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01.08.2014 | Leitthema

Neues auf dem Gebiet der Epilepsien

verfasst von: Prof. Dr. F. Rosenow, K.M. Klein, A. Strzelczyk, H.M. Hamer, K. Menzler, S. Bauer, S. Knake

Erschienen in: Der Nervenarzt | Ausgabe 8/2014

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Zusammenfassung

Neues in der Epileptologie hat sich auf verschiedenen Gebieten ergeben. Seitens der International League Against Epilepsy (ILAE) wurde eine neue Epilepsiedefinition vorgeschlagen, die erstmals auch die Rückbildung definiert. Fortschritte in der Diagnostik liegen v. a. auf den Gebieten der Genetik, der bildgebenden Untersuchungen und im zunehmenden Einsatz des Stereoelektroenzephalogramms (Stereo-EEG) in der prächirurgischen Diagnostik. Therapeutisch sind klinisch relevante Daten zu Pathophysiologie und Prävention des „sudden unexpected death in epilepsy“ (SUDEP) hinzugekommen. Für Zonisamid haben sich Zulassungserweiterungen ergeben (als Monotherapie bei Erwachsenen und als Kombinationstherapie bei Kindern ab 6 Jahren). Die neu zugelassenen Antiepileptika Retigabin und Perampanel (PER) sind derzeit außer Vertrieb gestellt, da der Gemeinsame Bundesausschuss (G-BA) aus formalen Gründen (es gibt keine Daten) keinen Zusatznutzen gegenüber Lamotrigin festgestellt hat. Für PER, das sich in der Praxis bewährt hat, wird diesbezüglich ein erneuter Antrag gestellt werden. Bezüglich der chirurgischen Therapie befinden sich neue Ablationstechniken (stereotaktische Radiofrequenz- bzw. Laserablation und fokussierte Utraschallablation) sowie Hirnstimulationstechniken in der Erprobung. Experimentell stehen (opto-)genetische (z. B. mithilfe der lentiviralen Transduktion), epigenetische (z. B. mikroRNA-bezogene) Ansätze und die Untersuchung von neuronalen Netzwerken in Fokus und werden erfreulicherweise durch die Europäische Union (EU) und die Deutsche Forschungsgemeinschaft (DFG) umfänglich gefördert.

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Titel: Neues auf dem Gebiet der Epilepsien
verfasst von: Prof. Dr. F. Rosenow
K.M. Klein
A. Strzelczyk
H.M. Hamer
K. Menzler
S. Bauer
S. Knake
Publikationsdatum: 01.08.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Der Nervenarzt / Ausgabe 8/2014
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-014-4039-1

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