Non-pharmacological Interventions for Intractable Epilepsy
In 30% of epileptic individuals, intractable epilepsy represents a problem for the management of seizures and severely affects the patient's quality of life due to pharmacoresistance with commonly used antiseizure drugs (ASDs). Surgery is not the best option for all resistant patients due to it...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-08-01
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| Series: | Saudi Pharmaceutical Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1319016420301353 |
| _version_ | 1828810676967047168 |
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| author | Faleh Alqahtani Imran Imran Hafsa Pervaiz Waseem Ashraf Nadia Perveen Muhammad Fawad Rasool Abdullah F. Alasmari Metab Alharbi Noreen Samad Saleh Abdullah Alqarni Salim S. Al-Rejaie Mohammed Mufadhe Alanazi |
| author_facet | Faleh Alqahtani Imran Imran Hafsa Pervaiz Waseem Ashraf Nadia Perveen Muhammad Fawad Rasool Abdullah F. Alasmari Metab Alharbi Noreen Samad Saleh Abdullah Alqarni Salim S. Al-Rejaie Mohammed Mufadhe Alanazi |
| author_sort | Faleh Alqahtani |
| collection | DOAJ |
| description | In 30% of epileptic individuals, intractable epilepsy represents a problem for the management of seizures and severely affects the patient's quality of life due to pharmacoresistance with commonly used antiseizure drugs (ASDs). Surgery is not the best option for all resistant patients due to its post-surgical consequences. Therefore, several alternative or complementary therapies have scientifically proven significant therapeutic potential for the management of seizures in intractable epilepsy patients with seizure-free occurrences. Various non-pharmacological interventions include metabolic therapy, brain stimulation therapy, and complementary therapy. Metabolic therapy works out by altering the energy metabolites and include the ketogenic diets (KD) (that is restricted in carbohydrates and mimics the metabolic state of the body as produced during fasting and exerts its antiepileptic effect) and anaplerotic diet (which revives the level of TCA cycle intermediates and this is responsible for its effect). Neuromodulation therapy includes vagus nerve stimulation (VNS), responsive neurostimulation therapy (RNS) and transcranial magnetic stimulation therapy (TMS). Complementary therapies such as biofeedback and music therapy have demonstrated promising results in pharmacoresistant epilepsies. The current emphasis of the review article is to explore the different integrated mechanisms of various treatments for adequate seizure control, and their limitations, and supportive pieces of evidence that show the efficacy and tolerability of these non-pharmacological options. |
| first_indexed | 2024-12-12T09:15:27Z |
| format | Article |
| id | doaj.art-8f590628b97b46889a7203d78226dd0e |
| institution | Directory Open Access Journal |
| issn | 1319-0164 |
| language | English |
| last_indexed | 2024-12-12T09:15:27Z |
| publishDate | 2020-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Saudi Pharmaceutical Journal |
| spelling | doaj.art-8f590628b97b46889a7203d78226dd0e2022-12-22T00:29:24ZengElsevierSaudi Pharmaceutical Journal1319-01642020-08-01288951962Non-pharmacological Interventions for Intractable EpilepsyFaleh Alqahtani0Imran Imran1Hafsa Pervaiz2Waseem Ashraf3Nadia Perveen4Muhammad Fawad Rasool5Abdullah F. Alasmari6Metab Alharbi7Noreen Samad8Saleh Abdullah Alqarni9Salim S. Al-Rejaie10Mohammed Mufadhe Alanazi11Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; Corresponding author.Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, PakistanDepartment of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, PakistanDepartment of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, PakistanDepartment of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, PakistanDepartment of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, PakistanDepartment of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi ArabiaDepartment of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi ArabiaDepartment of Biochemistry, Faculty of Science, Bahauddin Zakariya University, Multan 60800, PakistanDepartment of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi ArabiaDepartment of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi ArabiaDepartment of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi ArabiaIn 30% of epileptic individuals, intractable epilepsy represents a problem for the management of seizures and severely affects the patient's quality of life due to pharmacoresistance with commonly used antiseizure drugs (ASDs). Surgery is not the best option for all resistant patients due to its post-surgical consequences. Therefore, several alternative or complementary therapies have scientifically proven significant therapeutic potential for the management of seizures in intractable epilepsy patients with seizure-free occurrences. Various non-pharmacological interventions include metabolic therapy, brain stimulation therapy, and complementary therapy. Metabolic therapy works out by altering the energy metabolites and include the ketogenic diets (KD) (that is restricted in carbohydrates and mimics the metabolic state of the body as produced during fasting and exerts its antiepileptic effect) and anaplerotic diet (which revives the level of TCA cycle intermediates and this is responsible for its effect). Neuromodulation therapy includes vagus nerve stimulation (VNS), responsive neurostimulation therapy (RNS) and transcranial magnetic stimulation therapy (TMS). Complementary therapies such as biofeedback and music therapy have demonstrated promising results in pharmacoresistant epilepsies. The current emphasis of the review article is to explore the different integrated mechanisms of various treatments for adequate seizure control, and their limitations, and supportive pieces of evidence that show the efficacy and tolerability of these non-pharmacological options.http://www.sciencedirect.com/science/article/pii/S1319016420301353Intractable epilepsyKetogenic dietAnaplerotic dietVagus nerve stimulationTranscranial magnetic stimulation Biofeedback therapyMusic therapy |
| spellingShingle | Faleh Alqahtani Imran Imran Hafsa Pervaiz Waseem Ashraf Nadia Perveen Muhammad Fawad Rasool Abdullah F. Alasmari Metab Alharbi Noreen Samad Saleh Abdullah Alqarni Salim S. Al-Rejaie Mohammed Mufadhe Alanazi Non-pharmacological Interventions for Intractable Epilepsy Saudi Pharmaceutical Journal Intractable epilepsy Ketogenic diet Anaplerotic diet Vagus nerve stimulation Transcranial magnetic stimulation Biofeedback therapy Music therapy |
| title | Non-pharmacological Interventions for Intractable Epilepsy |
| title_full | Non-pharmacological Interventions for Intractable Epilepsy |
| title_fullStr | Non-pharmacological Interventions for Intractable Epilepsy |
| title_full_unstemmed | Non-pharmacological Interventions for Intractable Epilepsy |
| title_short | Non-pharmacological Interventions for Intractable Epilepsy |
| title_sort | non pharmacological interventions for intractable epilepsy |
| topic | Intractable epilepsy Ketogenic diet Anaplerotic diet Vagus nerve stimulation Transcranial magnetic stimulation Biofeedback therapy Music therapy |
| url | http://www.sciencedirect.com/science/article/pii/S1319016420301353 |
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