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Are We Too Pessimistic About Drug-Resistant Epilepsy?

机译：我们对耐药性癫痫病是否过于悲观？

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摘要

Drug-resistant epilepsy has been defined by an International League Against Epilepsy (ILAE) task force as failure of two tolerated, appropriately chosen and used antiepileptic medications to achieve sustained seizure freedom (1). How well does this definition predict long-term medical intractability, and can it be used for clinical decisions, such as determining candidacy for epilepsy surgery? Although a number of authors have suggested a variable but often low chance of achieving seizure control without surgery in drug-resistant epilepsy, all these studies have different limitations, such as use of other definitions of drug-resistant epilepsy, retrospective design, use of hospital-based referral populations, or inadequate follow-up for demonstration of sustained epilepsy remission (2-7). In the current study, Sillanpaa and Schmidt address these concerns with a prospective, population-based investigation over decades, of outcomes to medical treatment without surgery, after new onset of drug resistance.
机译：国际抗癫痫联盟（ILAE）工作队将抗药性癫痫定义为两种可耐受，经过适当选择和使用的抗癫痫药未能实现持续的癫痫发作自由（1）。此定义能否很好地预测长期的医学难治性，并且可以用于临床决策，例如确定癫痫手术的候选资格？尽管许多作者建议在耐药性癫痫中无需手术即可控制癫痫发作的机会可变，但通常发生率较低，但所有这些研究都有不同的局限性，例如使用耐药性癫痫的其他定义，回顾性设计，医院的使用推荐人群或随访不足以证明持续性癫痫缓解（2-7）。在当前的研究中，西兰帕（Sillanpaa）和施密特（Schmidt）通过对人群进行前瞻性，数十年来的调查来解决这些问题，这些调查是在新的耐药性出现后无需手术即可获得药物治疗的结果。

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