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J Korean Neurol Assoc. 2002;20(5):443-452.
- Management of Refractory Epilepsy
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Byung In Lee
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Department of Neurology College of Medicine, Yonsei University
- 난치성 간질의 치료
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연세의대 신경과학교실
- Abstract
- "Management of drug resistant epilepsy (DRE) requires a systematic approach consisting of (1) investigation of poten-tial
causes of DRE, (2) determination of the degree of DRE on the basis of previous drug therapy, (3) rational pharma-cotherapy
consisting of both monotherapy and combination therapy, and (4) referral to surgery or other alternative ther-apy.
The scheme of rational pharmacotherapy consists of (1) first drug monotherapy (2) second drug monotherapy, (3)
two drug combination therapy, (4) triple drug combination therapy, and (5) addition of second-line drug. With the intro-duction
of many new antiepileptic drugs (AEDs) having different mechanisms of action, the combination therapy has
become more effective and safer, which made the use of triple drug combination therapy feasible in practice if it
includes at least one new AED. It should be acknowleged that the rational combination therapy may achieve a seizure
free outcome in a significant proportion of patients with less severe DRE. For patients with surgically remediable
epileptic syndromes, a systematic trial of two to three drugs may suffice an earlier referral to surgery.Key words : Drug-resistant epilepsy (DRE), Monotherapy, Combination therapy, Surgically remediable epileptic syn-dromes"
Keywords :
- 초록
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