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2015 | 23 | 1 | 39-44
Tytuł artykułu

The ILAE definition of drug resistant epilepsy and its clinical applicability compared with “older” established definitions

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Background. Early identification of potential epilepsy surgery candidates is essential to the treatment process. Aim. To evaluate the clinical applicability of the ILAE definition of drug resistant epilepsy and its potential in identifying surgical candidates earlier compared to three established “older” definitions of drug resistant epilepsy. Material and Methods. Retrospective analysis of 174 patients who underwent epilepsy surgery between 1998 and 2009. Clinical factors and course of disease were extracted from patients' charts. Drug resistant epilepsy was classified according to four definitions and the time until fulfillment of criteria compared. Results. Mean time to fulfillment of criteria of drug resistant epilepsy ranged from 11.8 (standard deviation (SD) 9.8) to 15.6 years (SD 11.3). Time to drug resistance was significantly longer applying the only definition, requiring failure of three antiepileptic drugs (AEDs) (Canada definition), whereas time to fulfillment of all other definitions did not differ. Fifty percent of all patients experienced a seizure free period of ≥1 year prior to being classified as drug resistant, 13% entered another 1-year remission after fulfilling any criteria for drug resistance. Conclusion. We conclude that the ILAE definition identifies drug resistant epilepsy, with similar latency like two of three formerly used definitions. It is an easy applicable tool to minimize the delay of referral to a specialized center. Intermittent remissions delay assessment of drug resistance for all definitions and 13% of patients enter a remission despite established drug resistance.
Wydawca
Rocznik
Tom
23
Numer
1
Strony
39-44
Opis fizyczny
Daty
wydano
2015-06-01
otrzymano
2015-01-25
zaakceptowano
2015-03-19
online
2015-05-16
Twórcy
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Centre for Cognitive Neuroscience, Salzburg, Austria
autor
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria , e.trinka@salk.at
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
Bibliografia
  • Berg A.T., Shinnar S., Levy S.R., Testa F.M., Smith-Rapaport S., Beckerman B.:Early development of intractable epilepsy in children: a prospective study. Neurology, 2001, 56: 1445–1452.
  • Berg A.T., Vickrey B.G., Langfitt J.T., Sperling M.R., Walczak T.S., Shinnar S. et al.:The Multicenter Epilepsy Surgery Study: recruitment and selection for surgery. Epilepsia, 2003, 44: 1425–1433.
  • Berg A.T., Kelly M.:Defining Intractability: Comparison among published definitions. Epilepsia, 2006, 47: 431–436.
  • Callaghan B.C., Anand K., Hesdorffer D., Hauser W.A., French J.A.:Likelihood of seizure remission in an adult population with refractory epilepsy. Ann. Neurol., 2007, 62: 382–389.[WoS]
  • Camfield P., Camfield C.:Nova Scotia pediatric epilepsy study. In: P. Jallon, A. Berg, O. Dulac, A. Hauser (Eds.), Prognosis of Epilepsies. John Libbey, Eurotext, Montrouge 2003, 113–126.
  • Engel J.Jr., Wiebe S., French J., Sperling M., Williamson P., Spencer D. et al.:Practice parameter: Temporal lobe and localized neocortical resections for epilepsy. Neurology, 2003, 60: 538–547.
  • Engel J.Jr., McDermott M.P., Wiebe S., Langfitt J.T., Stern J.M., Dewar S. et al.:Early Randomized Surgical Epilepsy Trial (ERSET) Study Group. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. JAMA, 2012, 307: 922–930.
  • José F., Téllez-Zenteno J.F., Dhar R., Wiebe S.:Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain, 2005, 128: 1188–1198.
  • Kwan P., Arzimanoglou A., Berg A.T., Brodie M.J., Allen Hauser W., Methern G. et al.:Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia, 2010, 51: 1069–1077.[WoS]
  • Langfitt J.T., Wiebe S.:Early surgical treatment for epilepsy. Curr. Opin. Neurol., 2008, 21: 179–183.[WoS]
  • Liimatainen S.P., Raitanen J.A., Ylinen A.M., Peltola M.A., Peltola J.T.:The benefit of active drug trials is dependent on aetiology in refractory focal epilepsy. J. Neurol. Neurosurg. Psychiatry, 2008, 79: 808–812.[WoS]
  • Mohanraj R., Brodie M.J.:Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur. J. Neurol., 2006, 13: 277–282.
  • Neligan A., Bell G.S., Elsayed M., Sander J.W., Shorvon S.D.:Treatment changes in a cohort of people with apparently drug-resistant epilepsy: an extended follow-up. J. Neurol. Neurosurg. Psychiatry, 2012, 83: 810–813.[WoS]
  • Sperling M.R., O’Connor M.J., Saykin A.J., Plummer C.:Temporal lobectomy for refractory epilepsy. JAMA, 1996, 276: 470–475.
  • Trinka E., Martin F., Luef G., Unterberger I., Bauer G.:Chronic epilepsy with complex partial seizures is not always medically intractable. Acta Neurol. Scand., 2001, 103: 219–225.
  • Wiebe S., Blume W.T., Girvin J.P., Eliasziw M.:Effectiveness and Efficiency of Surgery for Temporal Lobe Epilepsy Study Group. A randomized, controlled trial of surgery for temporallobe epilepsy. NEJM, 2001, 345: 311–318.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_1515_joepi-2015-0025
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