Nonpharmacologic treatment of the catastrophic epilepsies of childhood.
The catastrophic epilepsy syndromes of childhood are initially treated with a pharmacologic intervention in most cases. However, due to the poor response patients often have to pharmacologic interventions, nonpharmacologic treatment options are an important part of a comprehensive treatment plan for this group of children. Additionally, nonpharmacologic therapy may offer a method to minimize associated morbidity and mortality. This article discusses the use of epilepsy surgery, the ketogenic diet, and vagus nerve stimulation in the treatment of patients with infantile spasms, Lennox-Gastaut syndrome, and progressive myoclonic epilepsy. Efficacy of the nonpharmacologic treatment options, as measured by reduction in seizure frequency, as well as by developmental progress or behavioral improvement, varies according to the specific catastrophic epilepsy disorder and the treatment option.
Wheless
James W
JW
Department of Neurology and Pediatrics, Texas Comprehensive Epilepsy Program, University of Texas-Houston Medical School, 6431 Fannin Street #7044, Houston, TX 77030, U.S.A. james.w.wheless@uth.tmc.edu
D001921:Brain / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000378:metabolism; D004041:Dietary Fats / Q000008:administration & dosage / Q000378:metabolism; D004044:Dietary Proteins / Q000008:administration & dosage / Q000378:metabolism; D004599:Electric Stimulation Therapy; D004831:Epilepsies, Myoclonic / Q000178:diet therapy / Q000601:surgery / Q000628:therapy*; D004827:Epilepsy / Q000178:diet therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007223:Infant; D007662:Ketosis / Q000209:etiology / Q000378:metabolism; D019635:Neurosurgical Procedures; D013036:Spasms, Infantile / Q000178:diet therapy / Q000601:surgery / Q000628:therapy*; D014630:Vagus Nerve / Q000502:physiology
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins