Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies
Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies
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DOI：
10.1111/j.1528-1167.2009.02397.x
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发表时间：
2010-06-01
期刊：
影响因子：
5.6
通讯作者：
French, Jacqueline
中科院分区：
文献类型：
--
作者：
Kwan, Patrick;Arzimanoglou, Alexis;French, Jacqueline
为了改善病人护理和促进临床研究，国际抗癫痫联盟（ILAE）任命了一个工作组来制定耐药性癫痫的共识定义。该定义的总体框架有两个“层次”：1级提供了一个一般方案，对每种治疗干预的反应进行分类，包括所需干预知识的最小数据集; 2级提供了耐药性癫痫的核心定义，使用了一组基于抗癫痫药物试验反应分类（从1级开始）的基本标准。作为一个可检验的假设，耐药性癫痫定义为两种耐受的、适当选择和使用的抗癫痫药物方案（无论是单药治疗还是联合治疗）的充分试验失败，无法实现持续的癫痫发作自由。当出现新的证据时，可以进一步完善这一定义。背后的定义和管理其正确使用的原则进行了讨论，并举例说明其在临床实践中的应用。
P>To improve patient care and facilitate clinical research, the International League Against Epilepsy (ILAE) appointed a Task Force to formulate a consensus definition of drug resistant epilepsy. The overall framework of the definition has two "hierarchical" levels: Level 1 provides a general scheme to categorize response to each therapeutic intervention, including a minimum dataset of knowledge about the intervention that would be needed; Level 2 provides a core definition of drug resistant epilepsy using a set of essential criteria based on the categorization of response (from Level 1) to trials of antiepileptic drugs. It is proposed as a testable hypothesis that drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom. This definition can be further refined when new evidence emerges. The rationale behind the definition and the principles governing its proper use are discussed, and examples to illustrate its application in clinical practice are provided.