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[癫痫治疗方法的变化]

[Changes in the approach to epilepsy].

作者信息

Balogh A

机构信息

Fövárosi Szent István Kórház, Budapest.

出版信息

Orv Hetil. 1999 Aug 29;140(35):1923-33.

Abstract

The last decades resulted unlikely development in the investigation and therapy of epilepsy. This process made the classification and separation of the epileptic seizures and epileptic syndromes possible. The new classification established the functional assessment of the convulsive disorder and revealed the fact that epilepsy is not only a symptom but an illness. The new computer assisted neuroimaging methods disclose more and more details in the etiology and extremely reduce the number of cryptogen epilepsies. Understanding the role of different ionchanels and certain excitatory and inhibitory transmitters in the generation and propagation of epileptic excitement gives new possibilities in therapeutic approach. The pharmacokinetic features of the antiepileptic drugs basically determined therapeutic concepts. Most of the antiepileptic drugs exert their therapeutical effect through their blood level. This recognition led to the development of the mono and rational polytherapy. In the last five year developed large cohort of the newest antiepileptic drugs and the renaissance of the epilepsy surgery make a revolution in the treatment of the epileptic disorder.

摘要

在过去几十年里,癫痫的研究与治疗取得了显著进展。这一进程使得癫痫发作和癫痫综合征的分类与区分成为可能。新的分类方法对惊厥性疾病进行了功能评估,并揭示了癫痫不仅是一种症状,更是一种疾病这一事实。新型计算机辅助神经成像方法在病因学方面揭示了越来越多的细节,并极大地减少了隐源性癫痫的数量。了解不同离子通道以及某些兴奋性和抑制性递质在癫痫兴奋的产生和传播中的作用,为治疗方法带来了新的可能性。抗癫痫药物的药代动力学特性基本决定了治疗理念。大多数抗癫痫药物通过其血药浓度发挥治疗作用。这一认识推动了单药治疗和合理联合治疗的发展。在过去五年中,一大批最新的抗癫痫药物问世,癫痫外科手术的复兴也给癫痫疾病的治疗带来了一场革命。

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