Steven C. Schachter

To an outside observer, Psychogenic Non-Epileptic Seizures (PNES) look like epileptic seizures. The manifestations of PNES include collapses, impaired consciousness, and seizure-related injuries. However, unlike epileptic seizures, which are the result of abnormal electrical discharges in the brain, most PNES are an automatic psychological response to a trigger perceived as threatening. Not least because the changes in the brain that underpin PNES cannot be visualised easily with clinical tests (such as the EEG), there are many uncertainties and controversies surrounding the condition. Patients often provoke a mixture of emotions in healthcare professionals. In the authors' previous book, In Our Words: Personal Accounts of Living with Non-Epileptic Seizures, over 100 individuals with PNES and their family wrote about their experiences with the condition. While some had positive care experiences, many were left feeling confused, angry, and abandoned by the clinicians they had encountered. Non-Epileptic Seizures in Our Experience: Accounts of Health Care Professionals complements the authors' previous book by presenting the perspectives of over 90 members of different healthcare professions from around the world. The anonymous publication format has enabled many not only to share success stories but also to be open about difficulties and failures. This volume will be an invaluable resource for both highly experienced professionals as well as relative novice and those experiencing PNES. This book will challenge negative attitudes surrounding the condition, improve understanding between healthcare professionals and patients, and - ultimately - advance the quality of care provided for those with PNES.

Now more than ever, doctors are being targeted by government prosecutors and whistleblowers challenging the legality of their relationships with drug and device companies. With reputations at stake and the risk of civil and criminal liability, it is incumbent upon doctors to protect themselves. Managing Relationships with Industry: A Physician’s Compliance Manual is an indispensable resource for doctors, professional societies, academic medical centers, community hospitals, and group practices struggling to understand the ever changing law and ethical standards on interactions with pharmaceutical and device companies. It is the first comprehensive summary of the law and ethics on physician relationships with industry written for the physician. Authored by a former state Attorney General, Harvard Medical School Professor, health care lawyer and professor of ethics, Managing Relationships approaches the topic from a balanced and reasoned perspective adding to the on-going national dialogue and debate on the proper limits to medicine’s relationship with industry.

This common and very important disorder of Epilepsy is led by Dr. Steven Schachter in this issue of Neurologic Clinics. The majority of articles review methods for application of standards, guidelines, and consensus statement to clinical practice by Primary Care physicians and general Neurologists using validated and evidence-based tools such as screening instruments and algorithms for a number of critically important topics, ranging from initial evaluation to monitoring patients on treatment to counseling and educating patients on SUDEP and driving. Topics in this issue include: Guidelines and quality standards for adult epilepsy patients; Guidelines and quality standards in care of children with epilepsy; Initial evaluation of the patient with suspected epilepsy; Starting, choosing, changing, and discontinuing treatment; Methods for measuring seizure frequency and severity; Assessment of treatment side effects and quality of life; Screening for depression and anxiety; Counseling patients on driving and employment; Issues for women with epilepsy; Patient education (SUDEP - Sudden Unexpected Death in Epilepsy; Self-management; Adherence; Rescue medication); Optimizing the patient-physician therapeutic alliance.

The clinical management of patients with epilepsy and the associated medical literature are rapidly evolving. This book differs from other epilepsy textbooks by focusing specifically on topics where the available evidence is sufficiently well developed to be synthesised into straightforward summaries of proven therapies. When evidence is missing or there is doubt, controversy or ambiguity, the distinguished authors offer treatment recommendations based on practice guidelines or consensus statements that span the gaps in evidence while pointing to those areas where further research is needed. The initial chapters cover critically important aspects of antiepileptic drugs (AEDs) and surgical treatment such as when to start and stop AEDs, how to monitor their effectiveness, special considerations in women who become pregnant, and when to consider surgery to alleviate seizures. The following chapters cover the therapy of seizures when they develop after traumatic brain injury or stroke, and the treatment of concomitant depression and anxiety in patients with epilepsy. The final chapters discuss emerging topics in epilepsy: the treatment of the post-ictal state, technologies to predict and detect seizures, strategies for closing the treatment gap and sudden unexpected death in epilepsy. The contributors are renowned experts in their fields who successfully and succinctly present state-of-the-art reviews based on the medical evidence designed to help the clinician be as best informed as possible in the care of patients with epilepsy.

Epilepsy afflicts more than two million people in the United States and over 50 million people globally. This issue of Neurologic Clinics contains the following articles on this condition: Sudden Unexplained Death in Epilepsy; Approaches to Seizure Prediction; Localizing Seizure Onset; Concomitant Mood Disorders; Advances in the Genetics of Epilepsy; Psychogenic Nonepileptic Seizures; Selection of AEDs; Indentification of Refractory Epilepsy; Therapeutic Brain Stimulation in Epilepsy; AED Tertogneiticity; Hormonal Aspects of Epilepsy; Epilepsy and Radiosurgery; Epilepsy and Cognition; and Determinants of Quality of Life in Epilepsy.

Psychiatric Controversies in Epilepsy addresses controversial clinical issues of the psychiatric aspects of epilepsy. The book explores the reasons behind the poor communication between psychiatrists and neurologists and suggests potential remedies to this important problem, and two chapters are devoted to examining whether psychiatrists and neurologists are properly trained to recognize and treat conditions that both disciplines commonly encounter in clinical practice. Identification of the causes behind the high rate of comorbidity between epilepsy and mood, anxiety, psychotic and attention deficit disorders is given high priority in the volume, and a specific review of the evidence of common pathogenic mechanisms that may be operant in epilepsy and these psychiatric disorders is included. Recently identified bidirectional relationship between mood disorders and epilepsy and its implication in the course and response to treatment of the seizure disorder are also explored. Several chapters are devoted to rectify common misunderstandings of the use of psychotropic drugs in patients with epilepsy, including the use of antidepressant and central nervous system stimulants. Finally, one chapter explores the possibility of organic causes of psychogenic non-epileptic seizures.