The definition of intractable (or drug-resistant) epilepsy is a difficult one. Intact both social and epidemiological (prognostic) factors have to be taken into account. In questionnaire about this matter was sent by mail to 5000 Italian neurologists. 227 answers have been obtained, mostly from members of the Italian League against Epilepsy. In general the notion of intractable epilepsy results doubtful since most of physicians considered severity of seizures (regardless their number) the most important factor for the diagnosis of drug-resistance, furthermore only in 10% of answers was defined as drug-resistant a patient whose seizures did not remit (regardless their number or severeness during the last year of therapy. 64% of neurologists do not make a diagnosis of drug-resistance if seizure frequency has reduced to 50% of the previous value. Epilepsy seems to be accepted as a chronic disease by most of physicians that answered the questionnaire. In fact most of them accept relapses during treatment as a normal event. In 50% of the answers plasma levels are used as a guideline for therapeutic modifications and the notion of maximum tolerated dosage is accepted by the other 50%. Most of neurologists define a patients as drug resistant when all therapeutical modalities have been attempted. Neurosurgical hypothesis is considered in 63% of the answers. This percentage increases to 75% and to 88% when the number of patients followed-up is more than 100/year and, respectively, 300/year.
|Title of host publication||Bollettino - Lega Italiana contro l'Epilessia|
|Number of pages||6|
|Publication status||Published - 1988|
ASJC Scopus subject areas
- Clinical Neurology