Tatalaksana Epilepsi Refrakter - Daniel Mahendrakrisna; Rizaldy Taslim Pinzon (Cermin Dunia Kedokteran, 2020)
Epilepsi refrakter atau resisten obat didefinisikan sebagai kegagalan respons terhadap dua obat anti-epilepsi sesuai jadwal, dosis, dan rute pemberian, baik monoterapi maupun kombinasi, untuk tercapainya bebas serangan. Serangan epilepsi yang tidak terkontrol atau resisten obat umumnya berkaitan dengan prognosis buruk, dan mengganggu kualitas hidup. Beberapa pilihan terapi kasus epilepsi refrakter, yaitu diet ketogenik, deep brain stimulator (DBS), vagal nerve stimulator (VNS), transcranial magnetic stimulation (TMS), responsive cortical neuro-stimulator (RNS), dan pembedahan. Terapi lini pertama adalah pembedahan reseksi. Refractory epilepsy is defined as epilepsy unresponsive to two or more anti epileptic drugs with proper schedule doses, and route of administration on monotherapy and combined therapy, to achieve seizures freedom. Refractory epilepsy was associated with poor prognostic and decreased quality of life. Several alternatives for refractory epilepsy are ketogenic diet, Deep Brain Stimulator (DBS), Vagal Nerve Stimulator (VNS), Transcranial Magnetic Stimulation (TMS), Responsive Cortical Neuro-Stimulator (RNS), and surgery. The first line therapy for refractory epilepsy is resection surgery.