Identifikace dětských pacientů s farmakorezistentní epilepsií a výběr kandidátů nefarmakologické terapie

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Title in English Identification of pediatric patients with pharmacoresistant epilepsy and selection of candidates of non-pharmacological therapy
Authors

HANÁKOVÁ Petra HORÁK Ondřej RYZÍ Michal OŠLEJŠKOVÁ Hana

Year of publication 2018
Type Article in Periodical
Magazine / Source Česká a slovenská neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.14735/amcsnn2018180
Keywords pharmacoresistant epilepsy; refractory epilepsy; epilepsy surgery; ketogenic diet; vagus nerve stimulation
Description Aim: The aim of the study was to perform an audit of pediatric patients with pharmacoresistant epilepsy who were observed on a long-term basis at our department and to select candidates who are potentially eligible for non-pharmacological therapy (epileptosurgery, ketogenic diet or its modification). Methods: This is a retrospective study evaluating medical records of 129 patients (aged 0-19 years) with refractory epilepsy examined at the Department of Pediatric Neurology from January 2014 to January 2015. Based on the type of seizures, epilepsy, etiology, MRI and brain PET findings, physicians recommended an educational interview concerning non-medication therapy or indicated that anti-epileptic drugs shall be continued. In the second group of patients, the reason why non-pharmacological therapy is not appropriate was given. Mathematical data analysis was performed. Results: Out of 129 refractory patients, 47 (36.4%) were indicated for the educational interview by at least one physician and 39 (30.2%) patients were indicated by two physicians. Out of 39 children, resection was considered in 15 patients, a disconnection procedure in 1, vagus nerve stimulation implantation in 31 and ketogenic diet in 26 patients. In 82 children (63.6%), the interview was not indicated. Conclusion: Patients with pharmacoresistant epilepsy who have seizures were identified at our department and eligible candidates were directed to an educational interview concerning non-pharmacological therapy. The study is to be followed with a prospective part where a specific therapeutic procedure will be implemented.
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