Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl

PL EN


Preferences help
enabled [disable] Abstract
Number of results
2015 | 23 | 1 | 39-44

Article title

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

Content

Title variants

Languages of publication

EN

Abstracts

EN
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.

Publisher

Year

Volume

23

Issue

1

Pages

39-44

Physical description

Dates

published
1 - 6 - 2015
online
16 - 5 - 2015
accepted
19 - 3 - 2015
received
25 - 1 - 2015

Contributors

  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
author
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
author
  • Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
author
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  • Centre for Cognitive Neuroscience, Salzburg, Austria
author
  • Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
  • Department of Neurology, Medical University Innsbruck, Innsbruck, Austria

References

  • Berg A.T., Shinnar S., Levy S.R., Testa F.M., Smith-Rapaport S., Beckerman B.:Early development of intractable epilepsy in children: a prospective study. Neurology, 2001, 56: 1445–1452.
  • Berg A.T., Vickrey B.G., Langfitt J.T., Sperling M.R., Walczak T.S., Shinnar S. et al.:The Multicenter Epilepsy Surgery Study: recruitment and selection for surgery. Epilepsia, 2003, 44: 1425–1433.
  • Berg A.T., Kelly M.:Defining Intractability: Comparison among published definitions. Epilepsia, 2006, 47: 431–436.
  • Callaghan B.C., Anand K., Hesdorffer D., Hauser W.A., French J.A.:Likelihood of seizure remission in an adult population with refractory epilepsy. Ann. Neurol., 2007, 62: 382–389.[WoS]
  • Camfield P., Camfield C.:Nova Scotia pediatric epilepsy study. In: P. Jallon, A. Berg, O. Dulac, A. Hauser (Eds.), Prognosis of Epilepsies. John Libbey, Eurotext, Montrouge 2003, 113–126.
  • Engel J.Jr., Wiebe S., French J., Sperling M., Williamson P., Spencer D. et al.:Practice parameter: Temporal lobe and localized neocortical resections for epilepsy. Neurology, 2003, 60: 538–547.
  • Engel J.Jr., McDermott M.P., Wiebe S., Langfitt J.T., Stern J.M., Dewar S. et al.:Early Randomized Surgical Epilepsy Trial (ERSET) Study Group. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. JAMA, 2012, 307: 922–930.
  • José F., Téllez-Zenteno J.F., Dhar R., Wiebe S.:Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis. Brain, 2005, 128: 1188–1198.
  • Kwan P., Arzimanoglou A., Berg A.T., Brodie M.J., Allen Hauser W., Methern G. et al.:Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia, 2010, 51: 1069–1077.[WoS]
  • Langfitt J.T., Wiebe S.:Early surgical treatment for epilepsy. Curr. Opin. Neurol., 2008, 21: 179–183.[WoS]
  • Liimatainen S.P., Raitanen J.A., Ylinen A.M., Peltola M.A., Peltola J.T.:The benefit of active drug trials is dependent on aetiology in refractory focal epilepsy. J. Neurol. Neurosurg. Psychiatry, 2008, 79: 808–812.[WoS]
  • Mohanraj R., Brodie M.J.:Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur. J. Neurol., 2006, 13: 277–282.
  • Neligan A., Bell G.S., Elsayed M., Sander J.W., Shorvon S.D.:Treatment changes in a cohort of people with apparently drug-resistant epilepsy: an extended follow-up. J. Neurol. Neurosurg. Psychiatry, 2012, 83: 810–813.[WoS]
  • Sperling M.R., O’Connor M.J., Saykin A.J., Plummer C.:Temporal lobectomy for refractory epilepsy. JAMA, 1996, 276: 470–475.
  • Trinka E., Martin F., Luef G., Unterberger I., Bauer G.:Chronic epilepsy with complex partial seizures is not always medically intractable. Acta Neurol. Scand., 2001, 103: 219–225.
  • Wiebe S., Blume W.T., Girvin J.P., Eliasziw M.:Effectiveness and Efficiency of Surgery for Temporal Lobe Epilepsy Study Group. A randomized, controlled trial of surgery for temporallobe epilepsy. NEJM, 2001, 345: 311–318.

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_1515_joepi-2015-0025
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.