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关于ILAE/AES联合报告"重新审视耐药性癫痫概念"的解读

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尽管新型抗癫痫药物(ASMs)不断涌现,目前已经发展到第三代,但仍有1/3癫痫患者可发展为耐药性癫痫(DRE).早在2010年,国际抗癫痫联盟(ILAE)就提出了DRE概念并沿用至今,及早诊断DRE,有助于对ASMs无反应的个体进行术前评估,并从癫痫外科手术中受益.由于DRE的发病率仍然很高以及概念一直没有更新,故在2023年8月ILAE/美国癫痫协会(AES)联合工作组从协调临床前和临床研究角度出发,在整个生命周期和跨物种基础上讨论了DRE表现和机制的异质性、复杂性及动态变化.联合工作组建议有必要重新审视DRE的当前定义,以更好地服务DRE临床管理以及指引DRE未来研究方向,为患者筛选更有效、更精准的个体化治疗,以减少DRE发病率,提高患者生活质量.本文旨在就ILAE/AES此份报告做一简要介绍和解读.
Interpretation of the International League Against Epilepsy/American Epilepsy Society joint report on revisiting the concept of drug-resistant epilepsy
Despite the availability of novel anti-seizure medications(ASMs)in their third generation,one-third of the patients with epilepsy may progress to drug-resistant epilepsy(DRE).In 2010,the International League Against Epi-lepsy(ILAE)introduced the concept of DRE,which is still used today,and early diagnosis of DRE can facilitate timely preoperative evaluation for individuals with no response to ASMs,helping them to benefit from epilepsy surgery.Since the incidence rate of DRE remains high and there is a lack of update in related concepts,the ILAE/American Epilepsy Society(AES)Joint Translational Task Force discussed the heterogeneity,complexity,and dynamic changes of DRE manifesta-tions and mechanisms throughout the lifespan and across various species from the perspective of coordinating preclinical and clinical studies.The Joint Translational Task Force advocates the necessity of revisiting the current definition of DRE to enhance the clinical management of DRE,steer future research efforts towards DRE,and provide patients with more ef-fective and individualized treatment strategies,so as to reduce the incidence rate of DRE and improve the quality of life of patients.This article provides a concise overview and interpretation of the ILAE/AES report.

Drug-resistant epilepsyPathogenesisAnimal ModelTreatment

张涵瑜、林卫红

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吉林大学第一医院神经内科癫痫中心,吉林 长春 130021

耐药性癫痫 发病机制 动物模型 治疗

2024

中风与神经疾病杂志
吉林大学

中风与神经疾病杂志

CSTPCD
影响因子:0.754
ISSN:1003-2754
年,卷(期):2024.41(6)
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