Wheless James W
Department of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, Tennessee 38105, USA.
J Child Neurol. 2009 Aug;24(8 Suppl):24S-32S; quiz 33S-6S. doi: 10.1177/0883073809338153.
Managing severe epilepsy syndromes of early childhood is challenging as the seizures are typically resistant to treatment and may cause disabling mental and behavioral problems in later life. A comprehensive treatment plan includes pharmacologic, nonpharmacologic, and surgical options. This article reviews clinical studies examining the efficacies of antiepileptic medications in reducing seizure frequency in Dravet syndrome, Doose syndrome, and Lennox-Gastaut syndrome. The benefits of the ketogenic diet for children with these severe epilepsies, together with the advantages of vagus nerve stimulation and corpus callosotomy in those patients with Lennox-Gastaut syndrome, are also discussed. Special treatment considerations for each syndrome are also highlighted to improve the management of patients with these syndromes.
管理儿童早期的严重癫痫综合征具有挑战性，因为癫痫发作通常对治疗有抵抗性，并且可能在日后生活中导致致残性的精神和行为问题。全面的治疗计划包括药物、非药物和手术选择。本文综述了关于抗癫痫药物在降低德雷维特综合征、杜斯综合征和伦诺克斯-加斯东综合征发作频率方面疗效的临床研究。还讨论了生酮饮食对患有这些严重癫痫的儿童的益处，以及迷走神经刺激和胼胝体切开术对伦诺克斯-加斯东综合征患者的优势。还强调了每种综合征的特殊治疗注意事项，以改善这些综合征患者的管理。
