Refractory epilepsy: drug treatments

Evidence-based neurology checklist on refractory epilepsy: drug treatments: Indications for aggressive treatment Major disabling seizures High risk of injury or death Seizures with stigmatising behaviour: incontinence or disrobing Significant post-ictal symptoms: cognitive, psychiatric, fatigue,…

Indications for aggressive treatment

  • Major disabling seizures
  • High risk of injury or death
  • Seizures with stigmatising behaviour: incontinence or disrobing
  • Significant post-ictal symptoms: cognitive, psychiatric, fatigue, or sleepiness
  • Progressive syndromes
  • Surgically remediable cause

Treatments of resistant adult focal epilepsy (TRAFE)

Treatments of resistant childhood focal epilepsy (TRCFE)

Treatment of other forms of refractory epilepsy (Level B evidence)

Treatments considerations to minimise side effects

Treatment considerations for severe symptomatic cases

Treatment considerations for primary generalised epilepsy

Treatments considerations for partial onset epilepsy

Other treatment considerations

Synonyms

References

  1. Beleza P. Refractory epilepsy: a clinically oriented review. Eur Neurol 2009; 62: 65-71.
  2. Krauss GL, Sperling MR. Treating patients with medically resistant epilepsy. Neurol Clin Pract 2011; 1: 14-22.
  3. Kanner AM, Ashman E, Gloss D, et al. Practice guideline update summary: efficacy and tolerability of the new antiepileptic drugs II: Treatment-resistant epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2018; 91:82-90. 
  4. Hu Q, Zhang F, Teng W, Hao F, Zhang J, Yin M, Wang N. Efficacy and safety of antiepileptic drugs for refractory partial-onset epilepsy: a network meta-analysis. J Neurol 2018; 265:1-11. 
  5. Tang V, Poon WS, Kwan P. Mindfulness-based therapy for drug-resistant epilepsy: an assessor-blinded randomized trial. Neurology 2015; 85:1100-1107.
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