摘要为提高医疗质量、促进临床研究,国际抗癫痫联盟(International League Against Epilepsy,ILAE)专项小组达成了对耐药性癫痫的统一定义.此定义包含2个层面的意义:(1)抗癫痫药物的疗效分类;(2)耐药性癫痫的核心定义为:2种正确选择、可耐受的抗癫痫药物经足够疗程及剂量的单药或联合用药仍未能控制发作的癫痫.
1Perucca E.Pharmacoresistance in epilepsy.How should it be defined? CNS Drugs,1998,10:171-179.
2Tanganelli P,Regesta G.Clinical aspects and biological bases of drug-resistant epilepsy.Epilepsy Res,1999,34:109-122.
3Berg AT,Vickrey BG,Testa FM,et al.How long does it take for epilepsy to become intractable? A prospective investigation.Ann Neurol,2006,60:73-79.
4Kwan P,Brodie MJ.Issues of medical intractability for surgicalcandidacy//Wyllie E.The treatment of epilepsy:principles and Practice.4th ed.Philadelphia:Lippincott Williams & Wilkins,2006:983-991.
5Arzimanoglou A,Ryvlin P.Towards a clinically meaningful definition of drug-resistance//Kahane P,Berg A,L(o)scher W,et al.Progress in Epileptic Disorder.Vol.7.Drug-resiatant eplilepsies.Montrouge:John Libbey Eurotext,2008:1-6.
7World Health Organization.Collaborating Centre for Drug Statistics Methodology.About the ATC/DDD system.Accessed December 1,2008 at http://www.whocc.no/atcddd/.
8Perucca E,Dulac O,Shorvon S,et al.Harnessing the clinical potential of antiepileptic drug therapy:dosage optimisation.CNS Drugs,2001,15:609-621.
9Sillanp(a)(a) M,Haataja L,Shinnar S.Perceived impact of childhood-onset epilepsy on quality of life as an adult.Epitepsia,2004,45:971-977.
10Vickrey BG,Hays RD,Bausch R,et al.Outcomes in 248 patients who had diagnostic evaluations for epilepsy surgery.Lancet,1995,346:1445-1449.
4Thompson PJ, Dunean JS. Cognitive decline in severe in- tractable epilepsy[ J ]. Epilepsia, 2005,46 (11 ):2780.
5Wolfgang L. How to explain muhidrug resistance in epilepsy [ J ]. Epilepsy Curt, 2005,5 (3) : 107.
6Viteri C, Iriarte J, Schlumberger E, et al. Surgical treat- ment of epilepsies : criteria for the selection of patients and results [J]. Revista de Neurologia, 2000,30(1) :s141.
7Carbrao MN, Quigg M, Broshek DK, et al. A multicenter prospective pilot study of gamma knife radiosurgery for mesial tem-poral lobe epilepsy: seizure response adverse events and rbal memory[ J ]. Ann Neuro1,2009,65 (2) : 167.
8Benifla M, Rutka, Jame T, et al. Vagal nerve stimulationfor refractory epilepsy in children: indications and experience atThe Hospital for Sick Children[ J]. Childs Nervous System, 2006, 22(8) :1018.
9You S J, Kang HC, Kim HD, et al. Vagus nerve in intracta-ble childhood epilepsy: a Korean multicenter experience [ J ]. J Korean Med Sci, 2007,22(3) :442.
10Kwan P, Brodie MJ. Early identification of refractory epi- lepsy[J]. N Engl J Med, 2000,342(5) :314.