Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

1 results

  • 9 - What to Do When Your Patient Fails Two Antiseizure Medicines

  • Patrick Landazuri, University of Kansas Medical Centre, Nuria Lacuey Lecumberri, University of Texas Health Science Center, Houston, Laura Vilella Bertran, University of Texas Health Science Center, Houston, Mark Farrenburg, University of Kansas Medical Centre, Samden Lhatoo, University of Texas Health Science Center, Houston
  • Book:
    Seizure and Epilepsy Care
    Published online:
    28 January 2023
    Print publication:
    09 February 2023, pp 156-174

  • Summary

    Around a third of patients have drug-resistant epilepsy (DRE). This is crucially and easily determined if a patient continues to have seizures after being on two adequately dosed and appropriately selected antiseizure medicines (ASMs). For these patients, your initial efforts to make a specific and localized diagnosis will inform next treatment decisions. If a patient presents suddenly with DRE, it is key to assess for a possible autoimmune cause, as a separate treatment pathway should be considered. Otherwise, consider epilepsy surgery as an effective treatment. These treatments include brain resections and neuromodulation. Minimally invasive techniques have recently become more common, including laser surgery as well as stereotactically placed depth electrodes. Given the prevalence of neurostimulators, consideration for obtaining MRIs in patients with these devices is addressed, as pathways exist for all of these patients to safely undergo MRI testing.