PARALLEL SESSIONS

Epilepsy Classification
Ingrid Scheffer (Australia) & Kazuichi Yagi (Japan)

Epilepsy Classification: Where are we Heading?
Ingrid Scheffer (Australia)

Idiopathic Generalized Epilepsies - GEFS+ and Classical IGE
Yue-Hua Zhang (China)

Symptomatic Generalized Epilepsies - Clinical Significance and Problems
Yoko Ohtsuka (Japan)

Epilepsy classification is the most important clinical and research tool we have for delineating the epilepsies. At a clinical level, the classification underpins diagnosis, investigation, optimisation of therapy and genetic counselling. As a research instrument, it enables new discoveries that impact on daily practice. Despite this central role, it is, and should be, constantly evolving on the basis of higher levels of evidence. The new basis on which the classification will be built will be presented to aid discussion in the epilepsy community about the way forward. At a practical clinical level, the generalized epilepsies will be presented. The idiopathic forms pose different dilemmas to the symptomatic syndromes. What syndromes should be included in the Idiopathic Generalized Epilepsies? How do the classical Idiopathic Generalized Epilepsies relate to Generalized Epilepsies and Febrile Seizures Plus at a clinical and molecular level? The Symptomatic Generalized Epilepsies also pose complex problems in terms of classification. The clinical significance and problems in dissecting the Symptomatic Generalized Epilepsies will be discussed.

AED Issues in the Asian Oceanian Region
Dede Gunawan (Indonesia) & Jing-Jane Tsai (Taiwan)

AED Trials in Asia
Jing-Jane Tsai (Taiwan)

Use of AEDs in the Absence of Laboratory Monitoring
Dede Gunawan (Indonesia)

Use of AEDs in Patients with Brain Tumour
Siew-Ju See (Singapore)

AED Use in Medical Disorders
P. Satishchandra (India)

This parallel session will address several of the many antiepileptic drug (AED) issues in the Asian and Oceanic region. Potential antiepileptic drugs undergoing worldwide clinical trial assessment are involving investigators and enrolling patients of the region more than ever. The benefits and difficulties of these trials will be discussed. How further studies might be undertaken to improve use of AEDs will be considered.

Medical illnesses can be associated with seizure disorders or affect a patient with epilepsy. Disturbance of liver or kidney function can alter both the pharmacokinetics and pharmacodynamics of various AEDs. Interactions with other medications may increase the occurrence of adverse events. Drug selection and dose titration in these settings need to be individualized as does patient monitoring.

Many patients receiving AED therapy do not have access to laboratory monitoring. In this setting clinical assessment of toxicity and tolerability are vital. Whether AED selection is modified in this circumstance will be considered. In addition the practical issue of compliance, that is the reliable intake of medication, needs to be addressed.

There are changes occurring in the use of AEDs in patients with brain tumours. Certain AEDs may modify tumour response to treatment. Not all patients will require AED treatment so discussion of factors that indicate when AED therapy should be initiated or withdrawn will be presented. Clinical monitoring for adverse effects of AEDs in the patient with progressive neurological impairment resulting from brain tumor can present challenges.

Ethical Issues
Shih Hui Lim (Singapore) & Shunglon Lai (Taiwan)

Ethics of Resource Allocation and Utilization for Research in Countries with Limited Financial Resources
Chong-Tin Tan (Malaysia)

Internet and AED Trials - What are the Ethical Issues?
Peter Bergin (New Zealand)

The Ethical Issues of using Plecebo in AED and Epilepsy Surgery Trials in Asia
Byung-In Lee (Korea)

Lay People's Perspectives on Ethics in Epilepsy
Shunglon Lai (Taiwan)

The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. It is no difference in the field of epilepsy. In Asia, many countries have scarce resources and narrowing of treatment gap should have priority over the research gap. Therefore is it ethical to allocate the scarce resources for research? There is plan to use the Internet to recruit patients for AED trials in Asia. Will such Internet-recruitment make ethical issues such as obtaining informed consent and interaction of researchers with participants whom they have no knowledge more complex? In control clinical trials, is the use of placebo suitable in Asia where the difference in morality is particularly marked between Eastern and Western values? Last but not least, are the views of lay publics in Asia on medical ethics for epilepsy different from those in the West? In this parallel session, these ethical issues will be presented and discussed.

Imaging Seizures and Epilepsy
David Reutens (Australia) & Kenneth Tan (Philippines)

MRI in Epilepsy
Graeme Jackson (Australia)

 fMRI in Functional Mapping
Amanda Wood (Australia)

SPECT in Epilepsy
Seung Bong Hong (Korea)

PET in Epilepsy
David Reutens (Australia)

Epilepsy Imaging: Regional Context
Kenneth Tan (Philippines) 

In this session, clinical applications of MRI, PET and SPECT in epilepsy will be discussed. The aim of the session is to provide a basic understanding of the uses and limitations of these technologies; the appropriate use of the investigations; common findings in epilepsy and some of the newer applications of the techniques of relevance to epilepsy.

Video sessions 1 & 2

Video 1: General Epiletology
Andrew Bleasel (Australia)

Xing-Zhou Liu (China)
Shih Hui Lim (Singapore)
David Reutens (Australia)
Andrew Bleasel (Australia)

Video 2: Localization in Focal Seizures
Xing-Zhou Liu (China)

Xing-Zhou Liu (China)
Yoshi Inoue (Japan)
Lixin Cai (China)
Andrew Bleasel (Australia)

Two video sessions will be presented during the Congress. The aim will be to present typical and atypical seizure semiologies occurring within focal and generalised epilepsy syndromes. Cases of children and adults will be shown. The format will be interactive with audience participation encouraged. Although unusual features will be discussed the concentration will be upon the common and key features that define focal epileptic seizures involving particular cerebral regions and generalised epileptic seizures. The video examples will be complemented with clinical history, EEG and neuroimaging.
Discussion points will include;
Can seizure semiologies provide reliable guides to epilepsy syndromes?
Is accurate localisation of seizure onset possible with semiology?
What are the reliable lateralising signs?
What focal signs are permissible in generalised epilepsy syndromes?
What features reliably indicate non-epileptic seizures?