Rahim Fakher, Azizimalamiri Reza, Sayyah Mehdi, Malayeri Alireza
Molecular Medicine and Bioinformatics, Research Center of Thalassemia & Hemoglobinopathy, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Pediatrics, Division of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
J Exp Pharmacol. 2021 Mar 11;13:265-290. doi: 10.2147/JEP.S267029. eCollection 2021.
Epilepsies are among the most common neurological problems. The disease burden in patients with epilepsy is significantly high, and epilepsy has a huge negative impact on patients' quality of life with epilepsy and their families. Anti-seizure medications are the mainstay treatment in patients with epilepsy, and around 70% of patients will ultimately control with a combination of at least two appropriately selected anti-seizure medications. However, in one-third of patients, seizures are resistant to drugs, and other measures will be needed. The primary goal in using experimental therapeutic medication strategies in patients with epilepsy is to prevent recurrent seizures and reduce the rate of traumatic events that may occur during seizures. So far, various treatments using medications have been offered for patients with epilepsies, which have been classified according to the type of epilepsy, the effectiveness of the medications, and the adverse effects. Medications such as Levetiracetam, valproic acid, and lamotrigine are at the forefront of these patients' treatment. Epilepsy surgery, neuro-stimulation, and the ketogenic diet are the main measures in patients with medication-resistant epilepsies. In this paper, we will review the therapeutic approach using anti-seizure medications in patients with epilepsy. However, it should be noted that some of these patients still do not respond to existing treatments; therefore, the limited ability of current therapies has fueled research efforts for the development of novel treatment strategies. Thus, it seems that in addition to surgical measures, we should look for more specific agents that have less adverse events and have a greater effect in stopping seizures.
癫痫是最常见的神经系统问题之一。癫痫患者的疾病负担显著较高,癫痫对癫痫患者及其家庭的生活质量产生了巨大的负面影响。抗癫痫药物是癫痫患者的主要治疗手段,约70%的患者最终通过至少两种适当选择的抗癫痫药物联合使用得以控制。然而,三分之一的患者癫痫发作对药物耐药,需要采取其他措施。在癫痫患者中使用实验性治疗药物策略的主要目标是预防癫痫复发,并降低癫痫发作期间可能发生的创伤性事件的发生率。到目前为止,已经为癫痫患者提供了各种药物治疗方法,这些方法根据癫痫类型、药物疗效和不良反应进行了分类。左乙拉西坦、丙戊酸和拉莫三嗪等药物处于这些患者治疗的前沿。癫痫手术、神经刺激和生酮饮食是药物难治性癫痫患者的主要治疗措施。在本文中,我们将回顾癫痫患者使用抗癫痫药物的治疗方法。然而,应该注意的是,这些患者中的一些人仍然对现有治疗没有反应;因此,当前疗法的有限能力推动了新型治疗策略开发的研究工作。因此,似乎除了手术措施外,我们应该寻找更具特异性、不良事件较少且在终止癫痫发作方面效果更佳的药物。