Uncontrolled epilepsy in children
1Epilepsy Unit, University Hospital, University of Western Ontario, London, Canada.
Insights
Intractable seizures require careful management, considering seizure frequency, patient lifestyle, and potential surgical benefits. Surgery
Area of Science:
- Neurology
- Neurosurgery
Background:
- Intractable seizures are defined by persistent, unacceptable seizure activity despite medical and social management, or seizure control at the cost of medication toxicity.
- The determination of unacceptable seizure levels is influenced by seizure type, patient lifestyle, and the consequences of uncontrolled epilepsy.
Purpose of the Study:
- To define intractable seizures and outline the factors influencing their management.
- To highlight the potential role and future improvements in surgical interventions for intractable epilepsy.
Main Methods:
- This abstract does not detail specific methods but discusses the conceptual framework for defining and managing intractable seizures.
- It emphasizes the need for objective evaluation of surgical outcomes.
Main Results:
- The abstract does not present specific results but establishes criteria for defining intractable seizures.
- It posits that the value of epilepsy surgery will increase with improved patient selection and diagnostic accuracy.
Conclusions:
- Accurate selection of surgical candidates and sites, along with precise identification of diagnostic tests, will enhance the efficacy of surgical interventions for intractable epilepsy.
- Objective evaluation of surgical outcomes is crucial for understanding its true value.
Abstract:
Intractable seizures in any age indicates (1) the continued presence of an unacceptable quantity of seizures despite reasonable medical and social management or (2) seizure eradication at the expense of medication toxicity. The incidence of seizures deemed unacceptable depends on their nature, the patient's life-style, physiological and social consequences of uncontrolled seizures, and the promise of surgical alleviation. The true value of surgery should increase as candidates and surgical sites can be more accurately selected, the necessary (and unnecessary) diagnostic tests better identified, and all aspects of its effects objectively evaluated in follow-up.
Related Concept Videos
Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Antiepileptic Drugs: Calcium Channel Blockers
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
Seizures l: Introduction
Epilepsy ll: Types


