[Clinical treatment of resistant epilepsy].
The authors analysed 34 cases of resistant epilepsy (20 males and 14 females, mean age 23 years), treated clinically between February/1984 and May/1986. The patients underwent neurological, neuropsychological, psychological, psychiatric, cerebrospinal fluid, electroencephalographic, tomographic and/or angiographic examination. Most of the patients had complex partial seizures. The etiology was unknown in 19 patients (55.8%), probable neurocysticercosis in 6, perinatal hypoxia in 5, delivery trauma in 3 and probable sequelae of encephalitis in 2 patients. There was a clear past history of infantile febrile convulsion in 2 patients. Most patients received carbamazepine (mean dose 24.5 mg/kg/day), phenytoin (5 mg/kg and valproic acid (28 mg/kg) as monotherapy or in association. Twenty-two patients (64.7%) had more than 80% decrease of the seizure frequency. Nine resistant epilepsy cases (24.5%) were evaluated as candidates for surgical therapy. The authors concluded that the resistant epilepsy is best managed by a specialised, multidisciplinary team, and pointed out the need of a correct diagnosis of the seizure type, an adequate drug therapy and a good engagement of the patient and his family in the treatment.
Damasceno
B P
BP
Departamento de Neurologia, Faculdade de Ciências, UNICAMP, Campinas SP - Brasil.
Campos Junior
S da S
Sda S
Martins
L F
LF
de Melo-Souza
S E
SE
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage; D002220:Carbamazepine / Q000627:therapeutic use*; D002648:Child; D004351:Drug Resistance; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010672:Phenytoin / Q000627:therapeutic use*; D011379:Prognosis; D014635:Valproic Acid / Q000627:therapeutic use*
D000927:Anticonvulsants; D002220:Carbamazepine; D014635:Valproic Acid; D010672:Phenytoin
Tratamento clínico da epilepsia resistente.