Refractory definition, hard or impossible to manage; stubbornly disobedient: a refractory child. { bidder: 'ix', params: { siteId: '555366', size: [300, 50] }}, { bidder: 'triplelift', params: { inventoryCode: 'Cambridge_MidArticle' }}, { bidder: 'onemobile', params: { dcn: '8a969411017171829a5c82bb4deb000b', pos: 'cdo_btmslot_300x250' }}, { bidder: 'appnexus', params: { placementId: '19061233' }}, 1. { bidder: 'ix', params: { siteId: '555366', size: [320, 50] }}, These examples are from corpora and from sources on the web. { bidder: 'openx', params: { unit: '539971066', delDomain: 'idm-d.openx.net' }}, The refractory period occurs after the resolution stage. FCD type IIB, or FCD with balloon cells, or Taylor-type dysplasia, is characterized by areas of thickening of the cortex on MRI, with blurring of the differentiation between the gray–white-matter interfaces, deep sulci, and abnormal cortical gyration. FCD is characterized by disorganization of the cortical lamination associated with bizarre (dysplastic) neurons or cells with eosinophilic cytoplasm and increased volume (ball cells) (Taylor et al., 1971). If side effects or drug costs are a problem, talk with your doctor and pharmacist to discuss options. { bidder: 'ix', params: { siteId: '195451', size: [300, 250] }}, Comment on Am J Psychiatry. storage: { expires: 365 { bidder: 'onemobile', params: { dcn: '8a9690ab01717182962182bb50ce0007', pos: 'cdo_mpuslot2_mobile_flex' }}, In some patients with drug-resistant epilepsy, surgical or stimulation-based treatments can be considered. Adults with relapsed or refractory Acute Myeloid Leukemia (AML) have very few options for treatments until this month. } { bidder: 'triplelift', params: { inventoryCode: 'Cambridge_MidArticle' }}, American Heart Association, 1994 { bidder: 'triplelift', params: { inventoryCode: 'Cambridge_SR' }}, Click on the arrows to change the translation direction. Derek G. Waller BSc (HONS), DM, MBBS (HONS), FRCP, Anthony P. Sampson MA, PhD, FHEA, FBPhS, in Medical Pharmacology and Therapeutics (Fifth Edition), 2018. } In normal brain, the multidrug resistance gene-1 P-glycoprotein (MDR1) and multidrug resistance-associated protein-1 (MRP1) contribute to the blood–brain barrier and the blood–cerebrospinal fluid barrier (Tan et al., 2000; Loscher and Potschka, 2002; Rogawski, 2002; Siddiqui et al., 2003). bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162050', zoneId: '776336', position: 'btf' }}, 13, chromosome 13q deletion, CMA-detectable rearrangements. initAdSlotRefresher(); { bidder: 'sovrn', params: { tagid: '387233' }}, There should be a continuing effort to validate existing models and identify new models of different types of refractory epilepsy. { bidder: 'sovrn', params: { tagid: '446383' }}, Most people have heard of the terms, "cancer" and "chemotherapy." googletag.cmd = googletag.cmd || []; ga('require', 'displayfeatures'); { bidder: 'ix', params: { siteId: '195454', size: [300, 250] }}, Refractory epilepsy greatly impacts quality of life, and in many cases surgery must be considered as a treatment option. { bidder: 'appnexus', params: { placementId: '11654156' }}, 1. { bidder: 'ix', params: { siteId: '195455', size: [320, 100] }}, For monoclonal antibodies (mAbs) acting on the CGRP pathway a minimum of 3 months is required and for OnabotulinumtoxinA a minimum of 6 months, in … Drug-resistant epilepsy occurs when a person has failed to become (and stay) seizure free with adequate trials of two antiseizure … Usage explanations of natural written and spoken English, 0 && stateHdr.searchDesk ? Analgesia using intrathecal drug delivery systems (IDDS) has been poorly studied specifically in this population. { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_mpuslot2' }}]}]; { bidder: 'openx', params: { unit: '539971081', delDomain: 'idm-d.openx.net' }}, { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_mpuslot1' }}]}, dfpSlots['leftslot'] = googletag.defineSlot('/2863368/leftslot', [[120, 600], [160, 600]], 'ad_leftslot').defineSizeMapping(mapping_leftslot).setTargeting('sri', '0').setTargeting('vp', 'top').setTargeting('hp', 'left').addService(googletag.pubads()); type: "html5", { bidder: 'openx', params: { unit: '539971079', delDomain: 'idm-d.openx.net' }}, FCD type IIA has dysmorphic neurons without balloon cells in the histopathology and the alterations on MRI are often discrete and without hyperintense signal in FLAIR (Fig. { bidder: 'ix', params: { siteId: '555366', size: [300, 50] }}, { bidder: 'appnexus', params: { placementId: '11654174' }}, Patients who are treated for relapsed or refractory CLL … "authorization": "https://dictionary.cambridge.org/auth/info?rid=READER_ID&url=CANONICAL_URL&ref=DOCUMENT_REFERRER&type=ENTRY_TRANSLATE&v1=english&v2=refractory&v3=&v4=english&_=RANDOM", },{ W. Löscher, in Encyclopedia of Basic Epilepsy Research, 2009. pbjs.que = pbjs.que || []; bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162036', zoneId: '776142', position: 'btf' }}, { bidder: 'criteo', params: { networkId: 7100, publisherSubId: 'cdo_topslot' }}, What does refractory mean? { bidder: 'criteo', params: { networkId: 7100, publisherSubId: 'cdo_mpuslot' }}, The causes, symptoms, and treatment of refractory epilepsy, which develops when your seizures aren't brought under control by medicine. { bidder: 'sovrn', params: { tagid: '708801' }}, 'min': 8.50, 1. 'increment': 0.01, { bidder: 'ix', params: { siteId: '555366', size: [320, 50] }}, { bidder: 'ix', params: { siteId: '195466', size: [728, 90] }}, { bidder: 'criteo', params: { networkId: 7100, publisherSubId: 'cdo_leftslot' }}, Am J Psychiatry. { bidder: 'ix', params: { siteId: '195455', size: [320, 50] }}, Refractory hypertension is rare with a prevalence of approximately 5% of patients with uncontrolled resistant hypertension. { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_stickyslot' }}]}, { bidder: 'sovrn', params: { tagid: '387232' }}, U.S. Food and Drug Administration (FDA) Accepts for Priority Review Bristol Myers Squibb and bluebird bio Application for Anti-BCMA CAR T Cell Therapy Idecabtagene Vicleucel (Ide-cel, bb2121) { bidder: 'appnexus', params: { placementId: '11654157' }}, { bidder: 'criteo', params: { networkId: 7100, publisherSubId: 'cdo_rightslot' }}, However, not all patients with malformations of cortical development present with refractory epilepsy (Barkovich et al., 2012). { bidder: 'openx', params: { unit: '539971063', delDomain: 'idm-d.openx.net' }}, { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_rightslot' }}]}, For that reason, epilepsy surgery centers must be careful to understand the factors that could increase the risk of detrimental cognitive changes. enableSendAllBids: false, { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_mpuslot2' }}]}]; {code: 'ad_topslot_b', pubstack: { adUnitName: 'cdo_topslot', adUnitPath: '/2863368/topslot' }, mediaTypes: { banner: { sizes: [[728, 90]] } }, Patients with “treatment resistant” or “treatment refractory” disorders are those who do not respond to the usual first- and even second- and third-line treatments. {code: 'ad_topslot_a', pubstack: { adUnitName: 'cdo_topslot', adUnitPath: '/2863368/topslot' }, mediaTypes: { banner: { sizes: [[300, 250]] } }, { bidder: 'openx', params: { unit: '539971069', delDomain: 'idm-d.openx.net' }}, The reason for this is that the fast sodium channels are not fully reactivated and … 16 A systematic review and meta-analysis of the efficacy of all novel AEDs as adjunctive treatment for drug-resistant epilepsy … { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_topslot' }}]}, bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162036', zoneId: '776156', position: 'atf' }}, iasLog("exclusion label : resp"); storage: { googletag.pubads().collapseEmptyDivs(false); { bidder: 'triplelift', params: { inventoryCode: 'Cambridge_MidArticle' }}, { bidder: 'openx', params: { unit: '539971079', delDomain: 'idm-d.openx.net' }}, { bidder: 'openx', params: { unit: '539971065', delDomain: 'idm-d.openx.net' }}, { bidder: 'criteo', params: { networkId: 7100, publisherSubId: 'cdo_mpuslot' }}, Medical definition of refractoriness: the insensitivity to further immediate stimulation that develops in irritable and especially nervous tissue as a result of intense or prolonged stimulation. A number of anti-CMV agents are commercially available, and others are in development. 1991 Jun;148(6):695-704. { bidder: 'triplelift', params: { inventoryCode: 'Cambridge_SR' }}, type: "html5", { var pbMobileLrSlots = [ ga('send', 'pageview'); Add refractory to one of your lists below, or create a new one. But besides the fact that chemotherapy is used to treat cancer, most people are unfamiliar with the nuances associated with chemotherapy, like what the specific term "chemorefractory" means. Did You Know? { bidder: 'openx', params: { unit: '539971067', delDomain: 'idm-d.openx.net' }}, { bidder: 'ix', params: { siteId: '195455', size: [300, 50] }}, Uncapping of the cyst refers to removal of the atrophic or gliotic cortex representing the outer wall of the porencephalic cyst without damaging the inner wall. {code: 'ad_rightslot', pubstack: { adUnitName: 'cdo_rightslot', adUnitPath: '/2863368/rightslot' }, mediaTypes: { banner: { sizes: [[300, 250]] } }, These proteins are members of the adenosine triphosphate (ATP)-binding cassette (ABC) transporter family and are localized within endothelial cells, epithelial cells of the intestine, kidney, hepatocytes, and different cell types within brain tissue. { bidder: 'ix', params: { siteId: '194852', size: [300, 250] }}, { bidder: 'ix', params: { siteId: '195464', size: [120, 600] }}, { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_stickyslot' }}]}, { bidder: 'triplelift', params: { inventoryCode: 'Cambridge_MidArticle' }}, { bidder: 'criteo', params: { networkId: 7100, publisherSubId: 'cdo_mpuslot' }}, bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162050', zoneId: '776340', position: 'btf' }}, { bidder: 'onemobile', params: { dcn: '8a9690ab01717182962182bb50ce0007', pos: 'cdo_mpuslot_mobile_flex' }}, { bidder: 'sovrn', params: { tagid: '387232' }}, { bidder: 'ix', params: { siteId: '195451', size: [320, 50] }}, dfpSlots['contentslot_2'] = googletag.defineSlot('/2863368/mpuslot', [[300, 250], [336, 280], 'fluid'], 'ad_contentslot_2').defineSizeMapping(mapping_contentslot).setTargeting('cdo_si', '2').setTargeting('sri', '0').setTargeting('vp', 'mid').setTargeting('hp', 'center').addService(googletag.pubads()); { bidder: 'ix', params: { siteId: '195452', size: [300, 250] }}, The National Cancer Institute breaks it down even further to say that there are two main types of refractory … { bidder: 'ix', params: { siteId: '195455', size: [300, 250] }}, Seizures sometimes are not controlled with antiseizure medications. { bidder: 'ix', params: { siteId: '194852', size: [300, 250] }}, googletag.pubads().setTargeting("cdo_t", "behaving-and-interacting"); Other agents associated with inhibition of the expression of P-gp and other multidrug-resistant proteins are verapamil, latilagascenes, and amlodipine derivatives ( Karwatsky et al., 2003; Trompier et al., 2004; Duarte et al., 2007). Lissencephaly spectrum disorders include isolated lissencephaly sequence disorder, agyria (absence of gyri), pachygyria (a few broad gyri), subcortical band heterotopia (arrested migration of cortical neurons), microlissencephaly, and cobblestone cortical malformations (Spalice et al., 2009; Pavone et al., 2010; Kato and Dobyns, 2003). ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. URL: https://www.sciencedirect.com/science/article/pii/B9780128029732000100, URL: https://www.sciencedirect.com/science/article/pii/B9780123739612002381, URL: https://www.sciencedirect.com/science/article/pii/B9780128099612000072, URL: https://www.sciencedirect.com/science/article/pii/B9780702071676000233, URL: https://www.sciencedirect.com/science/article/pii/B978044453486600051X, URL: https://www.sciencedirect.com/science/article/pii/B9780444521385000268, URL: https://www.sciencedirect.com/science/article/pii/B9780444640765000302, URL: https://www.sciencedirect.com/science/article/pii/B9780126213553500050, URL: https://www.sciencedirect.com/science/article/pii/B9780444528919000531, PHARMACORESISTANCE | Animal Models of Drug-Resistant Epilepsy, Caleb M. Pearson, ... Patrick Landazuri, in, Derek G. Waller BSc (HONS), DM, MBBS (HONS), FRCP, Anthony P. Sampson MA, PhD, FHEA, FBPhS, in, Medical Pharmacology and Therapeutics (Fifth Edition), Fernando Cendes, ... Gregory D. Cascino, in, Varadi et al., 2002; Aronica et al., 2003, 2005; Calatozzolo et al., 2005; Fattori et al., 2007, Tan et al., 2000; Loscher and Potschka, 2002; Rogawski, 2002; Siddiqui et al., 2003, Loscher and Potschka, 2002; Rogawski, 2002, Aronica et al., 2005; Cerveny et al., 2006, Luer et al., 1999; Potschka et al., 2004a, Karwatsky et al., 2003; Trompier et al., 2004; Duarte et al., 2007, Definition and Overview of Intractable Epilepsy, The Comprehensive Evaluation and Treatment of Epilepsy, Carreno et al., 2002; Wyllie et al., 2007, Lissencephaly spectrum, including subcortical band, Associated with cataracts, brainstem, and cerebellar hypoplasia (224050), Cobblestone cortical malformation (e.g., Walker–Warburg syndrome (236670) and Fukuyama congenital muscular dystrophy (253800)), Pachygyria (e.g., Barraitser–Winter syndrome) (, Elements of GATOR complex involved in the inhibition of mTOR, e.g., Tris. { bidder: 'sovrn', params: { tagid: '346693' }}, Indeed, overexpression of these proteins has been demonstrated in tumor cells of patients with glioma and those with intractable epilepsy, including patients with cortical dysplasia and ganglioglioma (Varadi et al., 2002; Aronica et al., 2003, 2005; Calatozzolo et al., 2005; Fattori et al., 2007). These patients may be candidates for standard temporal lobectomy despite more extensive lesion (Carreno et al., 2002). FCD type I (Fig. ga('set', 'dimension3', "default"); { bidder: 'onemobile', params: { dcn: '8a9690ab01717182962182bb50ce0007', pos: 'cdo_stickyslot_mobile_flex' }}, var pbAdUnits = getPrebidSlots(curResolution); Am J Psychiatry. googletag.pubads().setTargeting("cdo_tc", "resp"); googletag.pubads().setCategoryExclusion('lcp').setCategoryExclusion('resp').setCategoryExclusion('wprod'); Drug-resistant epilepsy, also named intractable epilepsy or refractory epilepsy, is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapy or in combination) to achieve sustained seizure freedom (Kwan et al., 2009). { bidder: 'openx', params: { unit: '539971080', delDomain: 'idm-d.openx.net' }}, { bidder: 'openx', params: { unit: '539971069', delDomain: 'idm-d.openx.net' }}, { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_mpuslot2' }}]}]; NCI's Dictionary of Cancer Terms provides easy-to-understand definitions for words and phrases related to cancer and medicine. It’s also called the “resolution” stage. { bidder: 'ix', params: { siteId: '195455', size: [300, 50] }}, { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_leftslot' }}]}, { bidder: 'criteo', params: { networkId: 7100, publisherSubId: 'cdo_leftslot' }}, See more. { bidder: 'onemobile', params: { dcn: '8a969411017171829a5c82bb4deb000b', pos: 'cdo_btmslot_300x250' }}, bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162050', zoneId: '776340', position: 'btf' }}, bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162050', zoneId: '776358', position: 'atf' }}, The spectrum of neurologic consequences in schizencephaly ranges from no neurologic sequelae to seizures, encephalopathy, and motor impairment. { bidder: 'onemobile', params: { dcn: '8a9690ab01717182962182bb50ce0007', pos: 'cdo_topslot_mobile_flex' }}, var mapping_stickyslot = googletag.sizeMapping().addSize([746, 0], []).addSize([0, 550], [[300, 50], [320, 50], [320, 100]]).addSize([0, 0], [[300, 50], [320, 50]]).build(); userIds: [{ Mutations in SIX3 and SHH have been implicated in both schizencephaly and holoprosencephaly (HPE) (discussed below) (Hehr et al., 2010). { bidder: 'triplelift', params: { inventoryCode: 'Cambridge_SR' }}, { bidder: 'openx', params: { unit: '539971065', delDomain: 'idm-d.openx.net' }}, Danielle Nolan, John Fink, in Handbook of Clinical Neurology, 2018. "sign-up": "https://dictionary.cambridge.org/auth/signup?rid=READER_ID", ‘Such refractory materials as silicon dioxide and aluminum oxide are so severely attacked that their use is hazardous.’ ‘Some compounds of hafnium are also used as refractory substances to line the inside of high-temperature ovens.’ ‘Also under investigation as possible container materials are certain types of refractory … Representative genetic causes of cortical malformations associated with epilepsy. googletag.pubads().setTargeting("cdo_dc", "english"); Typical definitions of TRD vary, and they do not include a resistance … The meaning of refractory may be somewhat different depending on the context. { bidder: 'ix', params: { siteId: '195451', size: [300, 50] }}, M.S.M. { bidder: 'ix', params: { siteId: '195466', size: [728, 90] }}, { bidder: 'onemobile', params: { dcn: '8a9690ab01717182962182bb50ce0007', pos: 'cdo_topslot_mobile_flex' }}, Atrial fibrillation (AF) is a common heart rhythm disorder caused by degeneration of the electrical impulses in the upper cardiac chambers (atria) resulting in a change from an organized heart rhythm to a rapid, chaotic rhythm. {code: 'ad_btmslot_a', pubstack: { adUnitName: 'cdo_btmslot', adUnitPath: '/2863368/btmslot' }, mediaTypes: { banner: { sizes: [[300, 250]] } }, { bidder: 'sovrn', params: { tagid: '448836' }}, Of all patients with a structural brain lesion, 12–50%, including those with a brain tumor, experience seizures despite using AEDs with adequate serum levels (Sisodiya et al., 2002). 'cap': true Alternatively, resistance may arise from genetic variation affecting targets for drug action. { bidder: 'appnexus', params: { placementId: '11654150' }}, Ahsan N.V. Moosa, Elaine Wyllie, in Handbook of Clinical Neurology, 2013. It is unclear why patients with brain tumors more often develop refractory seizures, although the answer is probably multifaceted. Fenestration of cyst refers to opening of the inner wall of porencephaly into the lateral ventricles with the aim of decreasing the pressure in the cyst thereby reducing the ‘irritation’ of the overlying cortex. Black DW. In a rat model of temporal lobe epilepsy. { bidder: 'ix', params: { siteId: '194852', size: [300, 250] }}, var mapping_topslot_a = googletag.sizeMapping().addSize([746, 0], []).addSize([0, 550], [[300, 250]]).addSize([0, 0], [[300, 50], [320, 50], [320, 100]]).build(); googletag.cmd.push(function() { }], Define refractoriness. { bidder: 'ix', params: { siteId: '195453', size: [300, 250] }}, Another member of the ABC transporter family with a high expression in brain tumor tissue, is breast cancer resistance protein (BCRP), which is also a transporter of AEDs. googletag.pubads().setTargeting("cdo_pc", "dictionary"); Meaning of refractory depression. The extent of resection requires a balance between extent of the epileptogenic zone and respect for intact eloquent cortex. expires: 365 // FIXME: (temporary) - send ad requests only if PlusPopup is not shown partner: "uarus31" bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162036', zoneId: '776160', position: 'atf' }}, expires: 60 Drug-resistant epilepsy, also named intractable epilepsy or refractory epilepsy, is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapy or in combination) to achieve sustained seizure freedom (Kwan et al., 2009). The newer AED gabapentin also seems to be a substrate for an unspecified protein transporter, although so far levetiracetam has not been found to use or need a substrate as a transporter into the brain, which may add to its potential use for brain tumors in patients with refractory epilepsy (Luer et al., 1999; Potschka et al., 2004a). var mapping_rightslot = googletag.sizeMapping().addSize([746, 0], [[300, 250]]).addSize([0, 0], []).build(); We therefore undertook a systematic review and meta-analysis of global literature on clozapine augmentation strategies. Many people whose lives have been adversely affected by psychiatric illness struggle with a range of difficulties that may include . mood and anxiety disorders; Refractory B. Storch DD. bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162036', zoneId: '776142', position: 'btf' }}, var pbTabletSlots = [ googletag.pubads().setTargeting('cdo_alc_pr', pl_p.split(",")); { bidder: 'sovrn', params: { tagid: '387233' }}, { bidder: 'ix', params: { siteId: '195451', size: [300, 250] }}, However this procedure when combined with uncapping is associated with more frequent postoperative complications such as prolonged postoperative fever and subgaleal CSF collection. Comments: At this time, we are enrolling patients in a sequential manner, meaning that the next patient will only be treated after the first patient has finished their course of therapy. Patients with relapsed and refractory multiple myeloma that have been exposed to all three major drug classes, including an IMiD agent, a PI and an anti-CD38 antibody, have fewer treatment options and poor outcomes, including shorter response durations and lower overall survival. A subset of patients with large infarcts or porencephaly may have mesial temporal sclerosis with classical electroclinical phenotype of mesial temporal epilepsy. { bidder: 'ix', params: { siteId: '195455', size: [320, 100] }}, Refer to Epilepsy surgery. {code: 'ad_contentslot_2', pubstack: { adUnitName: 'cdo_mpuslot', adUnitPath: '/2863368/mpuslot' }, mediaTypes: { banner: { sizes: [[300, 250], [336, 280]] } }, { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_mpuslot1' }}]}, { bidder: 'onemobile', params: { dcn: '8a969411017171829a5c82bb4deb000b', pos: 'cdo_mpuslot_flex' }}, { bidder: 'onemobile', params: { dcn: '8a969411017171829a5c82bb4deb000b', pos: 'cdo_topslot_728x90' }}, The refractory period is the time between orgasm and when you feel ready to be sexually aroused again. bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162050', zoneId: '1673732', position: 'atf' }}, bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162036', zoneId: '776130', position: 'btf' }}, if(pl_p) { bidder: 'triplelift', params: { inventoryCode: 'Cambridge_Billboard' }}, The International League Against Epilepsy (ILAE) has proposed the following definition of drug resistant epilepsy and suggests that this term be used instead of the term "refractory epilepsy." "sign-out": "https://dictionary.cambridge.org/auth/signout?rid=READER_ID" For example, the groundbreaking treatment known as CAR T-cell therapy was approved in October 2017 for adults with refractory aggressive B cell non-Hodgkin lymphoma. Failed adequate trails of preventive medicines, alone or in combination from at least 2 of 4 drug classes: a. In fact, carbamazepine, lamotrigine, and felbamate have been found to be substrates for P-glycoprotein (P-gp) (Loscher and Potschka, 2002; Rogawski, 2002). { bidder: 'onemobile', params: { dcn: '8a9690ab01717182962182bb50ce0007', pos: 'cdo_mpuslot_mobile_flex' }}, Epilepsy centers also offer a variety of other resources for patients with refractory seizures: neuropsychologic evaluation, psychologic counseling, psychiatric evaluation and treatment, social work evaluation and counseling, vocational rehabilitation, and the input of expert nurse clinicians, nurse practitioners, and patient support groups. bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162036', zoneId: '776142', position: 'btf' }}, Combination therapy at maximally tolerated doses does not control the seizures in some people with epilepsy, even when there is good adherence to treatment recommendations. { bidder: 'pubmatic', params: { publisherId: '158679', adSlot: 'cdo_rightslot' }}]}, THERE is a gap in patient-centred management of drug-resistant or refractory epilepsy, which means up to 80 000 Australians with this specific form of the disease can be overlooked, remaining undiagnosed or misdiagnosed and not receiving the specialised care they need for decades. {code: 'ad_btmslot_a', pubstack: { adUnitName: 'cdo_btmslot', adUnitPath: '/2863368/btmslot' }, mediaTypes: { banner: { sizes: [[300, 250], [320, 50], [300, 50]] } }, adj. Drug-resistant epilepsy, also named intractable epilepsy or refractory epilepsy, is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapy or in combination) to achieve sustained seizure freedom (Kwan et … Showing or characterized by obstinate resistance to authority or control: refractory children; refractory behavior. { bidder: 'appnexus', params: { placementId: '11654150' }}, Unlike chemotherapy, ADCs are intended to target and kill tumor cells while sparing healthy cells.As of 2019, some 56 pharmaceutical companies were developing ADCs. Headaches cause significant interference with function or quality of life despite modification of triggers, lifestyle factors, and adequate trials of acute and preventive medicines with established efficacy. { bidder: 'ix', params: { siteId: '195453', size: [320, 50] }}, bids: [{ bidder: 'rubicon', params: { accountId: '17282', siteId: '162050', zoneId: '776336', position: 'btf' }}, Lack of seizure control is more frequent if the onset was at an early age; if there are generalised, atonic, or absence seizures; or if there is underlying structural brain damage. Drugs Used for Refractory and Relapsed NHL. Present clues on the composition of organic refractories and silicates will be given. Minimal duration of drug trials was set at 2 months (after reaching the therapeutic dose) for oral drugs in line with previous definition of refractory migraine. {code: 'ad_contentslot_1', pubstack: { adUnitName: 'cdo_mpuslot', adUnitPath: '/2863368/mpuslot' }, mediaTypes: { banner: { sizes: [[300, 250], [336, 280]] } }, {code: 'ad_leftslot', pubstack: { adUnitName: 'cdo_leftslot', adUnitPath: '/2863368/leftslot' }, mediaTypes: { banner: { sizes: [[120, 600], [160, 600], [300, 600]] } }, But even when the diagnosis seems certain, monitoring may disclose that the patient’s attacks are not seizures or that the patient has a different seizure type than was suspected.

drug refractory meaning

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