Neurobiology of Epilepsy and Aging

1st Edition - April 16, 2007

Editor: R. Eugene Ramsay

Hardback ISBN:

9 7 8 - 0 - 1 2 - 3 7 4 0 1 8 - 2

eBook ISBN:

9 7 8 - 0 - 0 8 - 0 4 8 9 2 5 - 4

This volume in the International Review of Neurobiology series addresses the epidemiology, pathophysiology, and treatment of epilepsy in elderly patients. Demographically, the… Read more

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This volume in the International Review of Neurobiology series addresses the epidemiology, pathophysiology, and treatment of epilepsy in elderly patients. Demographically, the elderly comprise both the fastest-growing segment of the U.S. population and the adult age group with the highest incidence of epilepsy, yet there are relatively few publications devoted to this clinical subgroup. The intersection of these two complex processes—epilepsy and advancing age—will have an increasing impact on medical and community care. The etiology, prognosis, and differential diagnosis of epilepsy can all be affected by the normal aging process and by the frequent comorbidities encountered in an elderly population. Chapters in this book review the effects of aging on brain function and on drug metabolism and interactions, covering the gamut of research from animal models of aging and epilepsy to clinical trials and outcomes. Topics also include the dangers of misdiagnosing status epilepticus, the special issues encountered in recruiting and retaining elderly clinical trial participants, and the use of antiepileptic drugs in the elderly. In both the clinic and the research laboratory, a better understanding of how epilepsy may differ between younger and older patients will be valuable in determining the best possible care for geriatric patients with epilepsy.

Dedication
Contributors to Volume 81
Acknowledgment
Epilepsy in the Elderly: Scope of the Problem
- Abstract
- I Introduction
- II Known Knowns
- III Known Unknowns
- IV Unknown Unknowns
- V Unknown Knowns
- VI Conclusion
Animal Models in Gerontology Research
- Abstract
- I Animal Models in Aging Research: Considerations for Experimental Design
- II The Age Factor
- III Genetic Background
- IV Choice of Strain
- V Environmental Influences
- VI Genomic Manipulations
- VII Resources
Animal Models of Geriatric Epilepsy
- Abstract
- I Introduction
- II Mouse Models
- III Gerbil Model
- IV Rat Models
- V Conclusions
Life and Death of Neurons in The Aging Cerebral Cortex
- Abstract
- I Introduction
- II Cortical Circuitry and Alzheimer’s Disease
- III AAMI: Functional Decline Without Neuron Loss
- IV Interactions Between Neural and Endocrine Senescence
- V Conclusions
- Acknowledgments
An in vitro model of Stroke-Induced Epilepsy: Elucidation of The roles of Glutamate and Calcium in The induction and Maintenance of Stroke-Induced Epileptogenesis
- Abstract
- I Introduction
- II Role of Glutamate in the Pathophysiology of Stroke
- III Developing an In Vitro Model of Glutamate Injury That Causes a Mixed Population of Injured and Dead Neurons in Preparations of Hippocampal Neurons in Culture
- IV Development of SREDs in Neurons Surviving Injury
- V Neuronal Networks Display Synchronized SREDs and Respond to Anticonvulsant Treatment
- VI Use of the In Vitro Model of Stroke-Induced AE to Evaluate the Calcium Hypothesis of Epileptogenesis
- VII Role of Ca²⁺ and NMDA Receptor Activation in Epileptogenesis
- VIII Antagonism of Non-NMDA Receptor Subtypes of Glutamate Receptors Does Not Inhibit Glutamate Injury–Induced AE
- IX Stroke-Induced AE Is Associated With Prolonged Elevations in Neuronal [Ca²⁺]_i Levels and Alterations in Ca²⁺ Homeostatic Mechanisms
- X Glutamate Injury–Induced Epileptogenesis Causes Long-Lasting Elevations in Basal Neuronal [Ca²⁺]_i Levels
- XI Epileptic Neurons Demonstrate Impaired Recovery of Resting [Ca²⁺]_i After Brief Glutamate-Induced Ca²⁺ Loading
- XII The Importance of In Vitro Models of Stroke-Induced AE
- XIII Calcium Plays a Role in the Induction of Stroke-Induced Epileptogenesis
- XIV Long-Lasting Changes in [Ca²⁺]_i Levels and Ca²⁺ Homeostatic Mechanisms Play a Role in Maintaining AE
- Acknowledgments
Mechanisms of Action of Antiepileptic Drugs
- Abstract
- I Introduction
- II Modulation of Voltage-Gated Ion Channels
- III Enhanced Inhibition
- IV Excitation Reduction
- V First-Generation AEDs
- VI Second-Generation AEDs
- VII Summary and Implications for the Management of the Older Patient With Epilepsy
Epidemiology and Outcomes of Status Epilepticus in The Elderly
- Abstract
- I Introduction
- II Definitions
- III The Epidemiology of SE in the Older Patient
- IV Etiologies of SE in the Elderly
- V Mortality of SE in the Elderly
- VI Electroencephalogram
- VII Treatment
- VIII Conclusions
Diagnosing Epilepsy in the Elderly
- Abstract
- I Introduction
- II Etiology
- III Clinical Manifestations
- IV Differential Diagnosis
- V Cardiovascular and Cerebrovascular Diseases
- VI Confusional Migraine
- VII Drug Use
- VIII Infection
- IX Metabolic Disturbances
- X Sleep Disorders
- XI Syncope
- XII Psychiatric Disorders
- XIII Transient Global Amnesia
- XIV Dementia
- XV Primary Generalized Seizures (Idiopathic)
- XVI Summary
Pharmacoepidemiology in Community-Dwelling Elderly Taking Antiepileptic Drugs
- Abstract
- I Introduction
- II Methods
- III Results
- IV Discussion
- Acknowledgments
Use of Antiepileptic Medications In Nursing Homes
- Abstract
- I Introduction
- II Methods
- III Results
- IV Discussion
- Acknowledgments
Age-Related Changes in Pharmacokinetics: Predictability and Assessment Methods
- Abstract
- I Introduction
- II The Effect of Aging on Pharmacokinetics
- III Predicting Aging-Associated Pharmacokinetic Changes
- IV Assessing Aging-Associated Pharmacokinetic Changes
- V Conclusions
Factors affecting Antiepileptic Drug Pharmacokinetics in Community-Dwelling Elderly
- Abstract
- I Introduction
- II Preliminary Studies of PHT and CBZ Pharmacokinetics in Community-Dwelling Elderly
- III Discussion and Conclusion
Pharmacokinetics of Antiepileptic Drugs in Elderly Nursing Home Residents
- Abstract
- I Introduction
- II Older AEDs
- III Newer AEDs
The Impact of Epilepsy on Older Veterans
- Abstract
- I Introduction
- II Methods
- III Results
- IV Discussion
- Acknowledgments
Risk and Predictability of Drug Interactions in the Elderly
- Abstract
- I Introduction
- II Antiepileptic Drugs Used in the Elderly
- III Methods for Pharmacokinetic Evaluation
- IV Antidepressants and Drugs Used to Treat Dementia
- V Cardiovascular Agents
- VI Conclusions
Outcomes in Elderly Patients With Newly Diagnosed and Treated Epilepsy
- Abstract
- I Introduction
- II The Glasgow Registry
- III Analysis of the 1982–2001 Cohort
- IV Supplemental Analysis
- V Difficulties in Diagnosing Epilepsy in the Elderly
- VI Studies Comparing Newer and Older AEDs
- VII Initiating AED Treatment
- VIII Conclusions
Recruitment and Retention in Clinical trials of The Elderly
- Abstract
- I Introduction
- II Recruitment Outcomes of Veterans Affairs Cooperative Study 428
- III Factors Influencing Recruitment
- IV Cost of Recruitment
- V Retention Results From VA Cooperative Study 428
Treatment of Convulsive Status Epilepticus
- Abstract
- I Introduction
- II Presentation, Progression, and Diagnosis
- III Consequences and Prognosis
- IV Treatment
- V Conclusions
Treatment of Nonconvulsive Status Epilepticus
- Abstract
- I Introduction
- II Diagnosis
- III Neuronal Damage Models
- IV Complex Partial Status Epilepticus
- V NCSE in Coma
- VI Typical Absence Status Epilepticus
- VII Conclusions
Antiepileptic Drug Formulation and Treatment in the Elderly: Biopharmaceutical Considerations
- Abstract
- I Introduction
- II Biopharmaceutical Considerations
- III GI Function and Age
- IV Conclusions
Index
Contents of Recent Volumes