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Jerome Engel
To classify postoperative outcomes for epilepsy surgery, Jerome Engel proposed the following scheme, the Engel Epilepsy Surgery Outcome Scale, which has become the ''de facto'' standard when reporting results in the medical literature: * Class I: Free of disabling seizures * Class II: Rare disabling seizures ("almost seizure-free") * Class III: Worthwhile improvement * Class IV: No worthwhile improvement History Surgery for epilepsy patients has been used for over a century, but due to technological restrictions and insufficient knowledge of brain surgery, this treatment approach was relatively rare until the 1980s and 90s. Prior to the 1980s, no classification system existed due to the lack of operations performed up until the time. As surgery as a treatment grew more prevalent, a classification system became a necessity. The appropriate evaluation of patients following epilepsy surgery is extremely important, as medical professionals must know the appropriate course of action to ...
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Epilepsy Surgery
Epilepsy surgery involves a neurosurgery, neurosurgical procedure where an area of the brain involved in seizures is either resected, ablative brain surgery, ablated, disconnected or stimulated. The goal is to eliminate seizures or significantly reduce seizure burden. Approximately 60% of all people with epilepsy (0.4% of the population of industrialized countries) have focal epilepsy syndromes. In 15% to 20% of these patients, the condition is not adequately controlled with Anticonvulsant, anticonvulsive drugs. Such patients are potential candidates for surgical epilepsy treatment. First line therapy for epilepsy involves treatment with anticonvulsive drugs, also called antiepileptic drugs. Most patients will respond to one or two different medication trials. The goal of this treatment is the elimination of seizures, since uncontrolled seizures carry significant risks, including injury and sudden death. However, in up to one third of patients, medications alone do not elimina ...
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Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is an American imprint of the American Dutch publishing conglomerate Wolters Kluwer. It was established by the acquisition of Williams & Wilkins and its merger with J.B. Lippincott Company in 1998. Under the LWW brand, Wolters Kluwer, through its Health Division, publishes scientific, technical, and medical content such as textbooks, reference works, and over 275 scientific journals (most of which are medical or other public health journals). Publications are aimed at physicians, nurses, clinicians, and students. Overview LWW grew out of the gradual consolidation of various earlier independent publishers by Wolters Kluwer. Predecessor Wolters Samson acquired Raven Press of New York in 1986. Wolters Samson merged with Kluwer in 1987. The merged company bought J. B. Lippincott & Co. of Philadelphia in 1990; it merged Lippincott with the Raven Press to form Lippincott-Raven in 1995. In 1997 and 1998, Wolters Kluwer acquired Thomson Science (owner ...
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Seizures
An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or neural oscillation, synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much of the body with loss of consciousness (tonic-clonic seizure), to shaking movements involving only part of the body with variable levels of consciousness (focal seizure), to a subtle momentary loss of awareness (absence seizure). Most of the time these episodes last less than two minutes and it takes some time to return to normal. Urinary incontinence, Loss of bladder control may occur. Seizures may be provoked and unprovoked. Provoked seizures are due to a temporary event such as low blood sugar, alcohol withdrawal, abusing alcohol together with prescription medication, low blood sodium, fever, brain infection, or concussion. Unprovoked seizures occur without a known or fixable cause such that ongoing seizures are likely. Unprovoked seizur ...
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Surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually spa ...
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Epilepsy
Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrical activity in the brain. These episodes can result in physical injuries, either directly such as broken bones or through causing accidents. In epilepsy, seizures tend to recur and may have no immediate underlying cause. Isolated seizures that are provoked by a specific cause such as poisoning are not deemed to represent epilepsy. People with epilepsy may be treated differently in various areas of the world and experience varying degrees of social stigma due to the alarming nature of their symptoms. The underlying mechanism of epileptic seizures is excessive and abnormal neuronal activity in the cortex of the brain which can be observed in the electroencephalogram (EEG) of an individual. The reason this occurs in most cases of epilepsy is u ...
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Brain Surgery
Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peripheral nervous system. Education and context In different countries, there are different requirements for an individual to legally practice neurosurgery, and there are varying methods through which they must be educated. In most countries, neurosurgeon training requires a minimum period of seven years after graduating from medical school. United States In the United States, a neurosurgeon must generally complete four years of undergraduate education, four years of medical school, and seven years of residency (PGY-1-7). Most, but not all, residency programs have some component of basic science or clinical research. Neurosurgeons may pursue additional training in the form of a fellowship after residency, or, in some cases, as a senior resid ...
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UCLA
The University of California, Los Angeles (UCLA) is a public land-grant research university in Los Angeles, California. UCLA's academic roots were established in 1881 as a teachers college then known as the southern branch of the California State Normal School (now San José State University). This school was absorbed with the official founding of UCLA as the Southern Branch of the University of California in 1919, making it the second-oldest of the 10-campus University of California system (after UC Berkeley). UCLA offers 337 undergraduate and graduate degree programs in a wide range of disciplines, enrolling about 31,600 undergraduate and 14,300 graduate and professional students. UCLA received 174,914 undergraduate applications for Fall 2022, including transfers, making the school the most applied-to university in the United States. The university is organized into the College of Letters and Science and 12 professional schools. Six of the schools offer undergraduate degre ...
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Surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually spa ...
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Subjectivity
Subjectivity in a philosophical context has to do with a lack of objective reality. Subjectivity has been given various and ambiguous definitions by differing sources as it is not often the focal point of philosophical discourse.Bykova, Marina F. (February 2018). "On the Problem of Subjectivity: Editor's Introduction". ''Russian Studies in Philosophy''. 56: 1-5 - via EBSCOhost. However, it is related to ideas of consciousness, agency, personhood, philosophy of mind, reality, and truth. Three common definitions include that subjectivity is the quality or condition of: * Something being a '' subject'', narrowly meaning an individual who possesses conscious experiences, such as perspectives, feelings, beliefs, and desires. Solomon, Robert C. "Subjectivity," in Honderich, Ted. ''Oxford Companion to Philosophy (Oxford University Press, 2005), p.900. * Something being a ''subject'', broadly meaning an entity that has agency, meaning that it acts upon or wields power over some other en ...
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Status Epilepticus
Status epilepticus (SE), or status seizure, is a single seizure lasting more than 5 minutes or 2 or more seizures within a 5-minute period without the person returning to normal between them. Previous definitions used a 30-minute time limit. The seizures can be of the tonic–clonic type, with a regular pattern of contraction and extension of the arms and legs, or of types that do not involve contractions, such as absence seizures or complex partial seizures. Status epilepticus is a life-threatening medical emergency, particularly if treatment is delayed. Status epilepticus may occur in those with a history of epilepsy as well as those with an underlying problem of the brain. These underlying brain problems may include trauma, infections, or strokes, among others. Diagnosis often involves checking the blood sugar, imaging of the head, a number of blood tests, and an electroencephalogram. Psychogenic nonepileptic seizures may present similarly to status epilepticus. Other conditio ...
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Cross-sectional Study
In medical research, social science, and biology, a cross-sectional study (also known as a cross-sectional analysis, transverse study, prevalence study) is a type of observational study that analyzes data from a population, or a representative subset, ''at a specific point in time''—that is, cross-sectional data. In economics, cross-sectional studies typically involve the use of cross-sectional regression, in order to sort out the existence and magnitude of causal effects of one independent variable upon a dependent variable of interest at a given point in time. They differ from time series analysis, in which the behavior of one or more economic aggregates is traced through time. In medical research, cross-sectional studies differ from case-control studies in that they aim to provide data on the entire population under study, whereas case-control studies typically include only individuals who have developed a specific condition and compare them with a matched sample, o ...
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