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Avoiding complacency when treating uncontrolled seizures: why and how?
Ushtar Amin1, Selim R Benbadis1
1Department of Neurology, University of South Florida, Tampa, FL, USA.
Expert Review of Neurotherapeutics
|January 16, 2020
Summary
Approximately 30% of epilepsy patients have intractable seizures, leading to severe health issues. This review explores treatment gaps and options beyond medication, including surgery and neurostimulation, for drug-resistant epilepsy management.
Area of Science:
- Neurology
- Epileptology
Background:
- Epilepsy affects 1% of the population, with 30% experiencing drug-resistant, intractable seizures.
- Intractable seizures cause significant morbidity, including cognitive decline, reduced quality of life, and increased mortality.
Purpose of the Study:
- To address the treatment gap in intractable epilepsy.
- To discuss mechanisms of drug resistance.
- To present a treatment algorithm for drug-resistant epilepsy.
Main Methods:
- Review of current literature on intractable epilepsy management.
- Discussion of non-pharmacological treatment options.
- Algorithm development for treatment sequencing.
Main Results:
- Non-pharmacological treatments like diet and neurostimulation (vagus nerve stimulation, responsive neurostimulation, deep brain stimulation) offer alternatives.
- Epilepsy surgery, particularly resective surgery, is underutilized but offers the only potential cure.
- Neurostimulation provides palliative care and is evolving with advanced technologies.
Conclusions:
- Significant gaps persist in managing intractable epilepsy.
- Non-pharmacological interventions and surgical options are crucial for improving outcomes.
- Further research and utilization of surgical and advanced neurostimulation techniques are warranted.
Keywords:
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