Advanced Treatment of Intractable Childhood Epilepsy
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概要
- 論文の詳細を見る
Twenty to thirty percent of children with epilepsy continue to have seizures despite anti-epileptic drugs (AEDs) treatment and are defined as medically intractable epilepsy. Intractable epilepsy frequently has developmental impact, causing permanent neurodevelopmental deficits in children. Recently developed neurodiagnostic studies and treatment modalities have substantially altered the management of patients with intractable epilepsy. The newly developed AEDs are frequently used for the treatment of patients unresponsive to conventional AEDs. Nonpharmacologic options for intractable epilepsy include dietary therapy such as ketogenic diet and modified Atkins diet, epilepsy surgery, and neuromodulatory treatments such as vagus nerve stimulation. Ketogenic diet is an effective and safe treatment for epilepsy in children; increasing use has led to modification of protocol for higher efficacy and better tolerability. When epilepsy is intractable to medical treatment, epilepsy surgery including surgical resection of epileptogenic area, or palliative surgery can be considered. Vagal Nerve Stimulation is recommended for patients who are not candidates for resective surgery. These nonpharmcologic treatments could result in resumption of developmental progress in patients with childhood intractable epilepsy.Active application of newly developed medical and surgical treatments could provide better outcome in seizure control and developmental progress in patients with intractable epilepsy.
著者
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Seo Joo
Department Of Pediatrics Pediatric Epilepsy Clinic Severance Children's Hospital Yonsei Univeri
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Lee Joon
Department Of Ceramic Science And Engineering Korea Advanced Institute Of Science And Technology
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Kim Heung
Department Of Internal Medicine Jeju National University School Of Medicine
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Choi Kum
Department Of Surgery Ewha Womans University College Of Medicine Tongdaemoon Hospital
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Choi Kum
Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Yonsei University Health System
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Lee Joon
Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Yonsei University Health System
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Kim Heung
Department for Development of Preventive Medicine, National Center for Geriatrics and Gerontology
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