Talk:Epilepsy/Archive 3

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In out in out shake it all about

• in (James)
• out (James)
• in (CFCF)
• out (Colin)
• in (CFCF)
• out (Jophiel)

WTF? Did the RFC get closed and I missed it? Did the ongoing discussions above reach any kind of consensus? Did anyone even defend proposed text after my detailed critism of how bad it is? -- Colin°^Talk 15:54, 15 October 2014 (UTC)

Nope. Don't know what's up with CFCF. Jophiel 18:35, 15 October 2014 (UTC)

Nomenclature of partial seizures

89.100.80.93 (talk · contribs) added:

“ Or they could themselves constitute the "aura" for a generalised seizure that take place shortly after, where loss of consciousness is involved. In most simple partial seizures, people are fully awake and alert and able to interact throughout the seizure; however, for those with psychic partial seizure, their consciousness is altered such that the seizure affects how people think, feel, or experience things. There are also simple partial seizures which involve a disturbance or a loss of consciousness and the person will have no knowledge of what happened during the seizure. ”

References

The sources were websites rather than a stronger source such as a textbook. I have therefore moved it here while a stronger source is identified. We have to be a little bit careful about psychic or syncopal seizures as people will start to attribute all manner of paroxysmal phenomena to epilepsy (e.g. angry outbursts). JFW | T@lk 21:50, 13 November 2014 (UTC)

Psychic seizure? Do they mean psychogenic non epileptic seizures? Doc James (talk · contribs · email) 03:19, 14 November 2014 (UTC)

No, I think this is a seizure with psychological features such a hallucinations etc. Must be hard to distinguish from Todd's psychosis. JFW | T@lk 00:41, 16 November 2014 (UTC)

Surgery for focal epilepsy

When focal epilepsy is drug-refractory, surgery can help doi:10.1001/jama.2014.17426 JFW | T@lk 22:47, 26 January 2015 (UTC)

Other, more specialized, forms of epilepsy?

I didn't find anything about musical epilepsy in the article. It's my unlearned impression that this variety of specialized seizure disorder doesn't cause the violent gran mal seizures or even the less violent petit mal movements that epilepsy is usually associated with. The musical epilepsy condition manifests in a more subtle way while the effected person stays lucid. Are there any other "quiet" types of epilepsy? Is there a form that can manifest in the hallucination of hearing voices as opposed to hearing music? Thank you, Wordreader (talk) 07:50, 29 June 2015 (UTC)

@Wordreader: Probably a form of temporal lobe epilepsy. No need to discuss every single rare form... JFW | T@lk 09:47, 29 June 2015 (UTC)

I appreciate the information. I was thinking about Joan of Arc, even though "epilepsy" has supposedly been ruled out by somebody sometime. I think mentioning that there are other, more rare forms of the disease is in order even if you choose not to detail them. Thank you, Wordreader (talk) 14:45, 30 June 2015 (UTC)

Cannibis

There was the attempt to add this

"Except perhaps as a treatment for intractable epilepsy syndromes (Dravet syndrome, myoclonic epilepsy syndrome, and certain others), especially in children who have used the so-called Charlotte's Web strain of medical marijuana, there is only limited evidence on the use of cannabis, with mixed results; more research also needs to be done on its safety for long-term use, its potential physiological and psychological side effects, and drug interactions, especially in children. It is true that certain strains of medical marijuana, or their constituent ingredients, have been used with some success in certain U.S. states that have legalized its use, but these limited number of cases are mostly anecdotal reports from family members and patients, or they are case study reports; they are not repeated and well-documented long-term randomized controlled clinical studies which are the gold standard. Additionally, the needed further research is inhibited by federal and state regulations on experimentation with it."

However the 2014 Cochrane review[1] states "No reliable conclusions can be drawn at present regarding the efficacy of cannabinoids as a treatment for epilepsy." Doc James (talk · contribs · email) 22:28, 3 June 2015 (UTC)

I think the article should mention medical cannabis as a popular alternative treatment for the disease of epilepsy. I know that Wikipedia isn't responsible but we should be careful and mention the research isn't all in yet; I would hate for anybody to quit their anticonvulsants for pot. Andrea Carter (at your service | my good deeds) 08:13, 17 August 2015 (UTC)

Cannabinoids

NEJM doi:10.1056/NEJMra1407304 - could be additional source if we decided to broaden the discussion. JFW | T@lk 13:12, 18 September 2015 (UTC)

Disease or disorder?

Should we (Wikipedia) list epilepsy as a disease or a disorder. I support disease because of the ILAE definition and because it only takes 5 minutes (sometimes less) for the disease to kill you. Andrea Carter (at your service | my good deeds) 23:26, 15 August 2015 (UTC)

I view the two terms as more or less the same and happy with either you wish to use. Doc James (talk · contribs · email) 12:23, 16 August 2015 (UTC)

I prefer disease because epilepsy is serious. Andrea Carter (at your service | my good deeds) 19:31, 16 August 2015 (UTC)

I prefer "disorder" because epilepsy can be (and frequently is) caused by physical brain damage. Usually the word disease connotes a condition caused by biological, genetic, or idiopathic factors. This is not always the case, but for example if you google for "define:disease", you get: "a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury". Looie496 (talk) 13:08, 17 August 2015 (UTC)

I understand that. Well, Wikipedia seems to be big on medical consensus and the ILAE considers epilepsy to be a disease. Andrea Carter (at your service | my good deeds) 19:34, 17 August 2015 (UTC)

Does the ILAE consider anything to be a "disorder"? Do they say something like "it's a disease, not a disorder"? Or is that just the word that they happen to use? WhatamIdoing (talk) 22:36, 6 September 2015 (UTC)

In the definition, epilepsy is now called a disease, rather than a disorder. This was a decision of the executive committee of the ILAE, taken because the word "disorder," while perhaps having less stigma than does "disease," also does not express the degree of seriousness that epilepsy deserves.

— From the article

@WhatamIdoing: Yes, it does. Andrea Carter (at your service | my good deeds) 15:48, 21 September 2015 (UTC)

Thanks. WhatamIdoing (talk) 16:01, 21 September 2015 (UTC)

You are welcome. :) Andrea Carter (at your service | my good deeds) 16:05, 21 September 2015 (UTC)

Title Section "nearly 80% of cases occur in developing countries“ is somewhat misleading

The statement of epilepsy "nearly 80% of cases occur in developing countries" is misleading. It does not say how many people are in development and developed countries respectively. For example, if there were 100 people in all developing countries in the world, 4 of whom had epilepsy, and there were 2 people in all developed countries in the world, one of whom had epilepsy, that would be "80% of epilepsy cases occur in developing countries". That is ridiculous!

The correct method, I think, is to compare the percentage of people who have epilepsy among all people between developed countries and developing countries. For example, "In developed countries, 8 out of 1000 people have epilepsy, where as in developing countries, the ratio is 11 out of 1000". Some new references are needed for this.

All numbers are only for demonstration. They are not actual numbers.

183.173.61.207 (talk) 09:02, 20 November 2015 (UTC)

I don't think it's misleading. You seem to have assumed that it implies something about a difference in prevalence rates between developing and developed countries. Instead, I believe that it merely notes that most people with epilepsy aren't in wealthy countries.

Approximately 80% of people live in developing countries. The exact numbers depend upon exactly which countries are counted, but the WHO currently gives 5.9 billion people in developing countries and 1.2 billion in developed countries. WhatamIdoing (talk) 03:24, 22 November 2015 (UTC)

Copyright

This text was added

Extended content

The cause of seizures is largely unknown except for types of epilepsies like reflex epilepsies. The predictive changes in the EEG before a seizure and the methods to detect seizures may vary by patient. Recent studies have increased understanding seizure generation in humans. In both temporal lobe and neocortical epilepsies, high-frequency oscillations were discovered to have a function in the start of epileptiform activity and seizures. In patients with temporal lobe epilepsy, the intracranial EEG signal responded more strongly to electrical stimulation as the brain neared a seizure. Computational models have helped to understand the dynamic processes possibly involved in seizure generation. A better understanding of seizure generation and the complex spatiotemporal interactions between different brain regions for each type of epilepsy may improve the design of improved prediction methods and algorithms.

This source contains the text "In both temporal lobe and neocortical epilepsies, high-frequency oscillations were found to play a role in the initiation of epileptiform activity and seizures. In another study on patients with temporal lobe epilepsy, the intracranial EEG signal was found to respond more strongly to electrical stimulation as the brain approached a seizure (Kalitzin et al. 2005). A better understanding of the mechanisms of seizure generation that takes into consideration the complex spatiotemporal interactions between different brain regions for different types of epilepsy may eventually stimulate the design of improved prediction methods and algorithms."[2] and the source is CC BY SA NC

While this source states "A better understanding of the mechanisms of ictogenesis that takes into consideration the complex spatiotemporal interactions between different brain regions for different types of epilepsy may eventually stimulate the design of improved methods and algorithms."[3] which appears to be fully copyrighted.

This is not paraphrased enough and it is unclear if the Scolarpedia article is okay from a copyright perspective. Likely it is as it states the authors still own the copyright but only one is listed. Doc James (talk · contribs · email) 00:34, 18 January 2016 (UTC)

The article in Brain however is an okay source. Doc James (talk · contribs · email) 00:43, 18 January 2016 (UTC)

Scholarpedia as a source

Not sure scholarpedia is a sufficient source for

"The cause of seizures is largely unknown except for types of epilepsies like reflex epilepsies. The predictive changes in the EEG before a seizure and the methods to detect seizures may vary by patient. Recent studies have increased understanding seizure generation in humans. In both temporal lobe and neocortical epilepsies, high-frequency oscillations were discovered to have a function in the start of epileptiform activity and seizures. In patients with temporal lobe epilepsy, the intracranial EEG signal responded more strongly to electrical stimulation as the brain neared a seizure. Studies on animal models of epilepsy and computational models have helped to understand the dynamic processes possibly involved in seizure generation. A better understanding of seizure generation and the complex spatiotemporal interactions between different brain regions for each type of epilepsy may improve the design of improved prediction methods and algorithms."

Doc James (talk · contribs · email) 03:52, 10 January 2016 (UTC)

I believe Scholarpedia is a secondary review source. Article Author info: Florian Mormann MD, PhD http://www.cnl.ucla.edu/florian_mormann2.htm for the article: Seizure Prediction Florian Mormann (2008), Scholarpedia, 3(10):5770. doi:10.4249/scholarpedia.5770

From Scholarpedia: "Scholarpedia is a peer-reviewed ..encyclopedia written and maintained by scholarly experts... Scholarpedia is inspired by Wikipedia and aims to complement it by providing in-depth scholarly treatments of academic topics... Scholarpedia does not aim to publish original "research" or "position" papers. The focus..is.."living reviews"..by current and future generations of experts. Upon approval, articles in Scholarpedia are archived in a journal (ISSN 1941-6016). They can thus be cited as any other peer-reviewed article." http://www.scholarpedia.org/article/Scholarpedia:About. --CuriousMind01 (talk) 04:02, 10 January 2016 (UTC)

[4] would not be in line with the MEDRS sources we usually use, be it a position statement, review article, or textbook, I think it would be better not to use as a source...IMO--Ozzie10aaaa (talk) 11:23, 10 January 2016 (UTC)

Scholarpedia I believe fits the Wikipedia:MEDRS criteria and could be a new source to usually use. "A secondary source in medicine summarizes one or more primary or secondary sources, usually to provide an overview of current understanding of the topic, ...or to combine results of several studies. Examples include literature reviews or systematic reviews found in medical journals, specialist academic or professional books, ...."

As an example, the text from the Scholarpedia Seizure prediction article summarizes recent studies listed in the article. "A number of recent studies have attempted to increase our understanding of the dynamics of seizure generation in humans. In both temporal lobe and neocortical epilepsies, high-frequency oscillations were found to play a role in the initiation of epileptiform activity and seizures (Bragin et al. 1999, Worrell et al. 2004, Schiff et al. 2000, Bragin et al. 2002, Jirsch et al. 2006, Worrell et al. 2008). In another study on patients with temporal lobe epilepsy, the intracranial EEG signal was found to respond more strongly to electrical stimulation as the brain approached a seizure (Kalitzin et al. 2005). Remarkably, this study used active external perturbation of ongoing EEG activity rather than passive extraction of features from spontaneous EEG signals to detect impending seizures. In addition to empirical studies on seizure dynamics in humans (Franaszczuk et al. 1994, Jouny et al. 2007, Bartolomei et al. 2004, Schiff et al. 2005, Schindler et al. 2007) studies on animal models of epilepsy (McCormick and Contreras 2001, Avoli et al. 2002; Jefferys 2003; Beck and Yaari 2008) as well as computational models (Wendling et al. 2003, 2005, Suffczynski et al. 2005, Feldt et al 2007, Lytton 2008) have helped to gain insight into the dynamical processes potentially involved in seizure generation." --CuriousMind01 (talk) 16:33, 10 January 2016 (UTC)

I guess the question is dose scholarpedia have a reputation of publishing accurate content? It is not pubmed indexed is it? I am not seeing it as well respected in the academic community at this point in time. Doc James (talk · contribs · email) 01:42, 11 January 2016 (UTC)

Scholarpedia articles are not PubMed Indexed in general, I only found 2 Scholarpedia articles in PubMed. I don't know its reputation in academia. The Scholarpedia approach is a leading expert writes an article, which is peer-reviewed (anonomously) and an expert approves revisions.--CuriousMind01 (talk) 14:17, 11 January 2016 (UTC)

(←) There is no need to rely on Scholarpedia for an article such as this. There is a wealth of good secondary sources available in the regular core journals. It might be suitable for niche rare conditions that have not been written up properly in the core literature or textbooks. JFW | T@lk 15:54, 11 January 2016 (UTC)

Whatever the editors think is best. I did not find a good review of Epilepsy Seizure prediction research reviews, there are subsets like: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3233702/ Seizure Prediction: Methods; but not a comprehensive one. There may be. I was using the Scholarpedia article as the comprehensive review of the current state of the subject of Epilepsy Seizure prediction research.--CuriousMind01 (talk) 20:03, 11 January 2016 (UTC)

If it's not really covered in the literature, then this subject may not be WP:DUE, even if it's 100% verifiable (and true as well). I looked through a handful of sources via WP:Annual Reviews just now, and the research focus seems to be squarely on genetics (for better or worse). You might be able to trace some of the sources in that Scholarpedia article, to see whether they're cited in more recent reviews. The Scholarpedia article hasn't been updated for several years, but you could look at some of the more recent general ones, such as Snyder 2008 or Andrzejak 2009 or Mormann 2007. Presumably a good review article would cite at least some of these same sources as the Scholarpedia article. WhatamIdoing (talk) 21:02, 11 January 2016 (UTC)

Thank you, FYI, Mormann wrote the Scholarpedia review article Seizure detection in 2008, the article has been updated as of 2012, and Mormann includes the 3 articles you mentioned, and others studies, to create the Scholarpedia article.--CuriousMind01 (talk) 21:28, 11 January 2016 (UTC)

Yes, I know those articles are listed there; that's where I found them. Perhaps I wasn't clear: if you want to include this information, which you happened to find in the Scholarpedia article, and if citing Scholarpedia directly isn't going to be feasible (e.g., because other editors object to citing it), then you can try to find other sources that say something similar.

One way to find other sources that say something similar to the Scholarpedia article is to look at the sources. Most of the sources in the Scholarpedia article are old. There are three that are relatively recent: Snyder 2008 or Andrzejak 2009 or Mormann 2007. If you look for other sources that have also cited any of those three, then you might find a source that (a) could be used to support the same material, and (b) you can get other editors to accept. The question for you to answer is, "If I can't cite the Scholarpedia article for this information, then what else could I cite for this information?" WhatamIdoing (talk) 01:19, 11 February 2016 (UTC)

The Scholarpedia article looks like a legitimate secondary/tertiary source, suitable for Wikipedia's referencing. Axl ¤ [Talk] 13:08, 12 January 2016 (UTC)

I'm uncertain if its approach to editorial control is sufficient to meet basic WP:RS standards. WhatamIdoing (talk) 01:19, 11 February 2016 (UTC)

I think Scholarpedia's [| editorial control] is adequate for WP:RS, the question is does Scholarpedia meet Wikipedia:MEDRS criteria? For this article user:Doc James (see below) made an edit paraphrased on the the Pubmed/Brain review article (which has almost the same wording as the Scholarpedia article, because the same author Mormann wrote both articles).CuriousMind01 (talk) 03:35, 11 February 2016 (UTC)

I found Mormann et al did write a seizure prediction review article in 2007 http://www.ncbi.nlm.nih.gov/pubmed/17008335, but Mormann's Scholarpedia review article is more current as of 2012.CuriousMind01 (talk) 01:34, 13 January 2016 (UTC)

I added the text to the article based on the 2007 http://www.ncbi.nlm.nih.gov/pubmed/17008335 by Murmann et al. The added text is almost the same as Murmann' Scholarpedia article, minus the studies on animal models, which Murmann reviewed in his Scholarpedia article as of 2012.

Open question: Are Scholarpedia articles adequate as references for Wikipedia medicine articles?

Is there a consensus?

Note: there are only a few Scholarpedia related medicine articles today, in the Scholarpedia Computational Neuroscience section. CuriousMind01 (talk) 15:54, 17 January 2016 (UTC)

Thank you,CuriousMind01 (talk) 15:54, 17 January 2016 (UTC)

Is there, or is there not a cause??

It says Seizures that occur due to a specific cause are not deemed to represent epilepsy, but then it also says The cause of most cases of epilepsy is unknown, although some people develop epilepsy as the result of (a zillion things). That's just too unclear 182.255.99.214 (talk) 23:26, 7 April 2016 (UTC)

The article elaborates on it later. Some epilepsies are "primary" (i.e. no underlying disease) while others are "secondary" (i.e. associated with one of those zillion underlying causes). The first sentence, I agree, is confusing and I will rephrase. JFW | T@lk 07:54, 8 April 2016 (UTC)

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Prevalence

The 2015 prevalence is listed as "Epilepsy 23 414·5 (21 549·6 to 25 419·4)" on page 1567[5] Doc James (talk · contribs · email) 22:59, 16 March 2017 (UTC)

But than earlier in the article it also says "and epilepsy (39·2 million [34·3–43·7 million]; table 3;" which is strange. Doc James (talk · contribs · email) 23:02, 16 March 2017 (UTC)

WHO says about 50 M which 39 is close to. I guess we can go with 39 M Doc James (talk · contribs · email) 23:03, 16 March 2017 (UTC)

You're right. I was also revising it and I think that 39 or 40 millions is more accurate. The info is somewhat confusing.

Best regards. --BallenaBlanca (Talk) 02:39, 17 March 2017 (UTC)

Agree not sure why they say different stuff in different places. Doc James (talk · contribs · email) 05:22, 17 March 2017 (UTC)

Skewed statistic: Nearly 80% of cases occur in the developing world.

Quite prominently it's mentioned in the leading paragraphs of this article that 80% of cases occur in the developing world. I feel that without context, this suggests it's a disorder with a higher per-capita prevalence in developing countries. However, since roughly 80% of the worlds population itself is in developing countries, shouldn't this be removed/get less prominent attention/be added that 80% of the world lives in developing countries?

My first contribution to a talk, so please be gentle :) — Preceding unsigned comment added by Technocratius (talk • contribs) 11:39, 9 July 2017 (UTC)

New text

Those diagnosed with epilepsy who have a positive attitude and a positive outlook regarding their condition, and who can stay calm (including during a seizure), provided they adhere to their regimen of treatment, will usually have a better outcome than those who do not, though it must be stressed that that is not always guaranteed, and that adherence to the therapy regimen is still key.

References

Were does it say that "remaining calm during a seizure" have a better outcome? Not sure how that is possible. Doc James (talk · contribs · email) 16:19, 20 September 2017 (UTC)

Carbamazepine versus

I was updating a Cochrane review version and I just wanted to get some feedback on the present wording in the article. The Epilepsy article presently says: "There are a number of medications available. Phenytoin, carbamazepine and valproate appear to be equally effective in both focal and generalized seizures.[94][95]", ref 94 is the Cochrane review I updated.

The conclusions of the 2017 review version indicate that although a statistically significant difference has not been detected, they recommend caution when interpreting this result.

Cochrane review conclusions, pasted from pubmed:https://www.ncbi.nlm.nih.gov/pubmed/28240353 "AUTHORS' CONCLUSIONS: We have not found evidence for a statistically significant difference between carbamazepine and phenytoin for the efficacy outcomes examined in this review, but CIs are wide and we cannot exclude the possibility of important differences. There is no evidence in this review that phenytoin is more strongly associated with serious adverse events than carbamazepine. There is some evidence that people with generalised seizures may be less likely to withdraw early from phenytoin than from carbamazepine, but misclassification of seizure type may have impacted upon our results. We recommend caution when interpreting the results of this review, and do not recommend that our results alone should be used in choosing between carbamazepine and phenytoin. We recommend that future trials should be designed to the highest quality possible, with considerations of allocation concealment and masking, choice of population, choice of outcomes and analysis, and presentation of results."

Do you think that we should be expanding on this in the article and mention that the evidence suggesting that there is not a difference between carbamazepine and phenytoin is of weak quality?

Thanks for your assistance interpreting this edit.

JenOttawa (talk) 03:21, 19 August 2017 (UTC)

@JenOttawa: That's very guarded language. I think it is reasonable to say that the evidence suggesting no difference is very weak indeed. In practical terms, long-term phenytoin use is becoming increasingly less common. JFW | T@lk 08:25, 21 August 2017 (UTC)

@Jfdwolff: Thanks for the feedback. I was away from my computer for a couple of days and am back to clean this edit up. Taking a look at the other Cochrane review that was used in this sentence, there is also only low to very low evidence to support that valproate and phenytoin have a similar efficacy on seizure outcomes. I can change to text to read:

"There are a number of medications available including phenytoin, carbamazepine and valproate. Very low-quality evidence suggests that phenytoin, carbmazepine, and valproate may be equally effective in both focal and generalized seizures.[94][95]"

Thanks again, JenOttawa (talk) 00:41, 23 August 2017 (UTC)

Have adjusted to "Low-quality evidence suggests that phenytoin, carbamazepine, and valproate may be equally effective in both focal and generalized seizures." but looks good. Doc James (talk · contribs · email) 16:21, 20 September 2017 (UTC)

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Osmosis video

I have removed the Osmosis video File:Epilepsy video.webm, which was added by User:Doc James in this edit with the summary "Added". I see no discussion on this talk page proposing or announcing the video.

The video is not sourced per WP:MEDRS or WP:V and uses language throughout (e.g. "patients") that is discouraged by WP:MEDMOS. It uses out-of-date terminology ("complex partial seizure"). The style of the video is a lecture to medical students giving them key terms to revise for an exam. The video consists of audio narration combined with scribbles on an electronic whiteboard. It is heavy with text, bullet points, hand-drawings of stick figures, but contains nothing that actually augments what the article (should) contain already.

Per WP:V "any material whose verifiability has been challenged or is likely to be challenged, must include an inline citation that directly supports the material." This video does not contain any sources, nor any means to tie sources to specific facts and claims made. Per WP:V, "The burden to demonstrate verifiability lies with the editor who adds or restores material" and "Any material lacking a reliable source directly supporting it may be removed and should not be restored without an inline citation to a reliable source" This material must not be restored as-is.

There has been no community-wide discussion to gain approval for Wikipedia to accept articles-as-videos. The multiple problems with such content is discussed at WP:NOTYOUTUBE. Even if this video is revised to correct the above policy-level flaws, editors must gain Wikipedia consensus prior to restoring content that is totally at odds with Wikipedia's current model of content development and values. -- Colin°^Talk 13:02, 28 March 2018 (UTC)

I have restored the video in question that was removed without consensus.

If you read WP:LEAD, the lead just needs to be supported by the body of the text, it does not need inline references itself.

Yes we have thousands of instances of the term "patient" though tout Wikipedia. If you go and simple try to delete them all there is a good chance you will end up blocked. How many instances of "patient" have you converted to "person" over the last two years?

Videos do enhance articles. Just because you wrote an essay does not mean it automatically becomes policy. Doc James (talk · contribs · email) 16:25, 28 March 2018 (UTC)

I have removed the video as a consensus has not been reached here. Graham Beards (talk) 16:28, 28 March 2018 (UTC)

User:Graham Beards consensus is required for a change in content.

This video has been in this article for more than a year.

They are working to remove the term "patient" from all their videos. It is something that has been on their to do list for some time. It just takes time. Doc James (talk · contribs · email) 16:31, 28 March 2018 (UTC)

Firstly I remind James that when he claims "consensus is required for a change in content" this applies to his insertion. You were bold in inserting it without discussion; it has been reverted (twice); the onus is on you to gain consensus for your change. James, you live in a bubble where rules apply to other people. Secondly, if you make another comment like "How many instances of "patient" have you converted to "person" over the last two years?" I will take you to ANI to get you blocked. You are the reason I have not edited medical articles for years. You. Thirdly, WP:V does not permit you to edit war to restore challenged text. Do this again, and I will have you blocked.

OK, there's a bold claim that this video meets WP:LEAD and so coesn't need citations. There are two aspects to that. Firstly, whether a video that just happens to be inserted near the top of the article actually counts as a "lead" section, and secondly whether this means citations are not required and thirdly whether the claim is true, that the video is merely a summary of the article text.

1. It is a weird claim that a video can be a "lead". This is by all definitions a piece of writing at the top of an essay that summarises the contents. There's no such term as a "lead video". In addition, WP:LEAD clearly defines it as "the section before the table of contents and the first heading." It is a piece of writing: "The lead should be written in a clear, accessible style". Also "a lead section should contain no more than four well-composed paragraphs and be carefully sourced as appropriate". Hmm, paragraphs. Then we get to what a Lead contains: Disambiguation links, tags, info boxes, lead image(s), table of contents, and most importantly introductory text. Note the word "text".
2. MOS:LEADCITE does not in fact provide an exclusion for leads. I'm not going to repeat the text here. Since it is possible to edit the article body and article lead together, these can be kept in sync wrt facts and sources. That is not possible for these videos, so I am not convinced any special rules are merited.
3. Is the video a summary of the article. Well, no. (list forthcoming)... -- Colin°^Talk 17:24, 28 March 2018 (UTC)

Yes I get it. You do not like videos, especially these videos. Sure bring me to ANI. I have encouraged you to do so multiple times in the past. Doc James (talk · contribs · email) 18:00, 28 March 2018 (UTC)

I'm monitoring your fruitless conversation, Colin, I still don't see your point( the videos can be edited, what more do you want??)--Ozzie10aaaa (talk) 18:51, 28 March 2018 (UTC)

Does the video summarise the article

• "Epilepsy means seizure disorder". No. They are synonyms; one does not mean the other any more than "car" means "auto-mobile". The article does not claim this meaning, and in fact does not define the word at all (it used to).
• "A seizure is a period where cells in the brain, or neurons, are synchronously active, or active at the same time, when they're not supposed to be." -- "when they're not supposed to be"? Who wrote this? No, that's not in the article either.
• "Now, when I say neurons are active, I mean that they are firing, or sending a message using electrical signals relayed from neuron to neuron." -- The article does use the word "active" nor define the term "firing" or talk about electrical signals.
• "And if you look at a neuron under a microscope" -- nope, not the the article either.
• "each electrical signal that passes through it is really just ions flowing in and out through protein channels [screen shows Na+ and Ca2+ ions]" -- no explanation of "electrical signal" in the article. No mention of sodium and calcium ions either.
• "The way this ion flow is controlled is through neurotransmitters" Neurotransmitters are not mentioned in the article.
• "a type of signalling molecule" no mention of signalling molecules
• "and receptors" no discussion of receptors wrt electrical signalling and ion flow
• "Neurotransmitters bind to the receptors" Not in the article they don't.
• "And basically tell the cell to open up the ion channels, and relay the electrical message, (called Excitatory neurotransmitters), or close the ion channel and stop the electrical message (called Inhibitory neurotransmitters)." Would you be surprised that excitatory and inhibitory neurotransmitters are not mentioned in the article.
• "During a seizure, clusters of neurons in the brain become temporarily impaired, and start sending out a ton of excitatory signals, over and over again" Nothing about "temporarily impaired". The body says "excessive" but apparently these signals are weighed in tons. Who knew?
• "And these are sometimes said to be paroxysmal" Well the article mentions "a wave of depolarization known as a paroxysmal depolarizing shift." but since the reader isn't told what "paroxysmal" means, or "depolarization", or why it should be "waving", who knows if this is equivalent.
• "These paroxysmal electrical discharges are thought to happen due to either too much excitation or too little inhibition, which are kinda two sides of the same coin, right?". Not in the article. Coins aren't mentioned either.
• "The main exitatory neurotransmitter in the brain is glutamate, and NMDA is the primary receptor" We already know "exitatory neurotransmitter" isnt' in the article and it comes as no surprise that "glutamate" and "NMDA" aren't either.
• I'm less than 2 minutes into this video, but that's enough...

James the video is actually a not-bad introduction to a few aspects of epilepsy for medical students incapable of reading textbooks without taking stimulant drugs. The reason I know this video does not summarise the article is that the article is a collection of incoherent factoids that are both confused and confusing, resulting in a pile of steaming shite in pure form, and the video is not. Assuming you have actually watched the video, the reason you should already know the video does not summarise the article is that you wrote this article. -- Colin°^Talk 18:43, 28 March 2018 (UTC)

The premise of your argument is textbook WP:BADFAITH, screams of moving the goalposts once any first criticism is responded to, and is very DISRUPTIVE. I implore you to cut off this nonsense, and at the very least let the discussion pan out where it is most active before moving to a new place with it. You've now moved this off to at least 7 different forums. I will respond to this with an WP:AN/I-report regarding your conduct Colin if you do not stop. Carl Fredrik ^talk 19:23, 28 March 2018 (UTC)

CFCF the "moving the goalposts" attempt was you and James with your false claims that the videos are similar to the article lead text or summarise the article. You have both been shown to be spreading untrue statements. Be careful of ANI, as it has a habit of boomeranging on those who aren't truthful. -- Colin°^Talk 19:28, 28 March 2018 (UTC)

Request for comment on video inclusion

Should the article include this video? GMG^talk 21:43, 28 March 2018 (UTC)

Survey

• Neutral - But there is an extended discussion regarding this here for anyone who is interested in the context. Although it's hardly required reading, and I think it does everybody more good if we decide this particular case on its own merits. GMG^talk 21:43, 28 March 2018 (UTC)

Threaded discussion

@GreenMeansGo: this has already been decided by a global RFC, that was already up when you added this RFC. Could you please figure out how to remove this RFC, so other editors don't have to waste their time in coming here to find something that has already been decided? Thanks, SandyGeorgia (Talk) 14:23, 30 March 2018 (UTC)

SandyGeorgia  Done There's no requirement really other than to remove the template so Legobot doesn't notify anyone. Having said that, I'm not going to at all be surprised if any RfC at all with more than a half dozen options fails to find a strong and uniquely actionable consensus. But no need to have two going simultaneously and we can always restart this one if the other doesn't make any headway. GMG^talk 14:29, 30 March 2018 (UTC)

@GreenMeansGo: The broader RFC showed remarkable consensus in the first 24 hours, and is done. There is no longer a problematic video on this article, or any other, to discuss. Thanks for removing this one-- I was afraid it was more involved than just at this page. SandyGeorgia (Talk) 14:33, 30 March 2018 (UTC)

Umm...SandyGeorgia... I assume we are talking about the same RfC? Because that one has been open less that 48 hours and if there is a crystal clear consensus, I'm not seeing it at first glance. Is there another? GMG^talk 14:38, 30 March 2018 (UTC)

The videos have been removed. (sorry you don't see the direction that RFC was going) SandyGeorgia (Talk) 14:43, 30 March 2018 (UTC)

experiment proposal

I really want to know if someone with frequent epileptic episodes (without visible or audible stimuli) has any significant change in them if they are 100% surrounded (alone and without tech) with triple layer tin or aluminum foil that is earth grounded. The theory is that the seizures have something to do with hyper sensitivity emf or something that radiates in. This is based on numerous accounts of people being able to fill in words or respond to what another is saying before they finished question and some peoples ability to hear conversations at distance that weren't audible to my ears even though I have very sensitive hearing. — Preceding unsigned comment added by 91.155.19.195 (talk) 23:21, 9 October 2018 (UTC)

Greeks and Julius Caesar

In the 'History' section, in a paragraph that begins by discussing the ancient Greeks, it says: "The Greeks thought that important figures such as Julius Caesar and Hercules had the disease". The next sentence talks about the fifth century BC. Is 'Julius Caesar' an error / typo here - he came a long time after the period that the paragraph appears to be concerned with! JezGrove (talk) 22:30, 17 November 2018 (UTC)

Semi-protected edit request on 30 November 2018

Outdated: "As of 2011, no effective mechanism to predict seizures has been developed" -- See https://www.ibm.com/blogs/research/2017/12/ai-epileptic-seizure-prediction/ 71.105.245.95 (talk) 03:50, 30 November 2018 (UTC)

 Not done. It's not clear what change(s) you want to make. Please make a precise edit request. –Deacon Vorbis (carbon • videos) 21:03, 30 November 2018 (UTC)

Language of video

I can't edit this article, but i know from Polish version (Padaczka) , that viedo is in Spanish 83.8.195.63 (talk) 12:46, 4 March 2019 (UTC)

Lead

@Doc James: Abnormal electrical activity is essential to the definition of 'epileptic seizure', as succinctly set out by ILAE, within the Fisher reference of the same, and the lead of Epileptic seizure. The first paragraph is labelled as encompassing "Definition and Symptoms" and so I suggest that not including this information in the first paragraph is not a complete definition - as it reads currently the definition would include non-epileptic attack disorders, and a host of other mimics. Perhaps you have a preferred placement that does include this key information within the definition? |→ Spaully ^~talk~  09:45, 10 August 2019 (UTC)

Misleading definition of epileptic seizures in lead

The second sentence in the lead defining an epileptic seizure reads:

   "Epileptic seizures are episodes that can vary from brief and nearly undetectable periods to long periods of vigorous shaking."

The language in the sentence can be understood as either very confusingly alluding to mild/non-convulsive symptoms (periods of what?!) or as defining epileptic seizures solely as episodes of "shaking". Of course, there are many types of seizures involving a variety of neuropsychiatric symptoms. I'm concerned that a reader may be (mis)led to believe that convulsive seizures are the only kind. In an extreme case, this may lead a layperson to overlook a non-convulsive type of epilepsy in an acquaintance or oneself.

Furthermore, even the cited source itself is more nuanced:

   Seizure episodes are a result of excessive electrical discharges in a group of brain cells. Different parts of the brain can be the site of such discharges. Seizures can vary from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions.

I propose that the source is swapped and the language is changed to indicate the existence of non-convulsive seizures (by mentioning e.g. altered consciousness, hallucinations, odd feelings and behaviours, etc. (e.g. "Epileptic seizures may often appear as episodes of unconsciousness and intense shaking. Other types of seizures may involve periods of strange feelings or behaviour, reduced awareness, or seeing, hearing, or sensing unusual things.").

Kind regards, -J Jay Hodec (talk) 06:10, 22 May 2020 (UTC)

Dogs can predict a seizure

This wiki points out that "it is not clear" if dogs can predict seizures. That information seems rather outdated and the source which is being used to justify this claim is from 2007. Research from later showed that dogs can predict seizures in rats for around 2/3 to 100% of the time. https://www.discovermagazine.com/planet-earth/dogs-can-smell-epileptic-seizures-study-finds In this YouTube video (>500k subscribers) about a Tamaskan wolfdog it is being told that the owner her dog has taught himself to gently hold her hand in his mouth around 30 seconds before a seizure starts. I am not an expert in the subject but it seems clear to me that this part of the wiki needs to be reviewed and changed. https://www.youtube.com/watch?v=WfhJX9Hzgak 145.132.75.218 (talk) 11:54, 17 September 2020 (UTC)

Neither Discover Magazine, nor a YouTube video, meet WP:MEDRS. GirthSummit _(blether) 12:03, 17 September 2020 (UTC)

And, just to be a little more academic, I've had a brief glance at the admittedly limited range of scientific literature on the subject, and it appears that some studies do conclude that some dogs appear to have some innate sense to predict seizures. However, these tend to be older (1999/2003). The more recent studies (https://doi.org/10.1016/j.eplepsyres.2011.10.019 || https://doi.org/10.1212/01.wnl.0000252369.82956.a3) have more scepticism, arguing that evidence is simply not conclusive enough to put responses past random chance. This conflict, I would say, justifies the "it is not clear", purely because of the lack of studies on the subject. ƒin (talk) 12:11, 17 September 2020 (UTC)

How did Cameron Boyce die

Why did Cameron Brice die 2604:CB00:613:DB00:2018:4969:E8:7561 (talk) 11:42, 25 March 2022 (UTC)

See Cameron Boyce. While tragic, a specific case of SUDEP is not suitable for inclusion in this general article. |→ Spaully ^~talk~  12:18, 25 March 2022 (UTC)

Misleading statement -management -medication

“Recently, Nux vomica[147] and Cicuta virosa[148] have been shown to produce significant anti-epileptic effects and no side effects.”

Sources 147 and 148 link to a trial in rats, with no inclusion of human effect. The statements appear to promote the use of nux vomica and cicuta virosa in humans and are sandwiched between medications proven for use in humans.

This appears an intentional attempt to elevate the significance of the therapies listed. 2600:1700:2670:7780:ACFB:9BB1:8ED0:85E1 (talk) 20:30, 27 January 2023 (UTC)

Agree. In fact the studies listed are so dilute that they are unlikely to include any molecules of the original poison. Homeopathy nonsense pseudoscience. Removed. 2600:6C56:6900:6DC:453:E986:D3CC:BCFB (talk) 14:36, 19 August 2023 (UTC)

Image with bite at tip of tongue not typical for epileptic seizures

instead, lateral tongue bites are much more common. (Oliva M, Pattison C, Carino J, Roten A, Matkovic Z, O'Brien TJ. The diagnostic value of oral lacerations and incontinence during convulsive "seizures". Epilepsia. 2008 Jun;49(6):962-7. doi: 10.1111/j.1528-1167.2008.01554.x. Epub 2008 Mar 4. PMID: 18325019.)

In my own training in epileptology (sure, some 20 years ago) the bites at the tip of the tongue were considered as suspicious for psychogenic non epileptic seizures (PNEA) (dissociative seizures). I was having a bit difficulties to find really good free articles as sources for that, but strong hints are here: Brigo F, Storti M, Lochner P, Tezzon F, Fiaschi A, Bongiovanni LG, Nardone R. Tongue biting in epileptic seizures and psychogenic events: an evidence-based perspective. Epilepsy Behav. 2012 Oct;25(2):251-5. doi: 10.1016/j.yebeh.2012.06.020. Epub 2012 Oct 2. PMID: 23041172., and Alessi R, Vincentiis S, Rzezak P, Valente KD. Semiology of psychogenic nonepileptic seizures: age-related differences. Epilepsy Behav. 2013 May;27(2):292-5. doi: 10.1016/j.yebeh.2013.02.003. Epub 2013 Mar 17. PMID: 23507305, where the authors state "[...] classical signs [for PNEA], such as opisthotonos, postictal whispering, and biting the tip of the tongue, [...]" (emphasizing that PNEA also often occur without these signs).

I would suggest to change the picture into one with the classical lateral scars/wounds that one would find after generalized tonic-clonic seizures, or just delete it. Sebi772 (talk) 17:37, 6 September 2023 (UTC)

As that part of the tongue is inside the mouth, getting such a picture might be difficult? Eptalon (talk) 12:12, 7 September 2023 (UTC)

I've removed the tongue photo, along with two archaic photos that were very low quality and didn't help the reader understand epilepsy. I think this article has suffered a bit from "this is all I have so I'll use it anyway". I agree the research seems to point to only lateral bites having any diagnostic value. It is quite specific to generalised tonic clonic seizures but rather hopelessly insensitive (lots of people will have such seizures, or countless other kinds of seizures, and not or rarely bite their tongue). I also think giving so much attention to tongue biting fuels the myth that bystanders need to stick something in the person's mouth to prevent it. -- Colin°^Talk 13:29, 7 September 2023 (UTC)