Management of Adult Onset Seizures
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- 作者：Amy Z. Crepeau ; MD ; Crepeau.amy@Mayo.edu ; Joseph I. Sirven ; MD
- 关键词：AED ; antiepileptic drug ; ATL ; anterior temporal lobectomy ; CBD ; cannabidiol ; DBS ; deep brain stimulation ; ECoG ; electrocorticography ; FDA ; Food and Drug Administration ; GABA ; γ-aminobutyric acid ; LiTT ; laser interstitial thermal therapy ; MRI ; magnetic resonance imaging ; NMDA ; N-methyl-d-aspartate ; RNS ; responsive neurostimulation
- 刊名：Mayo Clinic Proceedings
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：92
- 期：2
- 页码：306-318
- 全文大小：423 K
- 卷排序：92
文摘
Epilepsy is a common yet heterogeneous disease. As a result, management often requires complex decision making. The ultimate goal of seizure management is for the patient to have no seizures and no considerable adverse effects from the treatment. Antiepileptic drugs are the mainstay of therapy, with more than 20 medications currently approved in the United States. Antiepileptic drug selection requires an understanding of the patient's epilepsy, along with consideration of comorbidities and potential for adverse events. After a patient has failed at least 2 appropriate antiepileptic drugs, they are determined to be medically refractory. At this time, additional therapy, including dietary, device, or surgical treatments, need to be considered, typically at a certified epilepsy center. All these treatments require consideration of the potential for seizure freedom, balanced against potential adverse effects, and can have a positive effect on seizure control and quality of life. This review article discussed the treatment options available for adults with epilepsy, including medical, surgical, dietary, and device therapies.