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Ultima descărcare din IBN: 2022-10-12 10:51 |
SM ISO690:2012 CHIOSA, Vitalie, DRAGAN, Diana, RĂCILĂ, Renata, GASNAȘ (CATERENIUC), Daniela, CIOLAC, Dumitru, GROPPA, Stanislav. Drug-resistant epilepsy: modern concepts, integrative mechanisms, and therapeutic advances. In: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 1, 20-22 octombrie 2021, Chişinău. Chișinău, Republica Moldova: 2021, p. 222. ISBN 978-9975-82-223-7 (PDF).. |
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Cercetarea în biomedicină și sănătate: calitate, excelență și performanță 2021 | ||||||
Conferința "Cercetarea în biomedicină și sănătate: calitate, excelență și performanță" 1, Chişinău, Moldova, 20-22 octombrie 2021 | ||||||
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Background. Drug-resistant epilepsy is the cause of severe disability. Multiple questions remain unanswered both in terms of pathogenesis and therapeutic management. Objective of the study. To present recent data on hypotheses explaining the mechanisms involved in drug resistance, as well as novel pharmacological and non-pharmacological therapeutic approaches. Material and Methods. For this narrative review, PubMed database and Infomedica library were searched by using “drug-resistance in epilepsy” and “treatment of drug-resistant epilepsy” as key words. Following filters were applied: “Clinical Trial”, “Meta-analysis”, “Multicenter Study”, and “Randomized Controlled Trial”, covering the period of 1.1.2015 – 6.1.2021. Results. Several hypotheses have been proposed, i.e., pharmacokinetic, intrinsic severity, gene, target, transporter, and neural network hypotheses. Many controlled trials showed different results in terms of seizure control after combined methods of therapies. Immunotherapy, palliative epilepsy surgery alone or associated with neurostimulation procedures including vagus nerve, trigeminal nerve, or deep brain stimulation may be efficient, however, seizure freedom is not always achieved. Genetic epilepsies might benefit from gene and exosome therapy, however, further studies are needed to verify their safety. Conclusion. Neuroscience of drug-resistant epilepsy faces many challenges. Inflammatory mediators, biomarkers, and genes might allow the identification of new treatment targets, contribute to an earlier diagnosis, and assess the clinical outcomes. |
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Cuvinte-cheie epilepsy, hypotheses of drug-resistance, therapeutic advances., epilepsia, ipotezele farmacorezistenței, avansări terapeutice |
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