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

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