耐药性癫痫的治疗

Treatment of drug resistant epilepsy

大约有1/3的癫痫患者受到耐药性的影响。当使用两种适当的抗癫痫发作药物均无法控制患者的癫痫发作后,应尽可能将患者转诊至综合性癫痫中心进行重新评估和针对性治疗。对于有明确病因的癫痫患者,应进行针对癫痫病因的治疗;对于无明确病因的患者,应尽早考虑癫痫手术和其他治疗的可行性。大量研究证据表明,未及时进行正确的治疗可能对癫痫患者的临床结局产生不利影响,并增加认知障碍、其他合并症和过早死亡的风险。癫痫的耐药性机制和新药开发研究进展迅速,包括疾病修饰疗法在内的新型治疗方法前景可观。

It is estimated that approximately one-third of epilepsy patients are affected by drug resistance.After 2 appropriately used antiseizure medications have failed to control seizures,patients should be referred to a comprehensive epilepsy center for re-evaluation and targeted treatment whenever possible.Patients with a clear cause should receive treatment targeted at the cause of epilepsy;patients without a clear cause should consider the feasibility of epilepsy surgery and other treatments as early as possible.Substantial evidence shows that delaying the effective treatment may adversely affect the clinical outcomes and increase the risk of cognitive impairment,other comorbidities,and premature death.Research on the mechanisms of drug resistance and new drug development in epilepsy is progressing rapidly,and new treatment methods,including disease-modifying therapies,are promising.