RESUMEN
Fever-induced refractory epileptic encephalopathy of school-age children is a rare epileptic syndrome that causes difficulties in diagnosis at the initial stage of disease. It is characterized by sudden onset with multifocal refractory status epilepticus in previously healthy children with normal development. Later, children suffer from resistant focal epilepsy in the combination with cognitive deficit and behavioral difficulties. Authors describe a clinical case of fever-induced refractory epileptic encephalopathy of school-age children in a child of 7 years old. Aspects of etiology, pathogenesis, clinical manifestation, differential diagnosis, treatment and prognosis of the disease are discussed.
Asunto(s)
Fiebre/complicaciones , Estado Epiléptico/diagnóstico , Niño , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/fisiopatología , Diagnóstico Diferencial , Electroencefalografía , Fiebre/diagnóstico , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Estado Epiléptico/etiología , Estado Epiléptico/fisiopatologíaRESUMEN
A clinical trial included 30 children, aged from 24 to 46 months, stratified into two groups on the basis of clinical-instrumental data: 22 (73%) patients with symptomatic focal epilepsy and 8 (27%) patients with cryptogenic (possibly symptomatic) focal epilepsy. Topamax (topiramate) was used as mono- (8 children) and combined (22 children) therapy. Mean treatment dose was 5,9 mg/kg per day. Efficacy of treatment was evaluated by the changes in frequency of seizures. After 6 months, the positive result (completed stopping of seizures or their reduction by 50% and more) was seen in 19 (63,75%) patients. The effect was absent or was minimal in 9 (29,5%). In 2 (6,75%) cases the frequency of seizures increased. Adverse events were recorded in 11 (36%) patients, side-effects that led to the treatment discontinuation (vomiting, increasing of seizure frequency, enuresis) were found in 5 (16%) patients.
Asunto(s)
Anticonvulsivantes/uso terapéutico , Epilepsias Parciales/tratamiento farmacológico , Fructosa/análogos & derivados , Anticonvulsivantes/administración & dosificación , Preescolar , Femenino , Fructosa/administración & dosificación , Fructosa/uso terapéutico , Humanos , Lactante , Masculino , Topiramato , Resultado del TratamientoRESUMEN
An aim was to study the efficacy of different groups of antiepileptic drugs in the treatment of focal symptomatic (or probably symptomatic) epilepsy in children. The study included 96 patients, aged from 1 month to 17 years, 55 boys and 41 girls. They were stratified into three groups by drug type: group 1 (34 patients) was treated with phenobarbital, group 2 (31 patients) received topiramate and group 3 (31 patients) received lamotrigine. It has been shown that antiepileptic drugs of the new generation have higher efficacy with regard to focal forms of epilepsy in children compared to phenobarbital. However therapeutic effect, especially regarding seizure frequency, was specific for each drug.
