klin Neurol, Gottingen, Germany

[22] Univ Med Rostock, Klinik & Poliklin Neurochirurg, Rostock, Germany

[23] Epilepsie Zentrum Berlin Brandenburg, Epilepsieklin Tabor, Bernau, Germany

[24] Univ Klinikum Tubingen, Klin Neurochirurg, Tubingen, Germany

[25] ZfP Sudwurttemberg, Uberlingen, Germany

[26] Krankenhaus Rummelsberg GmbH, Schwarzenbruck, Germany

[27] Rhon Klinikum AG Campus, Bad Neustadt an der Saale, Germany

[28] Klinikum Darmstadt, Klin Neurol & Neurointens Med, Darmstadt, Germany

[29] Neurozentrum Bellevue, Zurich, Switzerland

[30] Katholische Hsch Nordrhein Westfalen, Cologne, Germany

[31] Praxis Neurol & Epileptol, Kiel, Germany

[32] Evangel Krankenhaus Alsterdorf, Epilepsie Zentrum Hamburg, Hamburg, Germany

[33] Univ Klinikum Munster, Klin Neurol, Munster, Germany

[34] Hephata Klin, Schwalmstadt Trysa, Germany

[35] Univ Spital Basel, Klin Neurol, Basel, Switzerland

[36] Agaples Diakonieklinikum Rotenburg Wumme, Med Zentrum Erwachsene Geistiger Mehrfacher Behind, Rotenburg, Wumme, Germany

[37] Otto von Guericke Univ, Univ Klin Neurol, Magdeburg, Germany

[38] Praxis Neurol, Dortmund, Germany

[39] Luzerner Kantonsspital, Klin Neurochirurg, Luzern, Switzerland

[40] Univ Klinikum Freiburg, Epilepsiezentrum, Freiburg, Germany

[41] Praxis Psychotherapie, Saarbrucken, Germany

[42] Goethe Univ Frankfurt, Epilepsiezentrum Frankfurt Rhein Main, Klin Neurol, Univ Klinikum Frankfurt, Frankfurt, Germany

[43] Praxis Neurol & Schwerpunktpraxis Epilepsie, Cologne, Germany

[44] Gesell Epilepsieforsch eV, Bielefeld, Germany

[45] Univ Klinikum Erlangen, Abt Neuropadiatrie & Sozialpadiatr Zentrum, Kinder & Jugendklin, Erlangen, Germany

[46] Univ Klinikum Freiburg, Klin Neuroradiol, Freiburg, Germany

[47] Kepler Univ Klinikum Linz, Zentrum Altersmed, Linz, Austria

[48] Univ Klinikum Wurzburg, Arztl Direkt, Wurzburg, Germany

[49] Univ Med Greifswald, Klinik & Poliklin Neurol, Greifswald, Germany

[50] Schlossklin Bad Buchau, Abt Neurol, Bad Buchau, Germany

来源：

CLINICAL EPILEPTOLOGY | 2024年 / 37卷 / 02期

关键词：

Recommendations; Epilepsy surgery; Consensus; Pharmacotherapy; Psychosocial aspects; VAGUS NERVE-STIMULATION; ANTIEPILEPTIC DRUGS; UNCLASSIFIABLE EPILEPSY; INTERNATIONAL LEAGUE; COST-EFFECTIVENESS; CONTROLLED-TRIAL; ILAE COMMISSION; NON-INFERIORITY; POSITION PAPER; OPEN-LABEL;

D O I：

10.1007/s10309-024-00663-y

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

The new S2k guideline "First epileptic seizure and epilepsies in adulthood" provides recommendations on clinically relevant issues in five major topics: management of first epileptic seizures, pharmacotherapy, epilepsy surgery, complementary and supportive treatment, and psychosocial aspects. For the topic management of first epileptic seizures, the guideline provides recommendations on identifying the two major differential diagnoses, syncope and psychogenic non-epileptic seizure. The importance of additional examinations such as EEG, MRI and cerebrospinal fluid for syndromic classification and etiological allocation is discussed. Recommendations on neuropsychological and psychiatric screening tests are also given. The topic pharmacotherapy issues recommendations on antiseizure medication in monotherapy for focal, generalized and unclassified epilepsies; patient groups with special challenges such as the aged, women of childbearing potential and people with mental retardation are emphasized. Further issues are indications for measuring serum concentrations of antiseizure medication and possible risks of switching manufacturers. In the topic epilepsy surgery, indications for presurgical assessment and the multiple therapeutic approaches, such as resection, laser ablation, and neurostimulation are presented. Recommendations on postoperative management of patients, including rehabilitation and psychosocial counselling, are given. The topic complementary and supportive therapeutic approaches comprises recommendations on the diagnostics and treatment of common psychiatric comorbidities of epilepsy, such as anxiety disorder, depression and psychosis. Another important issue is the management of psychogenic non-epileptic seizures as a neuropsychiatric differential diagnosis or comorbidity of epileptic seizures. Furthermore, recommendations on the potential role of ketogenic diet and on acupuncture, homeopathy and other complementary approaches are made. The recommendations on psychosocial aspects comprise practical issues, such as fitness to drive a car, training and occupation, medical rehabilitation, sport, transition, patients' self-help, education programs for patients and next of kin, adherence, advise on SUDEP.

引用

页码：118 / 139

页数：22

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