Application of International League Against Epilepsy’ s New Consensus Definition of Drug-resistant Epilepsy in Developing Regions_West China Medical Journal

Authors：

LU Qian ¹ , HAO Xiaoting ¹ , YAN Bo ¹ , LIU Jia ² ,  ZHOU Dong. ¹

1. Department of Neurology, West China Hospital; 2. West China School of Medicine; Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZHOU Dong., Email: aliceluqian@163.com

Keywords：

癲癇; 國際抗癲癇聯盟; WHO每日劑量; 耐藥癲癇定義

DOI：

10.7507/1002-0179.20130006

Video：

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目的　評估國際抗癲癇聯盟（ILAE）耐藥癲癇定義專家共識在發展中國家、發展中地區應用的可行性及應用中存在的問題。方法　2010年12月9日－2011年2月18日，連續登記癲癇專科門診患者409例。共納入183例患者，根據ILAE耐藥癲癇新定義對每位納入患者癲癇分類進行評估。結果　耐藥癲癇患者18例（8.7%），臨床治愈患者29例（14.1%），不能判斷為159例（77.2%）。入組患者共涉及癲癇藥物治療方案321項。根據ILAE定義步驟一分類為不確定的治療方案共有199項（62.00%），其中數量最多的為服藥劑量＜50% WHO限定日劑量有157例（78.89%）。結論　由于治療劑量未能夠達到國際統一標準，大量患者分類不明確，使得該共識應用面臨巨大挑戰，但目前為止該共識對于發展中地區耐藥癲癇治療有很強的指導促進意義，對未來耐藥癲癇的早期識別有非常大的應用潛力。

Citation： LU Qian,HAO Xiaoting,YAN Bo,LIU Jia,ZHOU Dong.. Application of International League Against Epilepsy’ s New Consensus Definition of Drug-resistant Epilepsy in Developing Regions. West China Medical Journal, 2013, 28(1): 21-24. doi: 10.7507/1002-0179.20130006 Copy

1.	World Health Organization. Neurological disorders: public health challenges[EB/OL]. (2010-03)[2012-04-01]. http://www.who.int/mental_health/neurology/neurodiso/en/index.html.
2.	Kwan P, Arzimanoglou A, Berg A, et al. Definition of drug resistant epilepsy: consensusproposal by the adhoc task force of the ILAE commission on therapeutic strategies[J]. Epilepsia, 2010, 51(6): 1069-1077.
3.	Hao X, Wong ISM, Kwan P. Interrater reliability of the international consensus definition of drug-resistant epilepsy: a pilot study[J]. Epilepsy Behav, 2011, 22(2): 388-390.
4.	Picot MC, Baldy, Moulinier M, Daurès JP, et al. The prevalence of epilepsy and pharmacoresistant epilepsy in adults: a population-based study in a Western European country[J]. Epilepsia, 2008, 49（7）: 1230-1238.
5.	Kwan P, Brodie MJ. Early identification of refractory epilepsy[J]. N Engl J Med, 2000, 342(5): 314-319.
6.	Hui ACF, Wong A, Wong H, et al. Refractory epilepsy in a Chinese population[J]. Clin Neurol Neurosurg, 2007, 109(8): 672-5.
7.	謝惠君. 托吡酯與丙戊酸鈉緩釋片治療難治性癲癇療效比較[J]. 中國新藥與臨床雜志, 2001, 20(2): 90-93.
8.	黃圣明, 王海珍, 黃希順. 奧卡西平治療癲癎的臨床研究[J]. 中國實用神經疾病雜志, 2010, 13(1): 30-32.
9.	吳遜. 規范治療是提高癲癇療效的關鍵[J]. 中華內科雜志， 2006，45(10): 798-799.
10.	晏玉奎, 狄晴, 余年, 等. 新型和傳統抗癲癇藥治療新診斷癲癇患者的評價[J]. 中風與神經疾病雜志， 2010, 27(10): 894-897.
11.	中華醫學會神經病學分會癲癇與腦電圖學組. 成人癲癇診斷和藥物治療規范（草案）[J]. 中華內科雜志, 2006, 10(45): 875-877.
12.	Birbeck GL. Epilepsy care in developing countries: part Ⅱ of Ⅱ[J]. Epilepsy Cur, 2010, 10(5): 105-110.
13.	World Health Organization Collaborating Centre for Drug Statistics Methodology. About the ATC/DDD system[EB/OL]. [2012-04-01]. http://www.whocc.no/atcddd/.
14.	Xiao-Ting H, Patrick K. Update and overview of the international league against epilepsy consensus definition of drug-resistant[J]. US Neurology, 2010, 6(2): 122-124.
15.	Kwan P, Brodie MJ. Early identification of refractory epilepsy[J]. N Engl J Med, 2000, 342(5): 314-319.
16.	Perucca E. Pharmacoresistance in epilepsy: how should it be defined?[J]. CNS drugs, 1998, 10(3): 171-179.
17.	Kr?mer G. The limitations of antiepileptic drug monotherapy[J]. Epilepsia, 1997, 38(Supply 5): S9-S13.
18.	Arts WFM, Geerts AT, Brouwer OF, et al. The early prognosis of epilepsy in childhood: the prediction of a poor outcome. The Dutch study of epilepsy in childhood[J]. Epilepsia, 1999, 40(6): 726-734.

1. 　World Health Organization. Neurological disorders: public health challenges[EB/OL]. (2010-03)[2012-04-01]. http://www.who.int/mental_health/neurology/neurodiso/en/index.html.
2. 　Kwan P, Arzimanoglou A, Berg A, et al. Definition of drug resistant epilepsy: consensusproposal by the adhoc task force of the ILAE commission on therapeutic strategies[J]. Epilepsia, 2010, 51(6): 1069-1077.
3. 　Hao X, Wong ISM, Kwan P. Interrater reliability of the international consensus definition of drug-resistant epilepsy: a pilot study[J]. Epilepsy Behav, 2011, 22(2): 388-390.
4. 　Picot MC, Baldy, Moulinier M, Daurès JP, et al. The prevalence of epilepsy and pharmacoresistant epilepsy in adults: a population-based study in a Western European country[J]. Epilepsia, 2008, 49（7）: 1230-1238.
5. 　Kwan P, Brodie MJ. Early identification of refractory epilepsy[J]. N Engl J Med, 2000, 342(5): 314-319.
6. 　Hui ACF, Wong A, Wong H, et al. Refractory epilepsy in a Chinese population[J]. Clin Neurol Neurosurg, 2007, 109(8): 672-5.
7. 　謝惠君. 托吡酯與丙戊酸鈉緩釋片治療難治性癲癇療效比較[J]. 中國新藥與臨床雜志, 2001, 20(2): 90-93.
8. 　黃圣明, 王海珍, 黃希順. 奧卡西平治療癲癎的臨床研究[J]. 中國實用神經疾病雜志, 2010, 13(1): 30-32.
9. 　吳遜. 規范治療是提高癲癇療效的關鍵[J]. 中華內科雜志， 2006，45(10): 798-799.
10. 　晏玉奎, 狄晴, 余年, 等. 新型和傳統抗癲癇藥治療新診斷癲癇患者的評價[J]. 中風與神經疾病雜志， 2010, 27(10): 894-897.
11. 　中華醫學會神經病學分會癲癇與腦電圖學組. 成人癲癇診斷和藥物治療規范（草案）[J]. 中華內科雜志, 2006, 10(45): 875-877.
12. 　Birbeck GL. Epilepsy care in developing countries: part Ⅱ of Ⅱ[J]. Epilepsy Cur, 2010, 10(5): 105-110.
13. 　World Health Organization Collaborating Centre for Drug Statistics Methodology. About the ATC/DDD system[EB/OL]. [2012-04-01]. http://www.whocc.no/atcddd/.
14. 　Xiao-Ting H, Patrick K. Update and overview of the international league against epilepsy consensus definition of drug-resistant[J]. US Neurology, 2010, 6(2): 122-124.
15. 　Kwan P, Brodie MJ. Early identification of refractory epilepsy[J]. N Engl J Med, 2000, 342(5): 314-319.
16. 　Perucca E. Pharmacoresistance in epilepsy: how should it be defined?[J]. CNS drugs, 1998, 10(3): 171-179.
17. 　Kr?mer G. The limitations of antiepileptic drug monotherapy[J]. Epilepsia, 1997, 38(Supply 5): S9-S13.
18. 　Arts WFM, Geerts AT, Brouwer OF, et al. The early prognosis of epilepsy in childhood: the prediction of a poor outcome. The Dutch study of epilepsy in childhood[J]. Epilepsia, 1999, 40(6): 726-734.

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Application of International League Against Epilepsy’ s New Consensus Definition of Drug-resistant Epilepsy in Developing Regions

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