First epileptic seizure and epilepsies in adulthood: Abridged version of the S2k guideline of the German Society for Neurology in cooperation with the German Society for Epileptology. English Version

Holtkamp M, May TW, Berkenfeld R, Bien CG, Coban I, Knake S, Michaelis R, Rémi J, Seeck M, Surges R, Weber Y, Baum P, Baumgartner C, Beyenburg S, Brandt C, Brodisch P, Brückner S, Chatzikonstantinou A, Conrad S, Fauser S, Focke N, Freiman T, Freitag H, Fudali M, Geiger-Riess M, Greshake B, Grimmer A, Hebel J, Held L, Kaufmann E, Kerling F, Knieß T, Kollmar R, Krämer G, Kürsten K, Laufs H, Lüsebrink A, Lutz M, Möddel G, Müffelmann B, Noachtar S, Rösche J, Rozinat K, Rüegg S, Schäfer U, Schmidt PM, Schmitt FC, Schmitt J, Schneider UC, Schulze-Bonhage A, Speicher P, Strzelczyk A, Stutterheim K, Thorbecke R, Trollmann R, Urbach H, von Oertzen TJ, von Podewils F, von Wrede R, Wagner K, Weber R, Wehner T, Wendtland F, Winter Y, Woermann F, Zieglgänsberger D (2024)

Publication Type: Journal article

Publication year: 2024

Journal

DOI: 10.1007/s10309-024-00693-6

Abstract

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 intellectual disability 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.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Knappschaftskrankenhaus Bochum Germany (DE) Evangelisches Krankenhaus Alsterdorf Germany (DE) Universitätsmedizin der Johannes Gutenberg-Universität Mainz Germany (DE) Universität Bielefeld Germany (DE) Kantonsspital St.Gallen Switzerland (CH) Klinikum der Universität München Germany (DE) Geneva University Hospitals / Hôpitaux universitaires de Genève (HUG) Switzerland (CH) Universitätsklinikum Bonn Germany (DE) Universitätsklinikum Aachen (UKA) Germany (DE) Universitätsklinikum Leipzig Germany (DE) Kleinwachau - Sächsisches Epilepsiezentrum Radeberg gGmbH Germany (DE) Kliniken Schmieder Germany (DE) Deutsche Epilepsievereinigung e.V. Germany (DE) Regionale Kliniken Holding RKH Germany (DE) Universitätsklinikum Göttingen Germany (DE) Universitätsmedizin Rostock Germany (DE) Epilepsie-Zentrum Berlin-Brandenburg / Institut für Diagnostik der Epilepsien gGmbH (IDE) Germany (DE) Universitätsklinikum Tübingen Germany (DE) Südwürttembergische Zentren für Psychiatrie / ZfP Südwürttemberg Germany (DE) Evangelisches Krankenhaus Königin Elisabeth Herzberge Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Krankenhaus Rummelsberg Germany (DE) Rhön-Klinikum Germany (DE) Klinikum Darmstadt Germany (DE) Neurozentrum Bellevue Switzerland (CH) Agaplesion Diakonieklinikum Rotenburg Germany (DE) Bethel Epilepsy Center Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) Germany (DE) Hephata-Klinik Germany (DE) Universitätsspital Basel Switzerland (CH) Otto-von-Guericke-Universität Magdeburg Germany (DE) Luzerner Kantonsspital (LUKS) Switzerland (CH) Universitätsklinikum Freiburg Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) Gesellschaft für Epilepsieforschung e.V. Germany (DE) Kepler Universitätsklinikum (KUK) Austria (AT) Universitätsmedizin Greifswald / Universitätsklinikum Greifswald Germany (DE) Schlossklinik Bad Buchau Germany (DE) Sigmund-Freud-Privatuniversität Wien (SFU) / Sigmund Freud University Austria (AT) Katholische Hochschule Nordrhein-Westfalen Germany (DE) Universitätsklinikum Münster Germany (DE) Luxembourg Hospital Center / Centre Hospitalier de Luxembourg (CHL) Luxembourg (LU) Diakonie in München und Oberbayern e.V. Germany (DE)

How to cite

APA:

Holtkamp, M., May, T.W., Berkenfeld, R., Bien, C.G., Coban, I., Knake, S.,... Zieglgänsberger, D. (2024). First epileptic seizure and epilepsies in adulthood: Abridged version of the S2k guideline of the German Society for Neurology in cooperation with the German Society for Epileptology. English Version. Clinical Epileptology. https://doi.org/10.1007/s10309-024-00693-6

MLA:

Holtkamp, Martin, et al. "First epileptic seizure and epilepsies in adulthood: Abridged version of the S2k guideline of the German Society for Neurology in cooperation with the German Society for Epileptology. English Version." Clinical Epileptology (2024).

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