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耐药性小儿癫痫的治疗进展。

Advances in the Treatment of Drug-Resistant Pediatric Epilepsy.

机构信息

Department of Neurology and Pediatrics, Pediatric Epilepsy Center of Excellence, Benioff Children's Hospital, University of California San Francisco, San Francisco, California.

出版信息

Semin Neurol. 2020 Apr;40(2):257-262. doi: 10.1055/s-0040-1702941. Epub 2020 Mar 17.

Abstract

Epilepsy is a common disorder in children and adults that causes significant morbidity and affects many aspects of a patient's lives. Two-thirds of patients with epilepsy are controlled with established antiseizure medications, leaving a significant number of patients searching for other options. The purpose of this review is to provide an overview of recent advancements in the management of treatment-resistant epilepsy in pediatric patients. Recent publications have shown the efficacy of new pharmaceutical options such as fenfluramine and cannabidiol, some of which have been tested specifically in patients with childhood-onset epilepsy syndromes such as Dravet's syndrome and Lennox-Gastaut's syndrome. Furthermore, recent approval by the U.S. Food and Drug Administration of stiripentol has made available a previously difficult-to-obtain option for patients with Dravet's syndrome. Finally, implanted responsive neurostimulation devices for direct cortical stimulation and deep brain stimulation have shown efficacy in adult patients and may represent a thrilling new horizon for pediatric patients.

摘要

癫痫是一种常见的儿童和成人疾病,会导致严重的发病率,并影响患者生活的许多方面。三分之二的癫痫患者通过既定的抗癫痫药物得到控制,仍有大量患者在寻找其他选择。本综述旨在概述儿科患者治疗抵抗性癫痫管理方面的最新进展。最近的出版物表明,新型药物选择如芬氟拉明和大麻二酚具有疗效,其中一些已在儿童起病的癫痫综合征(如 Dravet 综合征和 Lennox-Gastaut 综合征)患者中进行了专门测试。此外,美国食品和药物管理局最近批准了 stiripentol,为 Dravet 综合征患者提供了一种以前难以获得的选择。最后,用于直接皮质刺激和深部脑刺激的植入式反应性神经刺激装置在成年患者中显示出疗效,可能为儿科患者带来令人兴奋的新前景。

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