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Review Article
Current Concepts
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Volume 340:1565-1570 May 20, 1999 Number 20
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Patients with Refractory Seizures
Orrin Devinsky, M.D.

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In the United States, epilepsy affects approximately 0.6 percent of the population (1.6 million persons) and has a lifetime prevalence of approximately 3 percent (and will thus affect 7.2 million persons).1 For the majority of patients, epileptic seizures are controlled with a single antiepileptic drug, which may be withdrawn when the patient has been without seizures for two years.2 Some patients, however, do not become completely free of seizures even though they comply scrupulously with the prescribed regimen. Aside from having deleterious effects on health, persistent epileptic seizures have psychosocial, behavioral, and cognitive consequences and often impose a financial burden.3

. . . [Full Text of this Article]

Diagnostic Considerations

Classification of Seizures

Differential Diagnosis

Therapeutic Considerations

Noncompliance

Optimal Use of Antiepileptic Drugs

Type of Seizure

Alternative Therapies

The Effects of Refractory Epilepsy


Source Information

From the Department of Neurology, New York University Medical Center, New York; and the Institute of Neurology and Neurosurgery, St. Barnabas Health Care System, Livingston, N.J.

Address reprint requests to Dr. Devinsky at the Comprehensive Epilepsy Center, Mount Sinai–NYU Medical Center, 560 First Ave.–Rivergate, 4th Fl., New York, NY 10016, or at od4@is4.nyu.edu.

References


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