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Chapter 15 - Approach to the Treatment of Medication-Resistant Epilepsy

Published online by Cambridge University Press:  20 August 2020

By
John M. Stern
Edited by
John M. Stern ,
Raman Sankar  and
Michael Sperling
John M. Stern
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Raman Sankar
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Michael Sperling
Affiliation:
Jefferson Hospital for Neurosciences, Philadelphia, PA
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Summary

This chapter provides an overview of a conceptual approach to providing care for the patient with medication-resistant epilepsy (MRE), with consideration of the care sequence and components. This discussion of the gestalt is not intended to provide one established algorithm, as one treatment pathway cannot serve the needs of the diverse MRE patient population. Nevertheless, the considerations described below comprise a generally accepted care process aimed to improve the MRE clinical outcome. Detailed discussions of the care elements are provided in other chapters.

Type
Chapter
Information
Medication-Resistant Epilepsy
Diagnosis and Treatment
 , pp. 171 - 178
Publisher: Cambridge University Press
Print publication year: 2020

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References

Fisher, RS, Acevedo, C, Arzimanoglou, A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia 2014;55:475–482Google Scholar
Rugg-Gunn, FJ, Harrison, NA, Duncan, JS. Evaluation of the accuracy of seizure descriptions by the relatives of patients with epilepsy. Epilepsy Res 2001;43:193–199Google Scholar
Mannan, JB, Wieshmann, UC. How accurate are witness descriptions of epilepsy seizures? Seizure 2003;12:444–447Google Scholar
Benbadis, SR, Tatum, WO. Overinterpretation of EEGs and misdiagnosis of epilepsy. J Clin Neurophysiol 2003;20:42–44CrossRefGoogle ScholarPubMed
Hussain, SA, Kwong, G, Millichap, JJ, et al. Hypsarrhythmia assessment exhibits poor interrater reliability: a threat to clinical trial validity. Epilepsia 2015;56:77–81CrossRefGoogle ScholarPubMed
Mohan, KK, Markand, ON, Salanova, V. Diagnostic utility of video EEG monitoring in paroxysmal events. Act Neurol Scand 1996;94:320–325CrossRefGoogle ScholarPubMed
Benbadis, SR, O’Neill, E, Tatum, WO, Heriaud, L. Outcome of prolonged video-EEG monitoring at a typical referral epilepsy center. Epilepsia 2004;45:1150–1153CrossRefGoogle Scholar
World Health Organization, 2003. Adherence to long-term therapies: Evidence for action. https://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf (accessed March 2020)Google Scholar
Quek, AML, Britton, JW, McKeon, A, et al. Autoimmune epilepsy: clinical characteristics and response to immunotherapy. Arch Neurol 2012;69:582–593Google Scholar
Graus, F, Titulaer, MJ, Balu, R, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol 2016;15:391–404Google Scholar
Glauser, TA, Cnaan, A, Shinnar, S, et al. Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy. N Engl J Med 2010;362:790–799Google Scholar
Vinten, J, Adab, N, Kini, U, et al. Neuropsychological effects of exposure to anticonvulsant medication in utero. Neurology 2005;64:949–954Google Scholar
Christensen, J, Grønborg, TK, Sørensen, MJ, et al. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. J Am Med Assoc 2013;309:1696–1703Google Scholar
Gerard, EE, Meador, KJ. An update on maternal use of antiepileptic medications in pregnancy and neurodevelopment outcomes. J Pediatr Genet 2015;4:94–110Google Scholar
De Lange, IM, Gunning, B, Sonsma, ACM, et al. Influence of contraindicated medication use on cognitive outcome in Dravet syndrome and age at first afebrile seizure as a clinical predictor in SCNA1A-related seizure phenotypes. Epilepsia 2018;59:1154–1165CrossRefGoogle ScholarPubMed
Suls, A, Mullen, SA, Weber, YG, et al. Early-onset absence epilepsy caused by mutations in the glucose transporter GLUT1. Ann Neurol 2009;66:415–419Google Scholar
French, JA, Lawson, JA, Yapici, Z, et al. Adjunctive everolimus therapy for treatment-resistant focal-onset seizures associated with tuberous sclerosis (EXIST-3): a phase 3, randomised, double-blind, placebo-controlled study. Lancet 2016;388:2153–2163CrossRefGoogle ScholarPubMed
Krueger, DA, Wilfong, AA, Mays, M, et al. Long-term treatment of epilepsy with everolimus in tuberous sclerosis. Neurology 2016;87:2408–2415CrossRefGoogle ScholarPubMed
De Flon, P, Kumlien, E, Reuterwall, C, Mattsson, P. Empirical evidence of underutilization of referrals for epilepsy surgery evaluation. Eur J Neurol 2010;17:619–625Google Scholar
Haneef, Z, Stern, J, Dewar, S, Engel, J, Jr. Referral pattern for epilepsy surgery after evidence-based recommendations: a retrospective study. Neurology 2010;75:699–704Google Scholar
Montenegro, MA, Novals, A, Hirsch, LJ. How long would it take to try all the antiepileptic drugs available? Epilepsy Res 2019;154:77–78Google Scholar
Kwan, P, Brodie, MJ. Early identification of refractory epilepsy. N Engl J Med 2000;342:314–319Google Scholar
Mattson, RH, Cramer, JA, Collins, JF, et al. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic–clonic seizures. N Eng J Med 1985;313:145–151Google Scholar
Chen, Z, Brodie, MJ, Liew, D, et al. Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs: a 30-year longitudinal cohort study. JAMA Neurol 2018;75:279–286CrossRefGoogle ScholarPubMed
Tracy, JI, Dechant, V, Sperling, MR, et al. The association of mood with quality of life ratings in epilepsy. Neurology 2007;68:1101–1107Google Scholar

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