MODERN TREATMENT OPTIONS FOR DRUG-RESISTANT EPILEPSY IN CHILDREN

Abstract: we present the experience of applying the methods of non-drug treatment drug-resistant epilepsy in children. These include surgery, ketogenic diet and chronic vagus nerve stimulation (VNS therapy). Methods. We observed 118 patients with refractory epilepsy. As a result of a comprehensive survey 46 patients became candidates for surgical treatment, VNS stimulator implanted in 17 patients, and the ketogenic diet recommended for 50 patients. Results. Surgical treatment showed the highest efficiency: the complete elimination of seizures (100%) was observed in 28 (61%) patients, reducing the number of seizures of >75% was observed in 1 (2%), >50% in 5 (11%) and <50 % in 12 (26%) patients. Efficiency of a ketogenic diet conceded to surgery: 100 % reduction of seizures observed in 9 (18%) patients, >75% in 10 (20%), >50 % in 4 (8%) and <50% in 27 (54%) patients. VNS stimulation, as well as the ketogenic diet was less effective compared with surgical treatment: 100% effect was observed in 3 (17.5%) patients, reducing the seizures of >75% in 2 (12%), >50 % in 17 (15%) and <50 % in 43 (38%) patients. Conclusions. The most effective and radical treatment of refractory epilepsy is surgery in comparing with the ketogenic diet and VNS stimulation. The overall efficiency of these treatments (seizure reducing more than 50%) was observed in 70 patients, representing 62% of the total. Thus, an integrated approach in the treatment of refractory epilepsy allows to achieve a positive effect in significant number of cases.