How long does it take for epilepsy to become intractable? A prospective investigation

Berg, Anne T.; Vickrey, Barbara G.; Testa, Francine M.; Levy, Susan R.; Shinnar, Shlomo; DiMario, Francis J.; Smith, Susan N.

doi:10.1002/ana.20852

Cited by 237 publications

(194 citation statements)

References 37 publications

Supporting

Mentioning

172

Contrasting

Unclassified

Order By: Relevance

“…In our study this was also one of the most influential risk factors for drug-resistant epilepsy (Cramer's V = 0.62). This view is shared by most authors [6,8,13,22,25]. According to Camifield, normal intellectual development is fundamental for good prognosis in epilepsy [26].…”

Section: Discussionmentioning

confidence: 95%

“…The most frequently mentioned clinical factors include the following: initial antiepileptic treatment [6,7], considerable initial frequency of epileptic seizures [6,[8][9][10][11][12], occurrence of status epilepticus [6,[13][14][15][16][17], symptomatic aetiology of epilepsy [6,16,18], type of epilepsy/epileptic syndrome [11,13,14,16,[19][20][21][22], onset of epileptic seizures before the first birthday [13,15,18,23,24], abnormal results of neurological examination [8,18,23,24,25], and abnormalities detected in imaging [18,23] and EEG examinations [15,16,18].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of clinical risk factors for drug-resistant epilepsy in children and teenagers

Kasprzyk¹,

Brola²,

Wendorff³

2014

View full text Add to dashboard Cite

Introduction: Epilepsy is one of the most common neurological illnesses occurring in children. In approximately 20-30% of cases it is drug-resistant. Aim of the research: To assess the already-known risk factors, analyse the rarely described ones, and find new causes of epilepsy drug resistance in children, taking into account the level of impact of each factor. Material and methods:The study comprised 152 of all 383 children hospitalised in 2012 at the Neurology Department of the Polish Mother's Memorial Hospital in Lodz due to epilepsy. Based on medical documentation, neurological examination, and our own questionnaire, we divided patients into two groups: drug-resistant epilepsy or drug-sensitive epilepsy. We compared the type, level of influence, and prevalence of different factors. For statistical analysis, the χ 2 test was used. Statistical significance was set at p < 0.05. Results: Drug-resistant epilepsy was found in 64 patients (42.1%), and drug-sensitive epilepsy was found in 88 patients (57.9%). Factors that were most probable to cause drug resistance included: high prevalence of seizures (Cramer's V = 0.66), type of epileptic syndrome (V = 0.62), psychomotor developmental delay (V = 0.62), and occurrence of status epilepticus (V = 0.6). Factors such as infections of CNS in early childhood, repeated severe infections of airways in childhood, and mother's infectious diseases with high fever during pregnancy were rare or non occurring (Cramer's V = 0.41, 0.32, and 0.31, respectively). Conclusions: The study confirmed the previously known causes of drug resistance and indicated the significance of underestimated inflammatory and infectious factors involving pyrexia, in children and also in mothers during pregnancy.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Assessment of clinical risk factors for drug-resistant epilepsy in children and teenagers

Kasprzyk¹,

Brola²,

Wendorff³

2014

View full text Add to dashboard Cite

show abstract

“…In particular, memory loss, learning disabilities, and behavioral problems are especially common in epilepsy patients, and often exhibit a progressive course, frequently correlating with worsening seizure control [1][2][3][4][5]. Furthermore, about one-third of all patients with epilepsy have seizures that are intractable to all currently-available treatments and that may escalate in frequency and severity [6][7][8]. There are multiple biological, environmental, and psychosocial factors that may contribute to progressive neurological dysfunction in epilepsy patients.…”

Section: Introductionmentioning

confidence: 99%

Stabilizing dendritic structure as a novel therapeutic approach for epilepsy

Wong¹

2008

Expert Review of Neurotherapeutics

View full text Add to dashboard Cite

SummaryPeople with epilepsy often experience long-term cognitive dysfunction and other neurological deficits, including memory loss, learning disabilities, and neurobehavioral disorders, which may exhibit a progressive course correlating with worsening seizure control. Furthermore, one-third of epilepsy patients have seizures that are intractable to all available treatments. Thus, novel therapies for seizures and the neurological comorbidities of epilepsy are desperately needed. As most current treatments are merely "symptomatic" therapies that suppress seizures, recently epilepsy researchers have realized the critical need for novel therapeutic strategies targeting the underlying mechanisms of epileptogenesis and seizure-related brain injury. Yet to date, few such "anti-epileptogenic" therapies have emerged or are even in developmental stages. Although many seizure medications modulate the functional or physiological activity of neurons, a relatively unexplored therapeutic strategy for epilepsy are methods for stabilizing the structure of neurons. Human pathological studies and animal models of epilepsy demonstrate obvious structural abnormalities in dendrites of neurons, which could contribute to neuronal dysfunction, epileptogenesis, and cognitive/neurological deficits in epilepsy patients. This dendritic injury may be caused by activity-dependent breakdown of cytoskeletal elements, such as actin. Mechanistically-targeted approaches to limit seizure-related structural changes in dendrites may represent a novel therapeutic strategy for treating epilepsy and its complications.

show abstract

“…Despite appropriate treatment with antiepileptic drugs, seizures persisted in approximately 20 and 35% of patients with primary generalized epilepsy and those with partial epilepsy, respectively [5]. A recent study demonstrated that up to 23% of epilepsy cases were intractable, if intractability was defined as failure of two drugs [6]. For patients with intractable seizures, other methods of treatment including surgical treatment should be considered.…”

Section: Introductionmentioning

confidence: 99%

Epilepsy Surgery in Children in Thailand: Preliminary Result from a Referral Center

Visudtibhan

Boongird

Khongkhatithum

et al. 2008

E&S

View full text Add to dashboard Cite

, and The Ramathibodi Epilepsy Surgery Group Purpose:To demonstrate the preliminary result of the surgical treatment in a university-based hospital in Thailand Methods: The medical records of children and adolescents, who received surgical treatment for epilepsy at Ramathibodi Hospital, Bangkok, Thailand from October 2005 till July 2007 were reviewed. Results: 38 children and adolescents (21 males and 17 females; ages ranged from 14 months to 18 ½ years, mean 9.5 years, median 9.75 years) were included in this study. 18 and 20 were classified into symptomatic and cryptogenic/ idiopathic groups, respectively. LennoxGastaut syndrome, West syndrome, tuberous sclerosis and Sturge-Weber syndrome were diagnosed in 10, 3, 2 and 1 patients, respectively. Presurgical evaluation consisted of ictal/interictal video-monitored EEG recording, MRI of brain and ictal/interictal SPECT scans. Surgical treatment were lesionectomy, lobectomy, corpus callosotomy, corpus callosotomy with lobectomy, anterior

show abstract

How long does it take for epilepsy to become intractable? A prospective investigation

Abstract: Intractable epilepsy may be delayed, especially in focal epilepsy. It often is preceded by a quiescent period, followed by further remissions. These findings help explain why surgically treatable epilepsies may take 20 years or longer before referral to surgery.

Cited by 237 publications

References 37 publications

Assessment of clinical risk factors for drug-resistant epilepsy in children and teenagers

Assessment of clinical risk factors for drug-resistant epilepsy in children and teenagers

Stabilizing dendritic structure as a novel therapeutic approach for epilepsy

Epilepsy Surgery in Children in Thailand: Preliminary Result from a Referral Center

Contact Info

Product

Resources

About