Drug-resistant epilepsy at the age extremes: Disentangling the underlying etiology.
Epilepsy Behav
; 132: 108739, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35636351
ABSTRACT
The incidence of epilepsy is highest at the extreme age ranges childhood and elderly age. The most common syndromes in these demographics - self-limited epilepsies of childhood and idiopathic generalized epilepsies in pediatric age, focal epilepsy with structural etiology in older people - are expected to be drug responsive. In this work, we focus on such epilepsy types, overviewing the complex clinical background of unexpected drug-resistance. For self-limited epilepsies of childhood and idiopathic generalized epilepsies, we illustrate drug-resistance resulting from syndrome misinterpretation, reason on possible unexpected courses of epilepsy, and explicate the influence of inappropriate treatments. For elderly-onset epilepsy, we show the challenges in differential diagnosis possibly leading to pseudoresistance and analyze how drug-resistant epilepsy can arise in stroke, neurocognitive disorders, brain tumors, and autoimmune encephalitis. In children and senior people, drug-resistance can be regarded as a hint to review the diagnosis or explore alternative therapeutic strategies. Refractory seizures are not only a therapeutic challenge, but also a cardinal sign not to be overlooked in syndromes commonly deemed to be drug-responsive.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Epilepsias Parciais
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Epilepsia Generalizada
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Epilepsia
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Epilepsia Resistente a Medicamentos
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
Limite:
Aged
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Child
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Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article