Document Detail

Can we predict refractory epilepsy at the time of diagnosis?
MedLine Citation:
PMID:  16120488     Owner:  NLM     Status:  MEDLINE    
The early prediction of intractability is a major challenge in epileptology. Some prognostic factors have been pointed out, most of which simply underlined that partial epilepsy is more difficult to control than idiopathic generalized epilepsy (IGE). Indeed, the main predictors are the presence of a brain lesion demonstrated by neuroimaging or suggested by a neurological deficit or a developmental delay, as well as electroclinical evidence of non idiopathic partial epilepsy. Little is known about the relationship between the location of the epileptogenic area and the chance of being seizure-free in patients with partial epilepsy. Some data suggest that temporal lobe epilepsy (TLE) is more difficult to control than other partial epilepsies, but this might only reflect the prognostic impact of hippocampal sclerosis. Indeed, several studies have shown that the majority of patients with MRI evidence of hippocampal sclerosis develop refractory epilepsy. This observation also applies to patients with malformation of cortical development (MCD). The response to the first AED is another early predictor of refractory epilepsy. At the time of diagnosis, several prognostic factors are available to predict drug resistance, but further studies are still needed to better delineate the specific role of each of these factors, and to offer a more accurate prediction of long term seizure outcome.
Franck Semah; Philippe Ryvlin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Epileptic disorders : international epilepsy journal with videotape     Volume:  7 Suppl 1     ISSN:  1294-9361     ISO Abbreviation:  Epileptic Disord     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-25     Completed Date:  2007-05-17     Revised Date:  2008-09-16    
Medline Journal Info:
Nlm Unique ID:  100891853     Medline TA:  Epileptic Disord     Country:  France    
Other Details:
Languages:  eng     Pagination:  S10-3     Citation Subset:  IM    
Service Hospitalier F. Joliot, CEA, Orsay.
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MeSH Terms
Drug Resistance
Epilepsy / diagnosis*,  genetics,  pathology*,  therapy
Hippocampus / pathology*
Magnetic Resonance Imaging
Temporal Lobe / pathology
Erratum In:
Epileptic Disord. 2008 Jun;10(2):191

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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