Differentiated tactics of antiepileptic therapy in children with resistant focal epilepsies

Abstract

Focal epilepsies, also known as partial epilepsies, are characterized by seizures that originate in a specific
area of the brain. Resistant focal epilepsies refer to cases where seizures persist despite treatment with
appropriate antiepileptic drugs (AEDs). Differentiated tactics of antiepileptic therapy aim to improve seizure
control and quality of life in children with resistant focal epilepsies. These tactics involve several key
considerations: Comprehensive evaluation: A thorough assessment is essential to identify the precise seizure
focus and underlying etiology. This may involve neuroimaging, electroencephalography (EEG), and other
diagnostic tests to guide treatment decisions. Multidisciplinary approach: Collaborative care involving
epileptologists, neurologists, neuropsychologists, and other specialists can help tailor treatment plans to the
specific needs of each child. This may include addressing comorbidities, cognitive and developmental
challenges, and psychosocial factors. Individualized medication selection: A careful review of the child's
medication history and response is necessary. The choice of AEDs should consider the seizure type, potential
side effects, drug interactions, and the child's age, comorbidities, and preferences. Polytherapy and
combination approaches: In some cases, combining multiple AEDs may be necessary to achieve better seizure
control. However, the benefits and risks of polytherapy should be carefully weighed, taking into account
potential drug interactions and side effects. Non-pharmacological interventions: Adjunctive therapies, such
as ketogenic diet, vagus nerve stimulation, or epilepsy surgery, may be considered if seizures remain
uncontrolled despite optimal medication regimens. Regular monitoring, dose adjustments, and close
communication between the healthcare team and the child's caregivers are crucial in managing resistant
focal epilepsies. The goal is to achieve the best possible seizure control while minimizing side effects and
optimizing the child's overall well-being