Epilepsy is one of the most common diseases of the nervous system: its frequency in the general population is 0.5-1%.
Basic Principles of Intractable Epilepsy Treatment
- improvement of the quality of life as the main criterion;
- systems concept;
- maximum individualization of treatment;
- stage therapy;
- management of patients.
In 2010, the International Epileptic League Commission (ILAE) suggested a working hypothesis that epilepsy is considered intractable childhood epilepsy if seizure control is not achieved with the adequate use of 2 correctly selected and well-tolerated antiepileptic drugs (AEDs) in mono or combination therapy.
The degree of improvement in the epilepsy course in children involves 3 options:
- moderate improvement – the reduction of epileptic seizures to 50%;
- improvement – the reduction to 50-75%;
- significant improvement – the reduction of more than 75%, with the implication of obtaining control over seizures. According to accepted international standards, an improvement is statistically significant when seizures are reduced by 50% or more from their original rate.
Prognosis for Epilepsy
The prognosis for epilepsy is dependent on the frequency of seizures. At the stage of remission, when the seizures occur not so often and predominantly at night, the patient’s ability to work remains. Daytime seizures of epilepsy, accompanied by loss of consciousness, limit the patient’s ability. Children suffer the most when coming across with ICE epilepsy. They should adjust to life with the diagnosis “Intractable Childhood Epilepsy”.
Epilepsy affects all aspects of the patient’s life, therefore, it is a significant medical and social problem. One of the spheres of lives is the lack of knowledge about intractable epilepsy and the associated stigmatization of patients whose judgments about the frequency and severity of mental disorders are often unreasonable. The vast majority of patients receiving the appropriate treatment, keep a normal lifestyle without attacks.
Prevention of epilepsy involves the possible prevention of traumatic brain injuries, intoxications and infectious diseases, prevention of possible marriages between epileptic patients, adequate temperature reduction in children to prevent fever, the consequence of which may be epilepsy.