Legido A
Departamento de Pediatría, Sección de Neurología, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, PA 19134-1095, USA.
Rev Neurol. 2002;34(2):186-95.
To review the preventive and prophylactic aspects of epilepsy.
The description of the prevention of the causes of epilepsy includes the measures to prevent epilepsy and epileptic seizures. The concept of antiepileptogenesis is discussed according to the available information about the role that both the classic and new antiepileptic drugs (AEDs) play in this process. Neuroprotection is discussed in the context of the mechanisms of action of the AEDs and of the mechanisms of neuronal lesion produced by the causes of epilepsy or by the seizures themselves. Among the new therapeutic modalities the current knowledge about the vagus nerve stimulator and the surgical treatment is summarized. The potential future therapeutic modalities include alternative medicine, pharmacologic treatment of the epileptogenic focus, genetic treatment and vaccination.
The first step in preventing epilepsy is to avoid the causes or the risk factors. Some classic AEDs have demonstrated to be effective in the prophylaxis of provoked seizures (acute, symptomatic) but not of unprovoked seizures (epileptic). The best knowledge of the pathogenesis and the molecular and biological basis of epileptogenesis secondary to lesional causes, suggest that antioxidant and neuroprotective agents, including the new AEDs, may prevent epilepsy. There is a need to design studies with the goal of demonstrating their antiepileptogenic and/or neuroprotective activity at different ages in life. New and future therapeutic modalities may offer additional preventive options.
综述癫痫的预防和预防性治疗方面。
对癫痫病因预防的描述包括预防癫痫及癫痫发作的措施。根据关于经典和新型抗癫痫药物（AEDs）在此过程中作用的现有信息，讨论了抗癫痫发生的概念。在AEDs的作用机制以及由癫痫病因或癫痫发作本身所产生的神经元损伤机制的背景下，讨论了神经保护作用。在新的治疗方式中，总结了目前关于迷走神经刺激器和手术治疗的知识。未来潜在的治疗方式包括替代医学、致痫灶的药物治疗、基因治疗和疫苗接种。
预防癫痫的第一步是避免病因或危险因素。一些经典AEDs已证明对预防性发作（急性、症状性）有效，但对特发性发作（癫痫性）无效。对继发于损伤性病因的癫痫发病机制以及分子和生物学基础的深入了解表明，抗氧化剂和神经保护剂，包括新型AEDs，可能预防癫痫。需要设计研究以证明它们在生命不同阶段的抗癫痫发生和/或神经保护活性。新的和未来的治疗方式可能提供更多的预防选择。
