Tratamento clínico da epilepsia resistente

Abstract

The authors analysed 34 cases of resistant epilepsy (20 males and 14 females, mean age 23 years), treated clinically between February/1984 and May/1986. The patients underwent neurological, neuropsychological, psychological, psychiatric, cerebrospinal fluid, electroencephalographic, tomographic and/or angiographic examination. Most of the patients had complex partial seizures. The etiology was unknown in 19 patients (55.8%), probable neurocysticercosis in 6, perinatal hypoxia in 5, delivery trauma in 3 and probable sequelae of encephalitis in 2 patients. There was a clear past history of infantile febrile convulsion in 2 patients. Most patients received carbamazepine (mean dose 24.5 mg/kg/day), phenytoin (5 mg/kg and valproic acid (28 mg/kg) as monotherapy or in association. Twenty-two patients (64.7%) had more than 80% decrease of the seizure frequency. Nine resistant epilepsy cases (24.5%) were evaluated as candidates for surgical therapy. The authors concluded that the resistant epilepsy is best managed by a specialised, multidisciplinary team, and pointed out the need of a correct diagnosis of the seizure type, an adequate drug therapy and a good engagement of the patient and his family in the treatment.

Epilepsia Do Tipo Ausência: Uma Revisão Bibliográfica Dos Mecanismos Fisiopatológicos E Abordagens Terapêuticas

“…A dieta cetogênica pode levar várias semanas para ser implementada e pode ser associada a efeitos colaterais iniciais, como fadiga, náuseas e irritabilidade, conhecidos como "ceto grip". No entanto, muitos pacientes se adaptam bem à dieta ao longo do tempo (Mendonça et al, 2024).…”

A few words about Luiz Fernando Martins.

“…También fue presidente de la Sociedad Latinoamericana de Neurocirugía Funcional y Estereotaxia (2008/2010). 1 Aunque es autor de pocos trabajos científicos [2][3][4][5][6][7][8] , ha hecho dos significativas contribuciones: la determinación de las coordenadas estereotácticas del foramen oval, 2 y la correlación entre la posición y tamaño de las lesiones talámicas mediales, y el grado de alivio del dolor en pacientes con dolor oncológico (un estudio de autopsias). 3,4 Otra importante contribución, aunque no haya sido publicada, fue su propuesta de combinar la amigdalotomía y la capsulotomía anterior, para el tratamiento de la agresividad refractaria (1985).…”