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Neue Systematik der Epilepsien und aktuelle Therapieempfehlungen

  • B. A. NeubauerEmail author
  • A. Hahn
Leitthema
  • 22 Downloads

Zusammenfassung

Die aktuelle Klassifikation der Epilepsien aus dem Jahr 2017 gleicht stark der Version des Jahres 1989. Die Versuche einer Reklassifikation in den Jahren 2001, 2006 und 2010 brachten aus heutiger Sicht keine wesentlichen Verbesserungen und wurden von der internationalen Gemeinschaft der Epileptologen nicht gut angenommen. Der jetzige Vorschlag überzeugt durch einen pragmatischen Ansatz und führt neue Konzepte nur dort ein, wo neue wissenschaftlich belegbare Befunde vorliegen. Anfallsform, Art der Epilepsie, Einteilung des Epilepsiesyndroms, Ätiologie und Komorbidität sind die wichtigsten Bestandteile.

Die Zahl der verfügbaren Antiepileptika nimmt fast von Jahr zu Jahr weiter zu. Dies eröffnet für den einzelnen Patienten neue therapeutische Alternativen bei Unverträglichkeit oder Versagen der Standardtherapie. Betrachtet man aber die gesamte Gruppe der Betroffenen, bleibt der Anteil der anfallsfrei werdenden Patienten fast gleich. Der entscheidende Vorteil einer Vielzahl neuer Antiepileptika liegt in ihrer guten kognitiven Verträglichkeit. Die Neuerungen der Behandlungskonzepte bei West-Syndrom, Absence-Epilepsien, strukturell/metabolischen, genetisch generalisierten, genetisch fokalen Epilepsien und dem Dravet-Syndrom werden berichtet.

Schlüsselwörter

Klassifikation Terminologie Anfälle Antikonvulsiva Behandlungswirksamkeit 

New classification of epilepsy and current treatment recommendations

Abstract

The current classification of epilepsies from 2017 strongly resembles its predecessor version from 1989. Attempts at reclassification in 2001, 2006 and 2010 did not reflect new scientific content and failed to find broad acceptance in the international community of epileptologists. The current version is convincing due to its pragmatic approach and introduces new concepts only when confirmed by scientific proof. Seizure types, epilepsy types, classification of epilepsy syndrome, etiology and comorbidities are the five major components.

The number of available antiepileptic drugs is constantly increasing. This provides treatment alternatives for individual patients with treatment failure or severe adverse effects after standard therapy; however, the group of patients who will become free of seizures under antiepileptic drug treatment remains roughly the same. A decisive advantage of many newly developed antiepileptic drugs lies in the lack of detectable cognitive side effects. Current improvements in drug treatment concepts for West syndrome, absence epilepsy, structural/metabolic, genetic generalized, genetic focal epilepsies and Dravet syndrome are presented.

Keywords

Classification Terminology Seizures Anticonvulsants Treatment efficacy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

B.A. Neubauer und A. Hahn geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Abteilung Kinderneurologie, Sozialpädiatrie u. EpileptologieUniv.-Klinikum Gießen/Marburg, Standort GießenGießenDeutschland

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