Early development of intractable epilepsy in children

Berg, Anne T.; Shinnar, Shlomo; Levy, Susan R.; Testa, Francine M.; Smith‐Rapaport, Susan; Beckerman, Barbara

doi:10.1212/wnl.56.11.1445

Cited by 332 publications

(281 citation statements)

References 34 publications

Supporting

Mentioning

239

Contrasting

Unclassified

Order By: Relevance

“…In one population-based study of 417 children with newly diagnosed epilepsy, in only 4% of patients who had a promising response with the first AED did refractory epilepsy develop, compared with 29% who failed to respond to the first AED (84). In another study, 613 children with newly diagnosed epilepsy were prospectively assessed (85). Ten percent of the children were considered intractable within the first 2 years of diagnosis (failure of two or more drugs and one or more seizure per month over 18 months).…”

Section: Pediatric Issuesmentioning

confidence: 99%

Is Refractory Epilepsy Preventable?

et al. 2002

View full text Add to dashboard Cite

Summary: About a third of the patients diagnosed with epilepsy will not be fully controlled with antiepileptic drugs (AEDs), and many of them will have frequent and disabling seizures. These patients will undergo multiple drug trials, most often without complete seizure remission. Moreover, refractory epilepsy is associated with increased morbidity (from seizures and medications), social isolation, unemployment, and overall reduced quality of life. There is evidence that refractory epilepsy can be a progressive disorder, which, if controlled early, might never develop into a full syndrome with all of its associated sequelae. The difficulty lies in identifying at an early stage patients who are likely to progress to intractability. No currently known markers enable clinicians to make this identification with confidence. Advances in pharmacogenomics and our understanding of pharmacologic responsiveness in epilepsy may change this situation. Even now, we are able to identify many patients with a poor prognosis earlier than before, particularly in the pediatric population, in which syndromic classification may provide an approach to predict intractability. The early initiation of aggressive therapy may improve outcome and overall quality of life.

show abstract

Section: Pediatric Issuesmentioning

confidence: 99%

Is Refractory Epilepsy Preventable?

et al. 2002

View full text Add to dashboard Cite

show abstract

“…In case of incomplete documentation of seizure frequency and duration of seizure free periods, seizure frequency as recollected by the patients were taken as reference and an average seizure frequency was estimated by the available data. Time point of intractability was established in retrospective according to three existing definitions of drug resistant epilepsy (Berg et al, 2001;Berg et al, 2003;Camfield and Camfield, 2003;Berg and Kelly, 2006) as well as the new ILAE definition (Kwan et al, 2010). The three "older" definitions of drug resistant epilepsy used in this study were taken from a prospective cohort study in children by A. Berg and M. Kelly (Berg and Kelly, 2006) and are in the following referred to as " Canada definition", "Connecticut definition" and "surgery definition" according to the way they were referred to in this paper.…”

Section: Clinical Factorsmentioning

confidence: 99%

“…Early identification of appropriate candidates for surgery is essential (José et al, 2012) as surgical intervention early in the course of the disease is superior to further medical trials (ERSET) (Engel et al, 2012). Various definitions of drug resistance have been used in previous studies (Berg et al, 2001;Berg et al, 2003;Camfield and Cam-field, 2003;Berg and Kelly, 2006). This makes it difficult to compare findings and establish practice recommendations as definitions differ according to the intended use and purpose, and may lead to significant differences in the decision for epilepsy surgery (Berg and Kelly, 2006).…”

Section: Introductionmentioning

confidence: 99%

The ILAE definition of drug resistant epilepsy and its clinical applicability compared with “older” established definitions

Rohracher¹,

Dobesberger²,

Granbichler³

et al. 2015

Journal of Epileptology

View full text Add to dashboard Cite

summArY Background. Early identification of potential epilepsy surgery candidates is essential to the treatment process. Aim. To evaluate the clinical applicability of the ILAE definition of drug resistant epilepsy and its potential in identifying surgical candidates earlier compared to three established "older" definitions of drug resistant epilepsy. material and methods. Retrospective analysis of 174 patients who underwent epilepsy surgery between 1998 and 2009. Clinical factors and course of disease were extracted from patients' charts. Drug resistant epilepsy was classified according to four definitions and the time until fulfillment of criteria compared. results. Mean time to fulfillment of criteria of drug resistant epilepsy ranged from 11.8 (standard deviation (SD) 9.8) to 15.6 years (SD 11.3). Time to drug resistance was significantly longer applying the only definition, requiring failure of three antiepileptic drugs (AEDs) (Canada definition), whereas time to fulfillment of all other definitions did not differ. Fifty percent of all patients experienced a seizure free period of ≥1 year prior to being classified as drug resistant, 13% entered another 1-year remission after fulfilling any criteria for drug resistance. Conclusion. We conclude that the ILAE definition identifies drug resistant epilepsy, with similar latency like two of three formerly used definitions. It is an easy applicable tool to minimize the delay of referral to a specialized center. Intermittent remissions delay assessment of drug resistance for all definitions and 13% of patients enter a remission despite established drug resistance.

show abstract

“…In spite of a high incidence of complex febrile seizures in patients with MTS, it is not well determined whether the febrile seizures are a causal factor or just an epiphenomenon of MTS (17,18) . Temporal lobe epilepsy due to MTS may present with different forms of epilepsy onset (19) .…”

Section: Etiologymentioning

confidence: 99%

Temporal lobe epilepsy in childhood: review article

Franzon

Guerreiro

2006

J. epilepsy clin. neurophysiol.

View full text Add to dashboard Cite

Introduction:The authors present a review article on temporal lobe epilepsy in childhood. Methods: We performed a search in the literature. Results: The main etiologies of temporal lobe epilepsy in childhood are developmental tumors and focal cortical displasia, besides temporal medial sclerosis. The clinical features may be variable particularly in children younger than six years of age. Epilepsy may present with generalized seizures. Electroencephalographic findings are also variable and show a functional dysfunction of several brain areas besides temporal lobes, especially frontal lobes. Conclusion: Recent advances demonstrate that temporal lobe epilepsy in childhood present with great etiologic, clinical and electroencephalographic diversity.

show abstract

Early development of intractable epilepsy in children

Cited by 332 publications

References 34 publications

Is Refractory Epilepsy Preventable?

Is Refractory Epilepsy Preventable?

The ILAE definition of drug resistant epilepsy and its clinical applicability compared with “older” established definitions

Temporal lobe epilepsy in childhood: review article

Contact Info

Product

Resources

About