Intractable Epilepsy in Children

M. B. Toosi, F. Ebrahimzadeh
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Abstract

A seizure is defined as a paroxysmal and transient occurrence of signs or symptoms resulting from abnormal synchronous or excessive neuronal activity in the brain. About 15 to 40 percent of children who have any type of seizure are resistant to standard anti-seizure drugs, so called intractable epilepsy. Before documenting the seizure attacks as refractory, the selected drugs using for the type of seizure and dose of them should be checked. There are several factors that predict development of refractory seizures. These include age <1 year, multiple seizures before starting the treatment, myoclonic seizures, neurologic defects, neonatal and daily seizures, male gender, and first abnormal electroencephalogram and brain imaging (including computerized tomography scan and / or MRI). Options for the management of refractory epilepsy, after prescribing routine anti-seizure drugs are: Second line drugs (IVIG treatment, Ketogenic diet, Prednisolone treatment or Herbal treatment), Surgery and Stem cell therapy. Because none of these methods can stop all the drug-resistant epilepsies, researches are going on.
儿童顽固性癫痫
癫痫发作被定义为由大脑中异常的同步或过度的神经元活动引起的阵发性和短暂性体征或症状的发生。大约15%到40%的癫痫患儿对标准的抗癫痫药物有抗药性,也就是所谓的顽固性癫痫。在将癫痫发作记录为难治性发作之前,应检查所选择的用于癫痫发作类型和剂量的药物。有几个因素可以预测难治性癫痫发作的发展。这些包括年龄<1岁,开始治疗前多次发作,肌阵挛性发作,神经系统缺陷,新生儿和日常发作,男性,以及首次脑电图和脑成像异常(包括计算机断层扫描和/或MRI)。在处方常规抗癫痫药物后,治疗难治性癫痫的选择有:二线药物(IVIG治疗、生酮饮食、强的松龙治疗或草药治疗)、手术和干细胞治疗。由于这些方法都不能阻止所有的耐药癫痫,研究还在继续。
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