What Training Is Available For Neurologists Or Epileptologists In Evaluation
Medical school students generally have basic science and clinical exposures in both neurology and psychiatry. A psychiatry clerkship is mandated at most medical schools, while the neurology clerkship is more variable, ranging from no mandatory exposure to 2 4 weeks of neurology, and sometimes including combined time in neurology and psychiatry or neurosurgery. The core curriculum for these clerkships certainly includes some multidisciplinary education, but the level of sophistication of the...
Contributors
Kenneth Alper Departments of Psychiatry and Neurology, NYU Comprehensive Epilepsy Center, New York University School of Medicine, New York, NY 10016, USA G. A. Baker Division of Neurological Science, Clinical Sciences Centre for Research and Education, Lower Lane, Liverpool L9 7LJ, UK John Barry Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA David W. Dunn Department of Psychiatry and Neurology, I ndiana University School of Medicine, Indianapolis, IN 46202,...
The Problem Of Depression Diagnosis In Epilepsy
To conclude, a definite diagnosis of depression in patients with epilepsy can be difficult because a number of symptoms, which are recognized as diagnostic criteria for a depressive episode by the ICD-10 and DSM-IV, may occur in epilepsy secondary to seizure activity or AED treatment e.g., loss of energy, insomnia or hypersomnia, increase or decrease in appetite, loss of libido, psychomotor agitation or retardation, diminished ability to think or concentrate . Because these symptoms may be...
Neuroanatomic Imaging Studies In Depression And Anxiety
In structural magnetic resonance imaging MRI studies of depression, it is reported that there is decreased brain volume in the frontal cortex, hippocampus, striatum, and limbic areas like the subgenual cingulate cortex Bremner et al, 2000 Bremner, 2002 Bremner et al, 2002 Anand and Shekhar, 2003 . Typically, total brain volume is not significantly decreased. Functional studies in depression, including functional MRI fMRI , single-photon emission-computed tomography SPECT , and positron emission...
Common Pathogenic Mechanisms In Depression Anxiety And Epilepsy
There are common pathogenic mechanisms shared by depression, anxiety, and epilepsy. Serotonin 5HT , NE, dopamine, GABA, and glutamate are likely involved in the expression of all three disorders Jobe et al., 1999 , Ressler and Nemeroff 2000 . In depression and anxiety, changes in the noradrenergic and serotoner-gic systems are implicated as playing a significant role in the expression of these disorders. There appears to be increased noradrenergic activity, contrasting with decreased activity...
Shared Functional Neuroimaging Abnormalities In Depression And Epilepsy
Utilizing various imaging techniques, functional abnormalities in both epilepsy and depression have been identified in common subcortical structures, as well as similar regions of the frontal and temporal lobes. Frontal lobe involvement in primary depression has been demonstrated with functional neuroimaging and neuropsychological studies Baxter et al., 1989 . Frontal lobe associated executive dysfunction has been consistently shown in studies on depressive illness. Abnormalities on...
References Gxt
Albano, C., Cupello, A. , Mainardi , P. , Scarrone, S., Favale, E. 2006 . Successful treatment of epilepsy with serotonin reuptake inhibitors proposed mechanism , Neurochem Res 31 , 509 514 , Betts , T. A. 1974 . A follow up study of a cohort of patients with epilepsy admitted to psychiatric care in an English city. In Epilepsy Proceedings of the Hans Berger Centenary Symposium P. Harris , C. Mawdsley, eds , pp. 326 338 , Edinburgh Churchill Livingstone, Bleuler, E. 1949 . Lehrbuch der...
Psychotherapeutic Interventions
There are a number of psychotherapeutic treatments that have been demonstrated to be efficacious for anxiety and depression. Psychotherapy appears to be more effective than placebo, and it is often comparable to pharmacotherapy Michels, 1997 . Empirical studies of cognitive-behavioral therapy CBT have increased over the past 15 years with a growing body of evidence indicating their utility and efficacy in the management of depression and anxiety. CBT has been recommended as a first line...