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：

癫痫; 国际抗癫痫联盟; WHO每日剂量; 耐药癫痫定义

DOI：

10.7507/1002-0179.20130006

Video：

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目的　评估国际抗癫痫联盟（ILAE）耐药癫痫定义专家共识在发展中国家、发展中地区应用的可行性及应用中存在的问题。方法　2010年12月9日－2011年2月18日，连续登记癫痫专科门诊患者409例。共纳入183例患者，根据ILAE耐药癫痫新定义对每位纳入患者癫痫分类进行评估。结果　耐药癫痫患者18例（8.7%），临床治愈患者29例（14.1%），不能判断为159例（77.2%）。入组患者共涉及癫痫药物治疗方案321项。根据ILAE定义步骤一分类为不确定的治疗方案共有199项（62.00%），其中数量最多的为服药剂量＜50% WHO限定日剂量有157例（78.89%）。结论　由于治疗剂量未能够达到国际统一标准，大量患者分类不明确，使得该共识应用面临巨大挑战，但目前为止该共识对于发展中地区耐药癫痫治疗有很强的指导促进意义，对未来耐药癫痫的早期识别有非常大的应用潜力。

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.	谢惠君. 托吡酯与丙戊酸钠缓释片治疗难治性癫痫疗效比较[J]. 中国新药与临床杂志, 2001, 20(2): 90-93.
8.	黄圣明, 王海珍, 黄希顺. 奥卡西平治疗癫癎的临床研究[J]. 中国实用神经疾病杂志, 2010, 13(1): 30-32.
9.	吴逊. 规范治疗是提高癫痫疗效的关键[J]. 中华内科杂志， 2006，45(10): 798-799.
10.	晏玉奎, 狄晴, 余年, 等. 新型和传统抗癫痫药治疗新诊断癫痫患者的评价[J]. 中风与神经疾病杂志， 2010, 27(10): 894-897.
11.	中华医学会神经病学分会癫痫与脑电图学组. 成人癫痫诊断和药物治疗规范（草案）[J]. 中华内科杂志, 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.	Krämer 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. 　谢惠君. 托吡酯与丙戊酸钠缓释片治疗难治性癫痫疗效比较[J]. 中国新药与临床杂志, 2001, 20(2): 90-93.
8. 　黄圣明, 王海珍, 黄希顺. 奥卡西平治疗癫癎的临床研究[J]. 中国实用神经疾病杂志, 2010, 13(1): 30-32.
9. 　吴逊. 规范治疗是提高癫痫疗效的关键[J]. 中华内科杂志， 2006，45(10): 798-799.
10. 　晏玉奎, 狄晴, 余年, 等. 新型和传统抗癫痫药治疗新诊断癫痫患者的评价[J]. 中风与神经疾病杂志， 2010, 27(10): 894-897.
11. 　中华医学会神经病学分会癫痫与脑电图学组. 成人癫痫诊断和药物治疗规范（草案）[J]. 中华内科杂志, 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. 　Krämer 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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