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About Disease

What is drug-resistant epilepsy?

What is proper drug treatment?

Select the right drugs, use an adequate dose and for a sufficient duration under the advice of an epilepsy specialist.


How to determine that the seizures have been effectively controlled?

Before starting a formal medication treatment plan, the doctor needs to know the longest period of time you have been seizure-free in the past. After formal medication treatment, if the seizure-free duration reaches three times the previously mentioned period or 12 months (whichever is longer), it can be considered that the medication has effectively controlled the seizures.



Focal Epilepsy

Epilepsy is a complex brain network disorder. Modern medicine pays more attention to the localization of the seizure origin, namely the epileptogenic zone. Through comprehensive examination and evaluation, doctors can classify epilepsy patients into three major categories: focal epilepsy, generalized epilepsy, and epilepsy of unknown origin. For patients with focal epilepsy, the epileptogenic zone may be a single lesion or multiple lesions, and may even involve the entire cerebral hemisphere. Although seizures in these patients usually follow a relatively fixed pattern, there may still be some differences in the specific manifestations of each episode. Among adult patients with drug-resistant epilepsy, the most common type is focal epilepsy caused by structural abnormalities in the brain.



The Selection of Treatment for Drug-Resistant Epilepsy

Surgical recection

If the location of the epileptic focus is clearly identified and does not involve important functional areas of the brain, open resection surgery may be considered after the doctor assesses that the surgical risks are controllable.



Magnetic Resonance-Guided Laser Interstitial Thermal Therapy (MRgLITT)

If the location and size of the lesion are appropriate, Magnetic Resonance-guided Laser Interstitial Thermal Therapy (MRgLITT) can also be considered. This is an advanced minimally invasive treatment technique. The doctor will precisely insert a laser-conducting fiber into the epileptogenic zone. The lesion is then thermally ablated by laser heating, thereby accurately eliminating the focus.

The advantages of LITT technology are as follows:

  1. High precision: Under real-time monitoring by MRI, the laser is ensured to act only on the target area, avoiding damage to surrounding normal brain tissue.
  2. Minimal invasiveness: Compared with traditional open surgery, MRgLITT requires only a small incision and no craniotomy.
  3. Rapid recovery: The hospital stay is significantly shortened, and postoperative recovery is faster.
  4. Safety: Real-time temperature monitoring and precise targeting technology ensure the safety and reliability of the surgery.

MRgLITT provides an efficient and minimally invasive treatment option for patients with drug-resistant epilepsy, If you would like to learn more about this therapy, it is recommended to consult a specialized epilepsy treatment center for a personalized assessment and treatment plan.


Neuromodulation


For patients with drug-resistant focal epilepsy, especially those with epileptogenic foci located in critical brain functional areas, ambiguous lesion locations, multiple lesions, or those who have not achieved effective control with previous surgeries, neuromodulation techniques offer an innovative treatment option. These techniques include Responsive Neurostimulation (RNS), Vagus Nerve Stimulation (VNS), and Deep Brain Stimulation (DBS). Among them, Responsive Neurostimulation (RNS) is the most advanced neuromodulation technique and the only treatment modality with brain-computer interactive functions. RNS involves precisely implanting electrodes into 1-2 epileptogenic foci regions to continuously monitor abnormal brain electrical activity and deliver responsive electrical stimulation. This effectively reduces epileptic seizures. Unlike VNS and DBS, which provide continuous stimulation, RNS only activates stimulation when abnormal brain electrical activity is detected. This significantly reduces the risk of side effects that may arise from long-term continuous stimulation. Additionally, RNS has the capability for real-time electroencephalogram (EEG) monitoring, which allows doctors to gain a more comprehensive understanding of the patient’s epilepsy condition. Based on the monitoring data, doctors can dynamically adjust the stimulation parameters to achieve personalized treatment. This provides a new therapeutic option for patients with drug-resistant epilepsy.


Other Treatments


The ketogenic diet can be considered as an adjunctive therapy. Additionally, the involvement of family members and psychological support are also crucial.