难治性全面性癫痫:治疗方法。
Intractable Generalized Epilepsy: Therapeutic Approaches.
机构信息
Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA.
出版信息
Curr Neurol Neurosci Rep. 2019 Feb 26;19(4):16. doi: 10.1007/s11910-019-0933-z.
PURPOSE OF REVIEW
To summarize recent developments in therapeutic options, both medical and surgical, for patients with drug-resistant generalized epilepsy syndromes, which continue to be a multifaceted challenge for patients and physicians.
RECENT FINDINGS
Newer generation pharmaceutical options are now available, such as brivaracetam, rufinamide, lacosamide, perampanel, and cannabidiol. Less restrictive dietary options appear to be nearly as effective as classic ketogenic diet for amelioration of seizures. The latest implantable devices include responsive neurostimulation and deep brain stimulation. Corpus callosotomy is an effective treatment for some seizure types, and newer and less invasive approaches are being explored. Resective surgical options have demonstrated success in carefully selected patients despite generalized electrographic findings on electroencephalogram. The current literature reflects a widening range of clinical experience with newer anticonvulsant medications including cannabinoids, dietary therapies, surgical approaches, and neurostimulation devices for patients with intractable generalized epilepsy.
目的综述
耐药性全面性癫痫综合征患者的医学和手术治疗选择的最新进展,这些选择仍然是患者和医生面临的多方面挑战。
最新发现
现在有新一代的药物治疗选择,如吡仑帕奈、拉考沙胺、普瑞巴林、依维莫司和大麻二酚。限制较少的饮食选择似乎与经典生酮饮食一样有效,可以改善癫痫发作。最新的植入式设备包括反应性神经刺激和深部脑刺激。胼胝体切开术是某些癫痫类型的有效治疗方法,正在探索新的、创伤更小的方法。对于一些患者来说,切除性手术治疗选择是成功的,尽管脑电图显示全面性电描记图异常。目前的文献反映了更广泛的临床经验,包括使用新型抗癫痫药物,包括大麻素、饮食疗法、手术方法和神经刺激设备,用于治疗耐药性全面性癫痫。