Introduction to Refractory Epilepsies

The therapeutic applications of Δ9-THC are limited, whereas cannabidiol (CBD), another phytocannabinoid, induces antiepileptic effects in experimental animals and in patients with refractory epilepsies.

They account for a significant proportion of the refractory epilepsies and are usually associated with poor outcome.

The obtained data suggest that food allergy may play a role in triggering refractory epilepsies and their adequate response to treatment.

To assess the long‐term efficacy and tolerability of stiripentol (STP) as an adjunctive treatment in different forms of refractory epilepsies.

Especially during the pre-surgical work-up of children with pharmaco-refractory epilepsies, however, diagnosing homonymous visual field defects (HVFDs) can be crucial for planning surgical strategies.

Genetic malformations of cortical development (MCDs), such as mild MCDs (mMCD), focal cortical dysplasia (FCD), and hemimegalencephaly (HME), are major causes of severe pediatric refractory epilepsies subjected to neurosurgery.

Thus, 68-70 were promising candidates for developing into anti-epileptic drugs, especially for treatment of refractory epilepsies such as Dravet syndrome.

Its role in the treatment of other refractory epilepsies requires further study.

Although tackling epilepsy's seizure-prone feature, by tonically modifying overall circuit excitability and/or connectivity, the last 50 years of drug development has not seen a substantial improvement in seizure suppression of refractory epilepsies.

BACKGROUND Mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy (MOGHE) is a newly described, rare histopathologic entity detected in resected brain tissue of patients with refractory epilepsies.

Effectiveness and tolerability of perampanel in children and adolescents with refractory epilepsies: first experiences.

Most previous studies in stereotactic-EEG have been directed toward temporal lobe epilepsy, which does not represent the whole spectrum of drug-refractory epilepsies.

Malformations of cortical development (MCDs) are an important cause of treatment refractory epilepsies.

Although baseline variables differed considerably, with most elderly patients with tumor-related and vascular etiologies in the mono group and most patients with refractory epilepsies with pronounced use of concomitant sodium channel blockers (SCBs) in the ≥2+ group, retention as a measure of real-life effectiveness turned out not to be substantially different and favorable in all groups.

Topiramate is a cheap, easily administrable, broad spectrum anti-epileptic, with multiple mechanisms of action and proven efficacy in many refractory epilepsies.

An elevated suspicion of sleep disorders in epileptic patients is needed to perform an adequate diagnosis and treatment, in order to achieve a better seizures control, especially in refractory epilepsies.

Vagus nerve stimulation (VNS) is a neuromodulation therapy, approved in Europe (1994), USA (1997) and Brazil (2000) as adjunctive for treatment for refractory epilepsies, which an electrical stimulus is applied in the cervical vagus nerve.

In a randomized, double-blind placebo-controlled cross-over design, we tried to demonstrate the efficacy of a mixture of Nigella sativa and Thymus vulgaris extracts (Epistop) on seizures in a group of children with refractory epilepsies.

Methods: To this end, we analyzed 820 seizures from 252 consecutive patients explored by stereoelectroencephalography (total of 2148 electrodes), including various forms of focal refractory epilepsies.

Our approach demonstrates that two-stage phenotype-based screening in a zebrafish model of DS successfully identifies synthetic cannabinoids with anti-seizure activity, and supports further investigation of SCs for refractory epilepsies.