epilepsy ppt for medical students

Training for your organisation. Ideal for a variety of courses and can be used as a classwork …  She writes, “I’m now having a life I never knew was possible”, Prostate Cancer: Diagnosis and Prevention, Nutritional Management of Diabetes And Heart Diseases, Common Musculoskeletal Problems in Primary Care, Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy. Essay # 1. The Epilepsy Nurse Line is a phone and email service to support people living with …  When should you consider an inpatient video EEG evaluation? suggesting the importance of coordinated medical care for this high risk sub-population of individuals with ASD.“ Bilder et al., 2012 ‘Excess Mortality and Causes of Death in Autism … Seizures account for about 1% of all ED visits for children younger than 18, and at least 5% of pediatric patients will experience a seizure by the … AEDs that have shown efficacy for Tonic Clonic seizures:  Carbamazepine  Phenytoin  Felbamate  Topiramate  Lamotrigine  Valproate  Levetiracetam  Zonisamide  Oxcarbazepine, C-Slide 27 Antiepileptic Drug Monotherapy  Simplifies treatment, reduces adverse effects  Conversion to monotherapy from polytherapy Eliminate sedative drugs first Withdraw antiepileptic drugs slowly over several months, C-Slide 28 Antiepileptic Drug Interactions  Drugs that induce metabolism of other drugs: carbamazepine, phenytoin, phenobarbital  Drugs that inhibit metabolism of other drugs: valproate, felbamate  Drugs that are highly protein bound: valproate, phenytoin, tiagabine, carbamazepine  Other drugs may alter metabolism or protein binding of antiepileptic drugs. IV line with NS, rapid assessment, blood draw 4-5 min. Discharge Instructions for Epilepsy. Lecture 1 Lecture 2 Lecture 3 Lecture 4 Lecture 5 Lecture 6 Lecture 7 … Fatal Arrhythmia in a 2-day-old Full-term Infant. EEG monitoring unless status ended and patient waking up 40 min. Rang & Dale’s Pharmacology provides you with all the knowledge you need to get through your pharmacology course and beyond. This free Epilepsy Medical PPT is royalty free and easy to … C-Slide 121 Case Study 5  She has tried several different medications, but is currently maintained on carbamazepine and lamotrigine. Goal: stop seizures as soon as possible.  Would you treat this patient or not? • Epilepsy is a chronic neurological disorder characterized by a tendency to have recurrent seizures. Davis Company, 1994. Free Download Clinical Epilepsy PowerPoint Presentation. Within the society are special interest groups including a nurses group.  Would you counsel the family regarding prognosis? Epilepsy Gregory B. Compared with students with other health concerns, a CDC study shows that students aged 6–17 years with epilepsy were more likely to miss 11 or more days of school in the past year.  Her seizures began with her typical aura followed by lip smacking and left hand automatisms. By: DrDwayne At some point, the well-being of a second person, a fetus, might also have to be taken into account. Epilepsy in Women provides a detailed guide to this challenge. C-Slide 30 AED Serum Concentrations  AED serum concentrations can be useful for documenting compliance and steady-state serum level. This study was conducted to develop consensus-based aims, contents, intended …  Febrile convulsions — 6 mo.-5 yrs. Describes the high fat. low protein, vegetables, and sugar diet used under medical supervision to control epilepsy in children. Includes comments from parents, children, and medical personnel. When the etiology … Views: 585, By: JenniferDwayne Primary Generalized EpilepsyPrimary Generalized Epilepsy 8/19/2010 Template copyright 2005 www.brainybetty.com 60 Secondary Generalized BisynchronySecondary Generalized Bisynchrony Microsoft ® PowerPoint, Microsoft ® Word and Microsoft ® Excel are registered trademarks of Microsoft Corporation in the United States and/or other countries. We are pleased to be able to offer the following courses either online via Zoom, or face-to-face at your venue. 2 0 obj  Epilepsy Currents (Bimonthly Journal for American Epilepsy Society.  She had a severe headache and noted some blood in her mouth, along with a very sore tongue. When you have a seizure, an electrical disturbance happens in your brain.  Medications: Carbamazepine 600/400 mg/day BID, Lamotrigine 50/75 mg/day BID, Conjugated estrogens 1.25 mg PO qd, thyroxine100 mcg PO qd, and sumatriptan PRN.  No one at her job noticed anything abnormal.  Seizure. C-Slide 103 Case Study 4  Oculocephalic reflex is intact. C-Slide 124 Case Study 5 Past Medical History: 1) Migraine headaches (with the last one occurring four years ago) 2) status-post hysterectomy with removal of one ovary 25 years ago 3) history of syndactyly at birth with surgical corrections; 4) partial thyroidectomy 32 years ago during pregnancy.  What might you learn from such an evaluation? Pharmacology PowerPoint Lectures All lessons will open in a new browser window allowing easy access to this menu.  Would you ask for other studies? Views: 114.  How would you evaluate the patient in the ER if you saw her after this episode? Views: 113, By: DrDwayne The patient has episodes in which she abruptly stops all activity for about 10 seconds, followed by a rapid return to full consciousness. Epilepsy syndromes are classified by specific pattern of clinical features, family history & seizures type. C-Slide 118 Case Study 5  At age 20, the seizures changed in character to the current pattern. Physical Medicine & Rehabilitation (PM&R) Residency, 1st year clinical correlations in neurosciences selective, Center on Biological Rhythms and Sleep (COBRAS), BBPU (Brain, Behavior and Performance Unit), MS Medical Staff and Health Professionals, © 2021 by Washington University in St. Louis, Localizing & Imaging Workshop – Lecture 1 – Anatomic Localization, Localizing & Imaging Workshop – Lecture 1 Handout – How to Talk Like a Neurologist, Localizing & Imaging Workshop – Lecture 2 – Intro to Head CT, Localizing & Imaging Workshop – Lecture 3 – Intro to MRI Neurology, Localizing & Imaging Workshop – Lecture 3 Handout – MRI for Neurology, Localizing & Imaging Workshop – Lecture 4 – Intro to Abnormal Head CT.  She feels excessively tired on higher doses. Chat rooms for four different groups: Women and Epilepsy; Parents Helping Parents; The Teen Chat Room; and Living Well with Seizures.  These episodes lasted 2-3 minutes. Time post onset Treatment 70 min.  She had marked weight gain while taking valproate.  Childhood Seizures, Shinnar, S., Amir N, Branski D, Karger, 1995. (800) EFA-1000 or www.epilepsyfoundation.org. The … Sharp, M.D.  The Epilepsy Diet Treatment An introduction to the Ketogenic Diet, Freeman JM, Kelly MT, Freeman JB. C-Slide 73 Case Study 1  A 5 y/o female is brought to your office because of episodic “ blanking out” which began 1 month ago. C-Slide 112 Medical Student Cases  Case 5: 51 year old female with frequent seizures. endobj Students will also have the opportunity to observe epilepsy surgery if they wish. • Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. C-Slide 61 Pregnancy and Epilepsy Guidelines for Management  Education Most women with epilepsy have normal children Risk of fetal malformations is increased AED teratogenicity is related to exposure in the first trimester of pregnancy Prenatal diagnosis of fetal malformations is possible Seizures may be deleterious to the fetus Compliance with AED treatment is important, C-Slide 62 Pregnancy and Epilepsy Guidelines for Management  Before pregnancy Attempt AED monotherapy with lowest effective dose Folate supplementation (at least 1 mg/day orally)  During pregnancy Monitor AED dose requirements to maximize seizure control Continue folate supplementation Consider prenatal diagnosis of fetal malformations Vit K (10 mg/day orally) starting at 36 weeks General prenatal care, C-Slide 63 Driving and Epilepsy  Regulation varies state by state regarding: Reporting requirements Required seizure-free period Favorable/unfavorable modifiers  Insurance issues  Employment issues Resource: www.efa.org, C-Slide 64 First Aid Tonic-Clonic Seizure  Turn person on side with face turned toward ground to keep airway clear, protect from nearby hazards  Transfer to hospital needed for: Multiple seizures or status epilepticus Person is pregnant, injured, diabetic New onset seizures  DO NOT put any object in mouth or restrain, C-Slide 65 Appendix References for Nurses Reprinted with permission from the American Association of Neuroscience Nurses, C-Slide 66 Appendix References for Nurses Journals  Clinical Nursing Practice in Epilepsy  Epilepsia (the Journal of the International League Against Epilepsy). The most common oral side effect of antiepi-leptic … A study in the collision between Western medicine and the beliefs of a traditional culture focuses on a hospitalized child of Laotian immigrants whose belief that illness is a spiritual matter comes into conflict with doctors' methods. C-Slide 79 Medical Student Cases Case 2: “Nervous” Disorder? This book describes and discusses the increasing public health impact of common neurological disorders such as dementia, epilepsy, headache disorders, multiple sclerosis, neuroinfections, neurological disorders associated with malnutrition, ... You have been diagnosed with epilepsy, a disorder of recurring seizures. Chapter 9: Epidemiology of Epilepsy in Children  What are the causes of seizures, including what conditions lower the seizure threshold? “Do my research Post Traumatic Epilepsy Medical Guide|Qontro Medical Guides paper” help is at your service 24/7. C-Slide 87 Case Study 2  She was given fosphenytoin 1000 mg PE intravenously and observed.  Typically, she experiences 4-5 seizures per month. This book, considered the 'bible' of basic epilepsy research, is essential for the student, the clinician scientist and all research scientists who conduct laboratory-based experimental epilepsy research using cellular, brain slice and ... A randomized study of carbamazepine versus no medication after a first unprovoked seizure in childhood.  What are the CSF findings during repeated convulsions?  Metabolic precipitant? Her carbamazepine dose is 700 mg/day and Lamotrigine 125 mg/day with BID dosing.  She had her first convulsive episode at age 2 in the setting of a febrile illness.  What is the diagnosis? 9-year-old Boy with Unresolving Pharyngitis. AEDs that have shown efficacy for myoclonic seizures: Clonazapam Lamotrigine Levetiracetam Topiramate Valproate Zonisamide, C-Slide 26 Choosing Antiepileptic Drugs (cont.)  Students with Seizures A manual for school nurses, Santilli N, Dodson WE, Walton AV. Epilepsy is a condition that causes seizures, temporary episodes that often include twitching and convulsions.  How do you initiate medication?  Hyperventilation in your office replicates the episodes. C-Slide 119 Case Study 5  Observers then note a behavioral arrest. %�� Equip your students for success today and tomorrow. Ppt Epilepsy - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online.  Medical history is otherwise benign and she has no medication allergies. Students’ use of the e … Supplements. <> Time post onset Treatment 10 min. View 2-vascular, heart, epilepsy and stroke.ppt from DNS HLT201 at Lebanese American University. In this succinct monograph, radiologist David Maudgil presents a useful introduction to the arsenal of imaging tools now available, or soon to be … Contact the Society for more information. Epilepsy is one of the most common neurological disorders. This book summarises current knowledge on the topic; covering the underlying anatomy and physiology of the eyelids, the clinical and electro-encephalographic features and differential diagnosis in children and adults, including a discussion ... Antiepileptic Drugs: Antiepileptic … C-Slide 31 Dose Initiation and Monitoring  Discuss likely and unlikely but important adverse effects  Discuss likelihood of success  Discuss recording/reporting seizures, adverse effects, potential precipitants. If so, Which? This book provides a practical, problem-oriented manual to help clinicians with diagnosis, evaluation and management. Copyright ©2016 MedicPresents All rights reserved. In thirteen chapters, Dr Panayiotopoulos gives clear and didactic guidance on the diagnosis, treatment and ongoing management of the full spectrum of epileptic syndromes with an insight and perception that only he can bring to the subject ... About 2.3 million Americans have epilepsy Roughly 181,000 new cases of seizures and epilepsy occur each year 50% of people with epilepsy develop seizures by the age of 25; however, anyone can get epilepsy at any time Now there are as many people with epilepsy who are 60 or older as children aged 10 or younger . • Students may not be aware they are having a seizure and  Anticonvulsant Prescribing Guide, PDR second edition, 1998, Ortho-McNeil. Numerous studies have proven this surgery’s superiority to medical therapy alone. As a result, the number of patients with epilepsy seeking treatment is increasing rapidly.  What clinical features are important in guiding your evaluation? Change medication?  She hated having seizures in public and she “felt like a prisoner in my own home”. … Microsoft offers a wide variety of … An Unusual Case of Severe Anion Gap Metabolic Acidosis in a 3-year-old Girl.  She has been on carbamazepine 32 years and on lamotrigine for four years. Was an appropriate choice made? Epilepsy in pregnancy poses a serious threat to the mother and to her developing child. Marijuana •Pot, weed, bud, grass, reefer, herb, or Mary Jane •Dried leaves, stems, and flowers of cannabis plant •Delta-9-tetrahydrocannabinol (THC) –Active compound –Produces “high” feeling … Mar 10, 2018 - Download affordable Epilepsy editable PowerPoint template now. What is Brother, You’re on My Mind?. Further, teachers specifically noted that they would like to obtain additional information about the medical, social, and academic accommodations that are effective for students with epilepsy (Wodrich et al., 2011). Browse … Right hand had tonic posture  She had a brief post-ictal aphasia, C-Slide 131 Case Study 5 EEG onsets consisted of a rapid build up of rhythmic theta frequency activity over the left temporal region (Arrows), C-Slide 132 Case Study 5  MRI reveals an atrophic L. Hippocampus, C-Slide 133 Case Study 5 Pre-surgical Evaluation:  Neuropsychological Testing Performance and Verbal IQ normal  Wada (Intracarotid amobarbital) test Language on Left side only No memory difference with left and right injections, C-Slide 134 Case Study 5 Pre-surgical Evaluation: Conclusions  She has complex partial seizures refractory to anticonvulsant treatment  Clinical and EEG features are compatible with seizure origin from the left, language- dominant temporal lobe  MRI suggests mesial temporal sclerosis is the underlying pathology  She has an excellent chance for a seizure-free outcome with a left anterior temporal lobe resection, C-Slide 135 Case Study 5 Surgery  Surgery under local anesthesia  Language map determined by electrical stimulation  Language areas (green arrow) and epileptogenic tissue (white arrow) labeled on next slide, C-Slide 136 Case Study 5  MRI showing language areas, C-Slide 137 Case Study 5 Surgery  Anterior temporal lobe resected (arrow)  Amygdala and hippocampus also resected, C-Slide 138 Case Study 5 Follow-up  Immediately following surgery she had mild dysnomia  At three months post-op, cognitive testing confirmed no change from pre-op  She has had no seizures for two years. A membership organization of nurses interested in child neurology. 18 Institute for Clinical Neurobiology, Julius-Maximilians-University … Epilepsy Action Australia have produced animated seizure first-aid videos aimed at both adults and children. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 552 732] /Contents 5 0 R/Group<>/Tabs/S/StructParents 0>> Epilepsy is a chronic seizure disorder with recurrent and/or random seizure activity (Devinsky, et al., 2015). Views: 218, By: DrDwayne Reference: Liporace J, D’Abreu. She called the hotel physician and was taken to the local emergency room. If you are looking for someone to complete your online class assignments such as term … This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research. As your skills increase, you'll appreciate the layers of wisdom Larsson has packed into this guide, and you'll find yourself returning to it again and again. Epilepsy Currents is a bi-monthly open access current-awareness journal providing reviews, commentaries and abstracts from the world’s literature on the research and treatment of … (*there is a section in this book that lists references for specific groups.) Neurology Lecture Presentations. Department of Neurology Washington University School of Medicine Campus Box 8111 660 S. Euclid Ave. St. Louis, MO 63110 Can repeat lorazepam or diazepam if seizures ongoing 30-60 min. 3 0 obj Although SE can be viewed and managed as an entity or disease in itself, somewhat separate from associated medical and …  The psychiatrist prescribed a benzodiazepine sleeping pill to be used as needed, and scheduled her for an electroencephalogram (EEG). • Epilepsy is also known as a “seizure disorder.” CONNECTICUT STATE DEPARTMENT OF EDUCATION Did you know that… • Most seizures are not medical emergencies. Syndrome type? Demos, 1994. Neurology 1998; 51: 944-948. The book's highly templated format - with abundant boxed overviews, bulleted points, case histories, algorithms, references, and suggested readings - enables you to locate essential information quickly.  Represents psychiatric disease  Once recognized, approximately 50% respond well to specific psychiatric treatment  Epileptic and nonepileptic seizures may co-exist  Video-EEG monitoring often required for diagnosis, C-Slide 58 Syncope  Characteristic warning, usually gradual (except with cardiac arrhythmia)  Typical precipitants (except with cardiac arrhythmia)  Minimal to no postictal confusion/somnolence  Convulsive syncope — tonic>clonic manifestations, usually < 30 sec; usually from disinhibited brainstem structures (only rarely from cortical hypersynchronous activity). <> The condition is a medical emergency … This free Epilepsy medical ppt is one of the free medical PowerPoint templates available for medical and healthcare professionals on MedicPresents.com. But on no account does this apply to childhood epilepsy. This volume provides a critical review of the pertinent literature and shows quite clearly that very little attention is paid to major topic in this field. This …  Evidence of interictal CNS dysfunction?  Respirations are rapid at 22/min and regular, heart rate is 105 with a temperature of 101. endobj How Doctors Diagnose Types of EpilepsyFigure out the types of seizures you hadBased on the type of seizure, figure out the type of epilepsy you haveDecide whether you have a specific epilepsy syndrome as well  Association of Child Neurology Nurses (ACNN), 1000 West County Road East, Suite 290, St. Paul, MN, 55126, (651) 486-9447. C-Slide 90 Case Study 2  Side effects were explained to the patient.  She was discharged home on phenytoin 300 mg per day and referred to a neurologist. C-Slide 22 Choosing Antiepileptic Drugs  Seizure type  Epilepsy syndrome  Pharmacokinetic profile  Interactions/other medical conditions  Efficacy  Expected adverse effects  Cost, C-Slide 23 Choosing Antiepileptic Drugs (cont.) A membership society of professionals interested in epilepsy. She was also started on folic acid 1 mg per day and was advised to take a multivitamin daily. 1. C-Slide 91 Case Study 2 What are the most reasonable choices of antiseizure treatment for this patient?  Serum concentrations are useful when optimizing AED therapy, assessing compliance, pregnancy, or teasing out drug-drug interactions. Views: 100, By: vbanales Reference: Camfield P, Camfield C, Dooley J, Smith E, Garner B. C-Slide 80 Case Study 2  25 year-old right-handed marketing executive for a major credit card company, began noticing episodes of losing track of conversations and having difficulty with finding words.  Epilepsy A to Z: A Glossary of Epilepsy Terminology, Kaplan PW, Loiseau P, Fischer RS, Jallon P, Demos Vermande, 1995. October 2009; ... a PowerPoint presentation, and a narrated PowerPoint lecture.  Idiopathic generalized epilepsies Childhood absence epilepsy — absence, occasionally with tonic-clonic seizures Juvenile myoclonic epilepsy — myoclonic, tonic-clonic, at times absence, C-Slide 54 AEDs in Pediatrics  Extrapolation of efficacy data from adult studies  Importance of adverse effects relative to efficacy  Susceptibility to specific adverse effects (valproate hepatotoxicity, lamotrigine rash)  Age-related pharmacokinetic factors  Neonate: low protein binding, low metabolic rate, possible decreased absorption if given with milk/formula  Children: faster metabolism, C-Slide 55 Differential Diagnosis of Non-epileptic Events  Syncope  Migraine  Cerebral ischemia  Movement disorder  Sleep disorder  Metabolic disturbance  Psychiatric disturbance  Breath-holding spells, C-Slide 56 Psychogenic Nonepileptic Seizures  10-45% of patients referred for intractable spells  Females > males  Psychiatric mechanism — disassociation, conversion  Common association with physical, emotional, and sexual abuse  Spells with non-epileptic etiology  Non-ictal patern on EEG, C-Slide 57 Psychogenic Nonepileptic Seizures (cont.) Treatment of Epilepsy Medical Treatment Approximately 15 medications are available for the treatment of epi-lepsy in Canada (Table 2). Management of Pediatric Seizures. C-Slide 60 Pregnancy and Epilepsy Guidelines for Management  All women of child-bearing potential should receive education and carefully considered management before and during pregnancy to optimize the chances of a good outcome for both mother and child. A school nurse can have a significant impact on the wellbeing of students with epilepsy. Over 3 million Americans have epilepsy.Roughly 181,000 new cases of seizures … Brunner is known for its strong Nursing Process focus and its readability. This edition retains these strengths and incorporates enhanced visual appeal and better portability for students. A plan for students with disabilities that don’t qualify for special education Child doesn’t need “specialized instruction” Child does need accommodations in regular classroom and for testing, … Word Document File.  Treatment of Epilepsy: Principles and Practice, Wyllie, E Videos  The Epilepsy Foundation Catalog contains many videos that can be used for education for nurses, families and schools. … Views: 91, By: DrDwayne <>>> C-Slide 77 Case Study 1 EEG for Case Study 1. A student with epilepsy should have a 504 plan, a formal plan that details the accommodations the student needs in order to fully access and participate in the general curriculum. About 1.5 million people in America have epilepsy 25 percent of new cases of epilepsy occur in children 14 years and younger Epilepsy refers to more than 20 different types of seizure activity … The patient’s eyes are open during the episodes and she remains motionless with occasional “ fumbling” hand movements.  His wife was awakened at 5:30 am by her husband making an odd gurgling noise with his head deviated to the left and left arm tonically stiffened. This book lends clarity and confidence to the practical management of patients with seizures. For easy accessibility to key information, the book is organized into two sections. This second edition of a successful book provides updated clinical and research knowledge, including information on the licensing of new antiepileptic drugs. All chapters are updated to reflect present accepted practice.  The Journal of Neuroscience Nursing (the Journal of the American Association of Neuroscience Nurses). How would you classify her event? Be effective with all your medical PowerPoint presentations by easily filling your medical and healthcare content in our free Epilepsy medical background for PowerPoint.  Describe the systemic manifestations of status epilepticus. A seizure is one of many neurologic conditions characterized by abnormal electrical brain activity. What considerations must be made since she is a woman of child-bearing potential? This guide is an invaluable tool to help school nurses manage students’ seizure conditions in school. A chronic noncommunicable disorder of the brain that affects people of all ages. Another great feature of our custom writing service is that we are available … There is a yearly index in the December issue by author and by topic (epilepsy) for easy reference. Randomized Clinical Trial on the efficacy of antiepileptic drugs in reducing the risk of relapse after a first unprovoked tonic-clonic seizure.  As you are leaving the room, the patient had another seizure. C-Slide 21 Medical Treatment of First Seizure Whether to treat first seizure is controversial 16-62% will recur within 5 years Relapse rate might be reduced by antiepileptic drug treatment Abnormal imaging, abnormal neurological exam, abnormal EEG or family history increase relapse risk … Phenobarbital 20 mg/kg at  5 mg per minute (0.75 mg/kg per minute) continued Reference: Lowenstein DH, Alldredge BK, Status Epilepticus. What advice should be given regarding lifestyle (sleep habits, alcohol intake) and driving? A trusted resource for anyone involved in EEG interpretation, this compact handbook is designed for on-the-go reference. Vascular, Cardiac, Epilepsy, and Stroke Wassim Nasreddine MD Stress Psychological … Epilepsy and Women’s Health: Family Planning, Bone Health, Menopause, and Menstrual Related Seizures.  At times, the spells seemed to be brought on by a particular memory from her past. Thiamine 100 mg, 50% glucose 25 mg IV Phenytoin or fosphenytoin 20 mg/kg IV (phenytoin PE) at  50 mg/per minute phenytoin or 150 mg per minute fosphenytoin ( 0.75 mg/kg/min) Pyridoxine 100-200 mg IV in children under 18 mo. November is Epilepsy Awareness Month, a month to raise awareness about this … 7 … Views: 388, By: DrDwayne In 70% of epilepsy cases, the specific etiology is not known for certain.  Laboratory tests including a CBC, chemistries and toxicology screen were normal. Brain Imaging in Epilepsy. Introduction Epilepsy is a group of syndromes characterized by recurring seizures. C-Slide 29 AED Serum Concentrations  AED serum concentrations are simply to be used as a guide. Epileptic seizures in the elderly population occur more frequently that previously thought. Views: 127, By: nsmith24  She tends to clench her teeth and breath heavily, such that her breathing sounds “almost as if she were laughing”. It is also called a seizure disorder.  She works as a sales clerk. This book collects the results of clinical experience and research, as well as the opionions of the specialists who have studied in depth several rare and complex syndromes associated with "Continuous Spikes and Waves During Slow Sleep", ...

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