Epilepsia Refratária

Conceito e Contribuição das Novas Drogas Antiepilépticas e de outras Modalidades Terapêuticas

Autores

  • Eliana Garzon Doutora em Neurologia. Médica da Unidade de Pesquisa e Tratamento das Epilepsias (UNIPETE) da Escola Paulista de Medicina – UNIFESP.

DOI:

https://doi.org/10.34024/rnc.2002.v10.8897

Palavras-chave:

Epilepsia refratária, novas drogas antiepilépticas, dieta cetogênica, estimulador do nervo vago

Resumo

O tratamento farmacológico para as epilepsias em geral produz o controle absoluto das crises epilépticas em apenas uma parcela de pacientes. Dependendo da etiologia e da síndrome, entre 35% e 75% destas, a despeito do tratamento clínico, continuam a apresentar as crises epilépticas. Neste artigo abordamos as definições de intratabilidade assim como outras opções de tratamento clínico, discutindo as principais indicações e efeitos colaterais das novas drogas e as formas alternativas de tratamento clínico, a dieta cetogênica e o uso do estimulador do nervo vago.

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Referências

Mattson RH, Cramer JA, Collins JF, and the Department of Veterans Affairs Epilepsy Cooperative Study No. 264 Group. A comparison of valproate with carbamazepina

for the treatment of complex partial seizures and secondarily generalized tonic-clonic seizures in adults. N Eng J Med, 327:765-71, 1992.

Bourgeois BF. General concepts of medical intractability. In: Lüders HO, Comair YG, (eds.). Epilepsy surgery, 2nd ed. Philadelphia, Lippincott Williams & Wilkins, 2001, 63-8.

Schmidt D, Richter K. Alternative single anticonvulsant drug therapy for refractory epilepsy. Ann Neurol, 19:85-7, 1986.

Lesser RP, Pippenger CE, Lüders HO, Dinner DS. Highdose monotherapy in the treatment of intractable seizures. Neurology, 34:707-11, 1984.

Mattson RH, Cramer JA, Collins JF, Smith DB, DelgadoEscueta AV, Browne TR, Williamson PD, Treiman DM, McNamara JO, Mucutchen CB. Comparison of carbamazepina, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. N Engl J Med, 313:145-51, 1985.

Meyer FB, Marsh WR, Laws ErJr., Sharbrough FW. Temporal lobectomy in children with epilepsy. J Neurosurg, 64:371-6, 1986.

Wyllie E. Surgery for catastrophic localization-related epilepsy in infants. Epilepsia, 37(suppl 1):S22-S25, 1996.

Reynolds EH. Early treatment and prognosis of epilepsy. Epilepsia, 28:97-106, 1987.

McLean MJ, Schmutz M, Wamil AW, Olpe HR, Portet C, Feldmann KF. Oxcarbazepine: mechanisms of action. Epilepsia, 35(suppl3):S5-9, 1994.

Cloyd JC, Remmel RP. Antiepileptic drug pharmacokinetics and interactions: impact in treatment of epilepsy. Pharmacol, 20:S139-S151, 2000.

Klosterskov JP, Saano V, Haring P, Svenstrup B, Menge GP. Possible interaction between oxcarbazepina and an oral contraceptive. Epilepsia, 38(suppl 1):S18-S23, 1997.

Smith PEM. Clinical recommendations for oxcarbazepina. Seizure, 10:87-91, 2001.

Gram L, Larsson OM, Johnsen A, Schousboe A. Experimental studies of the influence of vigabatrina on the GABA system. Br J Clin Pharmacol, 27(suppl1):13S17S, 1989.

Motte J, Trevathan E, Arvidsson JF, Barrera MN, Mullens EL, Manasco P. Lamotrigine for generalized seizures associated with the Lennox-Gastaut syndrome. Lamictal Lennox-Gastaut Study Group. N Engl J Med, 337:1807-12, 1997.

Dulac O, Plouin P, Shewmon A. Myoclonus and epilepsy in childhood: 1996 Royaumont Meeting. Epilepsy Res., 30:91-106, 1998.

Guerrini R, Belmonte A, Parmeggiani L, Perucca E. Myoclonic status epilepticus following high-dosage lamotrigine therapy. Brain Dev, 21(6):420-4, 1999.

Stembom Y, Tonnby B, Hagberg B. Lamotrigine in Rett syndrome: treatment experience from a pilot study. Eur Child Adolesc Psychiatry, 7(1):49-52, 1998.

Faught E, morris G, Jacobson M, French J, Harden C, Montouris G, Rosenfeld W. Adding lamotrigina to valproate: incidence of rash and other adverse effects. Postmarketing Antiepileptic Drug Survey (PADS) Group. Epilepsia, 40(8):1135-40, 1999.

Wild JM, Martinez C, Reinshagen G, Harding GF. Characteristics of a unique visual field defect attributed to vigabatrina. Epilepsia, 40(12):1784-94, 1999.

Miller NR, Johnson MA, Paul SR, Girkin CA, Perry JD, Endres M, Krauss GL. Visual dysfunction in patients receiving vigabatrina: clinical and electrophysiologic findings. Neurology, 53(9):2082-7, 1999.

Johnson MA, Krauss GL, Miller NR, Medura M, Paul SR. Visual function loss from vigabatrina. Effect of stopping the drug. Neurology, 55:40-5, 2000.

Chiron C, Dulac O, Beaumont D. Therapeutic trial vigabatrina in refractory infantile spasms. J Child Neurol., 6(suppl2):S52-S59, 1991.

Schadeo RC, Glauser TA, Ritter FJ, Reifer R, Lim P, Pledger G. A double-blind, randomized trial of topiramato in Lennox-Gastaut syndrome. Topiramate YL Study Group. Neurology, 52(9):1882-7, 1999.

Elterman RD, Glauser TA, Wyllie E, Reife R, Wu SC, Pledger G. A double-blind, randomized trial of topiramato as adjunctive therapy for partial-onset seizures in children. Topiramate YP Study Group. Neurology, 52(7):1338-44, 1999.

Sen HA, O’Halloran, Lee WB, Ky L. Topiramate-induced acute myopia and retinal striae. Arch Ophtalmol, 119: 775-7, 2001

Banta JT, Hoffman K, Budenz DL, Ceballos E, Greenfield DS. Presumed topiramato-induced bilateral acute angleclosure glaucoma. Am J Ophthalmol, 132:112-4, 2001.

Bourgeois B. Drug treatment of benign focal epilepsies of childhood. Epilepsia, 41(8):1057-8, 2000.

Uthman B, Beydoun A. Less commonly used antiepileptic therapies. In: E. Wyllie (ed). The treatment of epilepsy: principles and practice, 2nd ed. Baltimore, Williams & Wilkins, 1996, 937-57.

Keith HM. Factors influencing experimentally produced convulsions. Arch Neurol Psychiatr, 29:148, 1933.

Gamble JL, Ross GS, Tisdall FF. The metabolism of fixed base during fasting. J Biol Chem, 57:633-4, 1923.

McQuarrie I. Epilepsy in children. The relationship of water balance to the occurrence of seizures. Am J Dis Child, 38:451-67, 1929.

Lennox WG. Ketogenic diet in the treatment of epilepsy. N Engl J Med, 199:74-5, 1928.

Dodson WE, Prensky AL, DeVivo DC, Goldring S, Dodge PR. Management of seizure disorders: selected aspects. Part II. J. Pediatr, 89:695-703,1976.

Millichap JG, Jones JD, Rudis BP. Mechanism of anticonvulsant action of ketogenic diet. Am J Dis Child, 107: 593-604, 1964.

Dekaban A. Plasma lipids in epileptic children treated with a high fat diet. Arch Neurol, 15:177, 1966.

Owen OE, Morgan AP, Kemp HG, Sullivan JM, Herrara MG, Cahill GFJr. Brain metabolism during fasting. J Clin Invest, 46:1589-95, 1976.

Freeman JM, Kelly MT, Freeman JB. The epilepsy diet treatment. An introduction to the ketogenic diet, 2nd ed. In: Freeman K, Freeman (eds.). New York,Demos Vermand, 1996.

Appleton DB, DeVivo DC. An animal model for the ketogenic diet. Epilepsia, 15:211-27, 1974.

Al-Mudallal AS, LaManna JC, Lust WD, Harik SI. Dietinduced ketosis does not cause cerebral acidosis. Epilepsia, 37(3):258-61, 1996.

Trauner DA. Medium-chain triglyceride (MTC) diet intractable seizure disorders. Neurology, 35:237-8, 1985.

Kinsman St L, Vining EPG, Quaskey AS, Mellits D, Freeman JM. Efficacy of the ketogenic diet for intractable seizure disorders: review of 58 cases. Epilepsia, 36(6):1132-6, 1992.

Colle E, Ulstrom RA. Ketotic hypoglicemia. J. Pediatr, 64:632-51, 1964.

DeVivo DC, Pagliara AS, Prensky AL. Ketotic hypoglicemia and the ketogenic diet. Neurology, 23:640-9, 1973.

Huttenlocher PR, Wilbourn AJ, Signore JM. Medium-chain triglycerides as a therapy for intractable child epilepsy. Neurology, 21:1097-103, 1971.

Walther PL, Kaplan GW. Pediatric urolithiasis: a ten-year review. Pediatrics, 65:1068-72, 1980.

Herzberg GZ, Fivush BA, Kinsman SL, Gearhart JP. Urolithiasis associated with ketogenic diet. J. Pediatr, 117: 743-5, 1990.

Theda CH, Woody RC, Naidu S, Moser AB, Moser HW. Increased very long chain fatty acids in patients on a ketogenic diet: a cause of diagnostic confusion. J Pediat, 724-6, 1993.

Bailey P, Bremer F. A sensory cortical representation of the vagus nerve. J Neurophysiol, 1:4405-12, 1938.

Zanchetti A, Wang SC, Moruzzi G. The effect of vagal afferent stimulation on the EEG pattern of the cat. Electroencephalogr Clin Neurophysiol, 4:357-61, 1952.

Rojas JHP. Electroencephalographic synchronization resulting from direct current application to the vagus nerves. Exp Neurol, 9:367-71, 1964.

Zabara J. Inhibition of experimental seizures in canines by repetitive vagal stimulation. Epilepsia, 33:1005-12, 1992.

Lockard JS, Congdon WC, DuCharme LL. Feasibility and safety of vagal stimulation in monkey. Epilepsia, 31(suppl2):S20-S26, 1990.

Ko D, Heck C, Grafton S, Apuzzo ML, Coulwell WT, Chen T, Day JD, Zelman V, Smith T, DeGiorgio CM. Vagus nerve stimulation activates central nervous system structures in epileptic patients during PET H2O15 blood flow imaging. Neurosurgery, 39:426-31, 1996.

Henry TR, Dunwoody GA, Votaw JR. Therapeutic response correlates with thalamic blood flow increases induced acutely by vagus nerve stimulation in partial epilepsy. Neurology [abstract], 50:A66, 1998.

Nairotoku DK, Terry WJ, Helfert RW. Intermittent vagus nerve stimulation activates brainstem noradrenergic nuclei. Epilepsia [abstract], 35(suppl8):3, 1994.

Hammond EJ, Uthman BM, Wilder BJ, Ben-Menachem E, Hamberger A, Hedner T, Ekman R. Neurochemical effects of vagus nerve stimulation in human. Brain Res, 583:300-03, 1992.

McLachlan RS. Suppression of interictal spikes and seizures by stimulation of the vagus nerve. Epilepsia, 34:918-23, 1993.

Nyenhuis JA, Bourland JD, Foster KS. Testing of MRI compatibility of the Cyberonics Model 100NCP generator and model 300 series lead. Epilepsia [abstract], 8(suppl 8):140, 1997.

Uthman BM, Wilder BJ, Penry JK, Dean C, Ramsay RE, Reid SA, Hammond EJ, Tarver WB, Wernicke JF. Treatment of epilepsy by stimulation of the vagus nerve. Neurology, 43:1338-45, 1993.

DeGiorgio C, Handforth A, Schacter S. Multicenter, double-blind, controlled trial of vagus nervus stimulation (NCP system) for medically intractable partial-onset seizures: initial report of the United States EO5 study group. Epilepsia [abstract], 38(suppl8):113, 1997.

DeGiorgio CM, Thompson J, Lewis P, Arrambide S, Naritoku D, Handforth A, Labar D, Mullin P, Heck C, VNS US Study Group. Vagus nerve stimulation: analysis of device parameter in 154 patients during the long-term XE% study. Epilepsia, 42(8):1017-20, 2001.

Murphy JV, Hornig G, Schallert G. Left vagal nerve stimulation in children with refractory epilepsy. Arch Neurol, 52:886-9, 1995.

Hornig GW, Murphy JV, Schallert G, Tilton C. Left vagus nerve stimulation in children with refractory epilepsy: an update. South Med J, 90:484-8, 1997.

Ramsay RE, Uthman BM, Augustinsson LE Vagus nerve stimulation for treatment of partial seizures: 2.Safety, side effects and tolerability. Epilepsia, 35:627-36, 1994.

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Publicado

2002-06-30

Como Citar

Garzon, E. (2002). Epilepsia Refratária: Conceito e Contribuição das Novas Drogas Antiepilépticas e de outras Modalidades Terapêuticas. Revista Neurociências, 10(2), 66–82. https://doi.org/10.34024/rnc.2002.v10.8897

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Recebido: 2019-02-05
Publicado: 2002-06-30

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