Document Detail


[Refractory epilepsy: use of the new definition and related risk factors. A study in the Mexican population of a third-level centre].
MedLine Citation:
PMID:  22278892     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The International League against Epilepsy (ILAE) has recently proposed a consensus to define refractory epilepsy.
PATIENTS AND METHODS: A retrospective, analytical, descriptive study was conducted involving 206 patients who were attended at the epilepsy clinic of a third-level centre in Mexico. The ILAE's new definition of pharmacoresistance was used to classify the patients. The frequency and risk factors involved in the refractoriness were reported. The tendency to prescribe antiepileptic drugs (AED) in this population was analysed using secondary data.
RESULTS: Of the 206 patients analysed, 57 (28%) were free of seizures, 115 (56%) continued to have seizures, 17 (8%) were classified as undetermined and 17 (8%) were pseudo-refractory. The statistically significant factors associated to pharmaco-resistance that were found in our population were: focal versus generalised epilepsy (p = 0.02), catamenial epilepsy (p = 0.02), abnormal psychomotor development (p = 0.02), history of epilepsy in the family (p = 0.025), neurological examination with focal abnormality (p = 0.04), perinatal hypoxia (p = 0.06) and prior psychiatric illness (p = 0.03). The mostly frequently AED used in mono- and polytherapy were valproate and carbamazepine. Of all the patients who were free of seizures, 47% were treated using monotherapy.
CONCLUSIONS: The frequency of pharmacoresistance in the population analysed was estimated to be 56%. Identification of the factors associated with pharmacoresistance makes it possible to consider surgical treatment or to optimise the treatment with AED. There is a tendency to use the new AED, above all in combination therapy. Our findings are consistent with those described in the literature.
Authors:
Iris E Martínez-Juárez; Rosario López-Zapata; Bety Gómez-Arias; Erandi Bravo-Armenta; Liliana Romero-Ocampo; Zuleika Estévez-Cruz; Griega Hernández-De la Cruz; Saulo Morán-Molina
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Revista de neurologia     Volume:  54     ISSN:  1576-6578     ISO Abbreviation:  Rev Neurol     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-26     Completed Date:  2012-05-25     Revised Date:  2012-08-31    
Medline Journal Info:
Nlm Unique ID:  7706841     Medline TA:  Rev Neurol     Country:  Spain    
Other Details:
Languages:  spa     Pagination:  159-66     Citation Subset:  IM    
Affiliation:
Instituto de Neurologia y Neurocirugia de Mexico, DF Mexico. imartinez@innn.edu.mx
Vernacular Title:
Epilepsia farmacorresistente: uso de la nueva definición y factores de riesgo relacionados. Estudio en poblacion mexicana de un centro de tercer nivel.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anticonvulsants / therapeutic use
Drug Resistance / physiology*
Epilepsy / diagnosis*,  drug therapy,  physiopathology*
Female
Humans
Male
Mexico
Middle Aged
Outpatient Clinics, Hospital*
Retrospective Studies
Risk Factors
Young Adult
Chemical
Reg. No./Substance:
0/Anticonvulsants
Comments/Corrections
Comment In:
Rev Neurol. 2012 Jul 16;55(2):128   [PMID:  22760776 ]

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