Resumen
La epilepsia refractaria o farmacorresistente es una condición frecuente en nuestra práctica neurológica cotidiana. Se considera que aproximadamente el 30% de pacientes con epilepsia de cualquier tipo van a persistir con crisis epilépticas a pesar de la terapia farmacológica. La definición de epilepsia farmacorresistente ha sido motivo de controversia entre los grupos de investigación a lo largo de las últimas décadas. La nueva propuesta de la Liga Internacional contra la Epilepsia (ILAE) para definir la falla del tratamiento médico y facilitar la selección de pacientes candidatos a procedimientos quirúrgicos es un gran avance hacia un mejor tratamiento para esta población. El objetivo del presente artículo es dar pautas que le permitan al neurólogo clínico identificar a los pacientes con epilepsia refractaria y dirigir los estudios diagnósticos que permitan seleccionar aquellos candidatos a un procedimiento quirúrgico curativo o paliativo. El éxito de dichos procedimientos está condicionado por la precisión diagnóstica en el protocolo prequirúrgico, donde el neurólogo desempeña un papel fundamental.
Citas
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