Resumen
La epilepsia es un trastorno neurológico crónico que afecta cerca de 45 millones de personas y responde por el 1% de la carga global de enfermedad. Entre 20 y 40% de todos los casos son epilepsia fármaco resistente, cuya opción de manejo es generalmente quirúrgica. La ocurrencia de déficit neurológico secundario a cirugía por epilepsia fármaco resistente es menor al 6%. Puede presentarse un déficit motor en cirugía de epilepsia fármaco resistente por fenómenos vasculares en el posoperatorio, a pesar de preservar la corteza motora; o secundario a resección de la zona epileptogénica, cuando está ubicada sobre el área M1-S1 o en la corteza de asociación motora. Se presentan dos pacientes con cirugía para epilepsia fármaco resistente, la evaluación, el seguimiento y la rehabilitación controlada de la función motora voluntaria, por neurorehabilitación.
Citas
World Health Organization. Health topics: Epilepsy. [en línea]. Geneva: WHO; 2012 [accesado 7 ag. 2011]. Disponible en: http://wwwwho.int/topics/ epilepsy/en/index.html.
World Health Organization, International League Against Epilepsy. Atlas: Epilepsy Care in the World. Geneva: WHO; 2005.
PRADILLA AG, VESGA A, LEÓN-SARMIENTO FE; GENECO. National neuroepidemiological study in Colombia (EPINEURO). Rev Panam Salud Pubiica. 2003; 14: 104-11.
WIEBE S. Epidemiology of temporal lobe epilepsy. Can J Neurol Sci. 2000; 27 Supl 1: S6-10; discussion S20-1.
MOHANRAJ R, BRODIE MJ. Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur J Neurol 2006; 13: 277-82.
STEPHEN LJ, KELLY K, MOHANRAJ R, BRODIE MJ. Pharmacological outcomes in older people with newly diagnosed epilepsy. Epilepsy Behav. 2006; 8: 434-7.
No authors listed. Reports from the Spanish Agency for Health Technology Assessment (AETS). Int J Technol Assess Heath Care. 1998; 14: 590-5.
CHOI H, SELL RL, LENERT L, MUENNIG P, GOODMANA RR, GILLIAM FG, ET AL. Epilepsy surgery for pharmacoresistant temporal lobe epilepsy: a decision analysis. JAMA. 2008; 300: 2497505.
WIEBE S, BLUME WT, GIRVIN JP, ELIASZIW M. Effectiveness and Efficiency of Surgery for Temporal Lobe Epilepsy Study Group. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med. 2001; 345: 311-8.
ASZTELY F, EKSTEDT G, RYDENHAG B, MALMGREN K. Long term follow-up of the first 70 operated adults in the Goteborg Epilepsy Surgery Series with respect to seizures, psychosocial outcome and use of antiepileptic drugs. J Neurol Neurosurg Psychiatry. 2007; 78: 605-9.
ENGEL J JR, WIEBE S, FRENCH J, SPERLING M, WILLIAMSON P, SPENCER D, ET AL. Quality Standards Subcommittee of the American Academy of Neurology; American Epilepsy Society; American Association of Neurological Surgeons. Practice parameter: temporal lobe and localized neocortical resections for epilepsy: report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurological Surgeons. Neurology. 2003; 60: 538-47.
World Health Organization. International classification of functioning, disability and health WHA54/21. En: Fifty-Fourth World Health Assembly, ninth plenary meeting; Geneva, 22 my. 2001. Geneva: WHO; 2001.
TAUB E, USWATTE G, ELBERT T. New treatments in neurorehabilitation founded on basic research. Nat Rev Neurosci. 2002; 3: 228-36.
MORRIS DM, TAUB E, MARK VW. Constraint-induced movement therapy: characterizing the intervention protocol. Eura Medicophys. 2006; 42: 257- 68.
SIRTORI V, CORBETTA D, MOJA L, GATTI R. Constraint-induced movement therapy for upper extremities in stroke patients. Cochrane Database Syst Rev. 2009; (4): CD004433.
WU CY, CHEN CL, TANG SF, LIN KC, HUANG YY. Kinematic and clinical analyses of upper-extremity movements after constraint-induced movement therapy in patients with stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2007; 88: 964-70
TAUB E, USWATTE G, KING DK, MORRIS D, CRAGO JE, CHATTERJEE A. A placebo-controlled trial of constraint-induced movement therapy for upper extremity after stroke. Stroke. 2006; 37: 1045-9.
DAHL AE, ASKIM T, STOCK R, LANG0RGEN E, LYDERSEN S, INDREDAVIK B. Short- and long-term outcome of constraint-induced movement therapy after stroke: a randomized controlled feasibility trial. Clin Rehabil 2008; 22: 436-47
SUÁREZ-ESCUDERO JC. Neurorehabilitación motora por TMIR: Guía. Unidad de Neuro rehabilitación Motora, Sensorial y del Lenguaje. Instituto Neurológico de Antioquia; Medellín, 2011.
ENGEL J JR. Surgery for seizures. N Engl] Med. 1996; 334: 647-52.
World Health Organization. World report on disability 2011. Malta: WHO; 2011.
World Health Organization. International Classification of Impairments, Disabilities and Handicaps: a manual of classification relating to the consequences of disease. Geneva: WHO; 1980.
Organización Mundial de la Salud, Organización Panamericana de la Salud. Clasificación Internacional del Funcionamiento, de la Discapacidad y de la salud: CIF. Madrid: Ministerio de Trabajo y Asuntos Sociales, Secretaría General de Asuntos Sociales, Instituto de Migraciones y Servicios Sociales; 2001.
Organización Panamericana de la Salud. Discapacidad: lo que cada uno debe saber. El boletín de la Organización Panamericana de la Salud OPSa-hora. 2006; Agosto: 9.
SUÁREZ-ESCUDERO JC, RESTREPO SC, RAMÍREZ EP, BEDOYA CL, JIMÉNEZ I. Descripción clínica, social, laboral y de la percepción funcional individual en pacientes con accidente cerebrovascular. Acta Neurol Colomb. 2011; 27: 97-105.
USTÜN TB, CHATTERJI S, BICKENBACH J, KOSTANJSEK N, SCHNEIDER M. The International Classification of Functioning, Disability and Health: a new tool for understanding disability and health. DisabilRehabil. 2003; 25: 565-71.
World Health Organization, International League Against Epilepsy, International Bureau for Epilepsy. Global Campaign Against Epilepsy: out of the shadows. Netherlands: WHO; 2003.
LOLLAR DJ, CREWS JE. Redefining the role of public health in disability. Annu Rev Public Health. 2003; 24: 195-208.
World Health Organization. Chapter 1: Understanding disability. In WHO. World report on disability. Malta: WHO; 2011: 3-17.

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