What is considered refractory epilepsy?

What is considered refractory epilepsy?

Refractory epilepsy occurs when your antiepilepsy medicines are no longer controlling your seizures. Often the cause of refractory epilepsy is not known. Your healthcare provider will likely give you other medicines to try to get your seizures under control.

How do you manage refractory epilepsy?

Managing refractory epilepsy A special diet called a ketogenic diet may help control your seizures. This type of diet is high in fats and low in carbohydrates. If you follow this diet, you will need to work closely with your doctor and take supplements of certain nutrients as needed.

How is refractory status epilepticus treated?

Management of refractory status epilepticus involves treatment of an underlying etiology in addition to intravenous anesthetics and antiepileptic drugs. Alternative treatment options including diet therapies, electroconvulsive therapy, and surgical resection in case of a focal lesion should be considered.

How many people have refractory epilepsy in the US?

This condition is also referred to as intractable, medically refractory, or pharmacoresistant epilepsy. As many as 20 to 40 percent of patients with epilepsy (roughly 400,000 people living in the United States) are likely to have refractory epilepsy.

Does epilepsy shorten life expectancy?

Reduction in life expectancy can be up to 2 years for people with a diagnosis of idiopathic/cryptogenic epilepsy, and the reduction can be up to 10 years in people with symptomatic epilepsy. Reductions in life expectancy are highest at the time of diagnosis and diminish with time.

What are the causes of refractory epilepsy?

Alternative causes include noncompliance, seizures that are not epileptic, misdiagnosis of the seizure type or epilepsy syndrome, inappropriate use of medications such as inadequate doses or drug-drug interactions, and lifestyle issues such as alcohol binging, drug abuse, stress, and sleep deprivation.

What is new in refractory status epilepticus?

New-onset refractory status epilepticus (NORSE) is defined as a condition, not a specific diagnosis, with new onset of refractory status epilepticus without a clear acute or active structural, toxic or metabolic cause in a patient without active epilepsy.

What medication has been effective in treating status epilepticus that is refractory to phenobarbital?

Lorazepam is the most commonly used agent, used at a dose of 0.1 mg/kg given in dose of 2 mg/min to a maximum of 8 mg. Lorazepam was shown to be successful in 64.9% patients as the first line compared to 58.2% success with phenobarbital and 55.8 % with Diazepam plus Phenytoin.

Which drug is effective against refractory epilepsy?

Many drugs can treat epilepsy, including: Brivaracetam (Briviact) Cannabidiol (Epidiolex) Carbamazepine (Carbatrol, Tegretol)

Can I get disability for epilepsy?

The Social Security Administration considers epilepsy to be a qualifying condition for disability benefits. This means that if you’ve been diagnosed with epilepsy and are unable to work for an extended period of time, you have a high chance of being granted benefits.

Can refractory epilepsy be cured?

Even though you have refractory epilepsy, it’s still possible to get your seizures under control. It may be a matter of switching to a different treatment. Your doctor may find a different drug combination that helps.

Is favorable outcome possible after prolonged refractory status epilepticus?

In many series, prolonged, refractory SE has a mortality of 30% to 50%, and several studies indicate that most survivors have a substantial decline in functional status. Nevertheless, several reports demonstrate that good functional outcome is possible even after several days of SE and coma induction.

What drug do you give for status epilepticus?

BENZODIAZEPINES. The benzodiazepines are some of the most effective drugs in the treatment of acute seizures and status epilepticus. The benzodiazepines most commonly used to treat status epilepticus are diazepam (Valium), lorazepam (Ativan), and midazolam (Versed).

What is the preferred drug for status epilepticus?

Diazepam. Diazepam is one of the drugs of choice for first-line management of status epilepticus.