[The concept and treatment of drug-resistant intractable epilepsy].
Epilepsy is considered as being untreatable when attacks present unsatisfactory control or else when brought under control only with doses of anti-epileptic drugs which produce severe secondary effects. There has to be provable certainty that the anti-epileptic drugs were used correctly. Untreatable epilepsy is an essential condition for surgical intervention; consequently rigorous therapeutic and diagnostic criteria are needed which may also improve control of the attacks. About 20% of epilepsies are untreatable. The basic mechanisms of untreatable epilepsy are not well known and may be untreatable either from onset or as a consequence in the progression of the epileptogenetic process. Various factors may be involved in a bad prognosis. Spontaneous improvement is rare from the therapeutic point of view and before considering surgery at least two anti-epileptic drugs should be tried monotherapeutically prior to their use in combination. It is well known that bitherapy brings about an important improvement in a few cases. Anti-epileptic drugs should be used at their maximum tolerable dosage independently of theoretical plasmatic levels.
Iváñez
V
V
Servicio de Neurologia, Hospital La Paz, Madrid.
D000927:Anticonvulsants / Q000627:therapeutic use*; D001921:Brain / Q000503:physiopathology / Q000601:surgery; D004351:Drug Resistance; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D006801:Humans
D000927:Anticonvulsants
Epilepsia intratable o farmacorresistente. Concepto y tratamiento.