[Clinical features and treatment of refractory epilepsy in children].
Clinical features of refractory epilepsy in children are symptomatic localization-related epilepsy, especially frontal lobe epilepsy, the onset in young age less than 3 years-old, and complication of developmental retardation. The treatments usually start with one drug of choice for specific seizure type. In the idiopathic epilepsy group, valproic acid was effective in 82% of the patients with generalized epilepsy and in 45% of localization-related epilepsy while carbamazepine was effective in 71% and 67%, respectively. However, in the refractory group which did not react to the drugs of choice at the initial treatment and continued to have seizures, no specific drugs were effective. Therefore, various kind of drugs, new or old, should be tried in sequence irrespective of the type of seizures. The seizure control was attained only in 10% (in the cases of CZP), and 17% (CLB) in localization-related epilepsy and in 9% (VPA), 12% (NZP) and 20% (ZNS) in generalized one in the refractory group. Although new drugs developed, the patients with refractory epilepsy do not tend to decrease in frequency and overall management including daily life or surgical therapy is mandatory for the children with refractory epilepsy.
Kurokawa
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Department of Pediatrics, National Nishibeppu Hospital.
D000293:Adolescent; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D001569:Benzodiazepines; D002648:Child; D002675:Child, Preschool; D000078306:Clobazam; D002998:Clonazepam / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007555:Isoxazoles / Q000627:therapeutic use; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use; D000078305:Zonisamide
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D007555:Isoxazoles; D001569:Benzodiazepines; D000078306:Clobazam; D000078305:Zonisamide; D002998:Clonazepam; D014635:Valproic Acid