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 INVITED REVIEW
Year : 2008  |  Volume : 3  |  Issue : 1  |  Page : 35-40

Management in refractory epilepsy: Beyond epilepsy surgery...


Consultant Neurologist, P. D. Hinduja National Hospital, Veer Savarkar Marg, Mahim, Mumbai - 40016, India

Correspondence Address:
Roop Gursahani
2101, Hinduja Clinic, P. D. Hinduja Hospital, Veer Savarkar Marg, Mahim, Mumbai - 400016
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1817-1745.40588

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Although definititions of refractory epilepsy vary, about 40% of prevalent cases of epilepsy are not controlled by anti-epileptic drugs. A substantial proportion of this population requires palliative therapy since only a minority are candidates for epilepsy surgery. Drug therapy can be optimised after accurate classification of the epilepsy. Monotherapy is often as effective as polytherapy with fewer adverse effects. Depression and CNS adverse effects significantly impact quality of life and must be systematically screened for and treated. The ketogenic diet and vagal nerve stimulation provide substantial seizure control in a significant number of cases and may be used synergistically. Deep brain stimulation is another promising modality.






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