چاپ صفحه |  صفحه نخست سامانه |  نویسندگان |  اطلاعات تفضیلی |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| نویسنده | نفر چندم مقاله |
|---|---|
| شیدا شعفی | اول |
| ندا قائمیان | دوم |
| عنوان | متن |
|---|---|
| خلاصه مقاله | Intractable seizures, prediction, prognostic factors, intractability: a systematic review ABSTRACT Traditionally, therapeutic failure of three anti seizure drugs defined intractability.With many new anti seizure drugs.However, several prospective case series have shown that a high likelihood of medical intractability can be identified after two unsuccessful trials, as with each anti seizure drug failure, the likelihood of successful treatment with other drugs diminishe approximately ⅓ of patients with epilepsy are drug refractory (Kwan et al. 2010). When a person receives an initial diagnosis of epilepsy, the first question asked of the physician is “Why?” But the next question is “Can the seizures be controlled?” Our ability to answer that question is inadequate, even though the question of prognosis is implicit in every subsequent clinical interaction. OBJECTIVE:Determining the prognosis of patients with epilepsy is a challenging task. The risk assessment of a patient can be useful in adapting the therapeutic strategy. Aim of this study was to identify prediction, prognostic factors and intractability of the Intractable seizures according to the recent researches . One third of all epilepsy patients have medically intractable epilepsy. Knowledge of prognostic factors that, in an early therapeutic stage of epilepsy, herald intractability could facilitate patient management. In this systematic review, we also examined the evidence for independent prognostic factors of intractability in patients with epilepsy. Refractory patients have a higher risk of premature death, trauma, psychosocial difficulties, and reduced quality of life Methods:These patients are generally treated with multiple AEDs, which in combination can lead to cognitive and behavioral disorders. Knowledge of prognostic factors at an early therapeutic stage of epilepsy could facilitate patient management. Three electronic databases (Medline, Embase and Cochrane library) were searched to identify studies with a cohort design reporting on epidemiologic evidence regarding risk factors for DRE. (from 2010-2018) After selection of abstracts, full-text articles were obtained and their quality was assessed by two reviewers, using the QUIPS checklist. Results:All independent prognostic factors in the individual studies were summarized. Fourteen cohort studies were included, of which 12 hospital-based. None of the studies considered genetic, neurobiological, biomarkers or immunological factors. The studies were of moderate quality, mostly because they did not provide a conceptual model for the choice of predictors. Heterogeneity in study design, population, candidate prognostic factors, and outcome definitions precluded statistical pooling. Abnormal electroencephalography (EEG) (both slow wave and epileptiformdischarges)epilepticus(SE)symptomatic etiology multiple seizure types (polymorphism of seizure) were identified as strong risk factors for DRE. Conclusion:While potentially relevant prognosticators of medically intractable epilepsy have been identified, the evidence for these factors is not consistent. There is a need for well-designed prognostic population-based cohort studies that also include pharmacological, genetic, neurobiological, and immunological factors. A valid model for the early prediction of medically intractable epilepsy could improve patient management. |
| کلمات کلیدی | Intractable seizures-prognostic factors |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| Intractable seizures, prediction, prognostic factors, intractability_ A systematic review - ScienceDirect.pdf | 1399/05/07 | 164416 | دانلود |
| certificate dubie wcn2019.pdf 2.pdf | 1399/05/15 | 167786 | دانلود |
| shaafi.pdf | 1399/06/03 | 67076 | دانلود |
