MODERN TREATMENT OF DRUG-RESISTANT EPILEPSY, AVAILABLE IN RUSSIAN

Abstract

Treatment of drug-resistant epilepsy is an extremely difficult task. Unfortunately, in Russia there are no regulations containing the algorithm of actions to help the practical neurologist in management of drug-resistant patients. It is obvious that there is an urgent need to establish a network of specialized epilepsy centers of level 4 (classification of the National Association of Epilepsy Centers, USA) in the territory of the Russian Federation, united by a common ideology and methodology. Objective: to increase the quality of care for patients with refractory forms of epilepsy, by combined use of non-drug treatments such as surgery, ketogenic diet and chronic vagus nerve stimulation (VNS Therapy). Material and methods. We observed 168 patients aged 1 to 18 years with refractory epilepsy. Results. Surgical treatment was performed in 63 patients, ketogenic diet — 73, VNS therapy — 32 patients. Analysis of the combined effectiveness showed the following results: complete seizure control was observed in 59 (35.1%) patients; reducing the number of seizures of more than 75% — in 19 (11.3%), 50% — and 53 (31.5%), no effect, — 37 (22%). Thus, the significant improvement was observed on the whole in 131 (78%) patients of 168. Conclusions. An integrated approach, involving a differentiated choice of a non-drug treatment allows to achieve significant positive results, despite the resistance of epilepsy to drug therapy.