CLINICAL AND SURGICAL APPROACH TO EPILEPSY REFRACTORY
CLINICAL

Palavras-chave

Epilepsy, Refractory; Neurology; Neurostimulation.

Como Citar

Pedro do Valle Varela, J. ., Nasser Pauferro, L. ., Silva Santa Clara, N. ., Vitor Amorim Barbosa, J. ., Castello Agrizzi, L. ., Giselle Batt, J. ., Silva de Carvalho, J. ., Lobato Ferreira, J. ., Fairana Godeline Essali, G., & Luiz Teixeira Fully, F. . (2024). CLINICAL AND SURGICAL APPROACH TO EPILEPSY REFRACTORY. Health and Society, 4(02), 243–252. https://doi.org/10.51249/hs.v4i02.2023

Resumo

Refractory epilepsy is characterized by the persistence of epileptic seizures even after adequate use of at least two antiepileptic drugs. This condition represents a significant challenge in the treatment of epilepsy, requiring a more assertive clinical and, in some cases, surgical approach. This study aims to review and explore the clinical and surgical approach to refractory epilepsy, highlighting the available treatment options, indications, benefits and challenges faced by patients and health professionals. This is a bibliographic review, using qualitative premises, with the PubMed, Scopus, Web of Science and Scielo databases. To better refine the research, the health descriptors “epilepsy”, “surgical treatment”, “neurostimulation” and “refractory epilepsy” were used. The clinical approach to refractory epilepsy involves careful assessment of the patient, including a detailed clinical history, complete physical examination and complementary tests such as electroencephalogram (EEG), magnetic resonance imaging (MRI) and computed tomography (CT) of the brain. The aim is to identify the origin of the epileptic seizures and determine the best therapeutic strategy. Clinical treatment usually involves optimizing drug therapy, with adjustments to the doses of existing drugs or the introduction of new drugs. However, in many cases, the response to drug treatment is unsatisfactory, leading to consideration of surgical options. Surgery for refractory epilepsy can include removing the brain tissue responsible for epileptic seizures (temporal lobectomy, focal resection, etc.), deep brain stimulation or other less invasive techniques. These procedures aim to reduce the frequency and severity of epileptic seizures, improving the patient’s quality of life. The approach to refractory epilepsy requires a multidisciplinary and individualized assessment, taking into account the clinical characteristics and specific needs of each patient. Although clinical treatment is the first line of approach, surgery can be a viable option for those who do not respond adequately to antiepileptic drugs. It is essential that patients with refractory epilepsy are referred to specialized centers for a complete and appropriate evaluation of their case.

https://doi.org/10.51249/hs.v4i02.2023
CLINICAL

Referências

GARRIGA-CANUT M, SCHENIKE B, QAZI R, at al. 2-Deoxy-D-glucose reduces epilepsy progression by NRSF-CtBP-dependent metabolic regulation of chromatin structure. Nature Neuroscience. 2006; 9:1382-7.

VIEIRA JR J. Tratamento cirúrgico da epilepsia do lobo temporal. In: Cukiert A, ed. Tratamento clínico e cirúrgico das epilepsias de difícil controle. Lemos Editorial: São Paulo; 2002. p. 269-92.

RHODES ME, TALLURI J, HARNEY JP, FRYE CA, Ketogenic diet decreases circulating concentrations of neuroactive steroids of female rats. Epilepsy e Behavior. 2005; 7:231-39.

DA COSTA JC. Epilepsias refratárias da infância indicação cirúrgica. In: Fonseca LF, Pianetti G, Castro Xavier C, editores. Compêndio de neurologia infantil. Rio de Janeiro: Medsi Editora Médica e Científica; 2002. Cap. 24. p. 359-71.

WHELESS JW. Nonpharmacologic treatment of the catastrophic epilepsies of childhood. Epilepsia. 2004;45(Suppl 5):17-22.

THIELE EA. Managing epilepsy in tuberous sclerosis complex. J Child Neurol. 2004;19(9):680-6.

GUENOT, M. Surgical Treatment of epilepsy: outcome of various surgical procedures in adults and children. Rev Neurol (Paris). 2004 Jun;160(Spec 1):S241-50.

HAMIWKA L, JAYAKAR P, RESNICK T, et al. Surgery for epilepsy due to cortical malformations: ten-year follow-up. Epilepsia. 2005; 46(4):556-60.

TERRA-BUSTAMANTE VC, FERNANDES RM, INUZUCA LM, et al. Surgically amenable epilepsies in children and adolescents: clinical, imaging, electrophysiological, and post-surgical outcome data. Childs Nerv Syst. 2005 May 19; [Epub ahead of print].

CATALTEPE O, TURANLI G, YALNIZOGLU D, et al. Surgical management of temporal lobe tumor-related epilepsy in children. J Neurosurg. 2005;102(3 Suppl):280-7.

SINCLAIR DB, ARONYK K, SNYDER T, et al. Extratemporal resection for childhood epilepsy. Pediatr Neurol. 2004;30(3):177-85.

Creative Commons License
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.

Copyright (c) 2024 João Pedro do Valle Varela, Leonardo Basser Pauferro, Nicolly Silva Santa Clara, João Vitor Amorim Barbosa, Lucas Castello Agrizzi, Jennifer Giselle Batt, José Silva de Carvalho, Juliana Lobato Ferreira, Genese Fairana Godeline Essali, Fabio Luiz Teixeira Fully

Downloads

Não há dados estatísticos.

Métricas

Carregando Métricas ...