James J. Riviello, Jr, MD Section of Neurology and Developmental Neuroscience, Baylor College of Medicine; Texas Children’s Hospital, 6621 Fannin, CC 1250, Houston, TX 77030, USA.
Curr Treat Options Neurol. 2007 Nov;9(6):395-403. doi: 10.1007/s11940-007-0041-2.
The goal of epilepsy treatment is the prevention of recurrent seizures, and antiepileptic drugs (AEDs) are the mainstay. Uncontrolled seizures may cause medical, developmental, and psychologic disturbances. Treatment advances include 1) identification of the basic mechanisms of epilepsy and action of AEDs, 2) the introduction of many new AEDs, and 3) the use of neurostimulation, starting with vagus nerve stimulation. We must balance the efficacy of an AED versus its side effects, which if persistent, lead to patient discontinuation of the AED. Although all AEDs have a proven efficacy, they are differentiated by their efficacy for a given seizure type or epilepsy syndrome versus the side effects or tolerability. The many new AEDs give us a larger armamentarium for epilepsy treatment. We refer to studies and expert opinion consensus.
癫痫治疗的目标是预防反复发作,抗癫痫药物(AEDs)是主要手段。未得到控制的癫痫发作可能导致医学、发育和心理问题。治疗进展包括:1)确定癫痫和 AED 作用的基本机制,2)引入许多新的 AED,3)开始使用神经刺激,首先是迷走神经刺激。我们必须平衡 AED 的疗效与其副作用,因为如果副作用持续存在,患者将停止使用 AED。尽管所有 AED 都有已证实的疗效,但它们在特定的癫痫发作类型或癫痫综合征的疗效方面有所不同,而与副作用或耐受性有关。许多新的 AED 为我们提供了更多的癫痫治疗手段。我们参考研究和专家意见共识。