Drug-resistant epilepsy is a condition where seizures persist despite the patient having undergone treatment with two antiepileptic drug regimens without achieving long-term seizure control. For a 12-year-old child, this condition can significantly impact brain development, learning abilities, and social skills, which are still maturing at this age. Recurrent seizures can disrupt schooling, diminish concentration, memory, and knowledge acquisition, thereby affecting a child's overall development. This condition also makes it challenging for children to participate in sports and recreational activities.

It is crucial to take your child to a specialized neurological hospital for a thorough examination. Doctors will evaluate the medications already used, including dosage, treatment duration, adherence to the regimen, and any side effects. If the medication is not suitable for the type of seizure, the dosage is insufficient, or the patient is not taking medication consistently, the doctor may adjust the current treatment, combine it with other antiepileptic drugs, or change the entire regimen.

If your child is accurately diagnosed with drug-resistant epilepsy, doctors may recommend specialized subclinical tests. These could include brain magnetic resonance imaging (MRI), positron emission tomography (PET), or single-photon emission computed tomography (SPECT) to locate the seizure-generating focus within the brain.

Several advanced methods are available for treating drug-resistant epilepsy:

Surgery is an option when the child has structural lesions, such as focal cortical dysplasia or vascular malformations, directly linked to the seizure-generating area, and if surgical access is safe. Surgery can help reduce the frequency or control seizures without risking damage to vital brain functions.

Doctors perform surgery on a patient with drug-resistant epilepsy. *Illustration: Tam Anh General Hospital*

Deep brain stimulation (DBS) may be indicated for patients with drug-resistant epilepsy. This procedure involves implanting electrodes into the brain through small holes in the skull. These electrodes connect to an electrical pulse generator placed under the skin in the chest area, which sends electrical pulses to specific brain regions. This helps regulate abnormal signals and reduce the frequency of seizures.

Vagus nerve stimulation (VNS) is another procedure where an electrical pulse-generating device is implanted under the skin in the left chest. An electrode from this device connects to the left vagus nerve in the neck. The device emits regular electrical pulses to modulate brain electrical activity, thereby reducing seizure frequency in individuals with drug-resistant epilepsy.

Families should establish a scientific daily routine for the child, ensuring sufficient and consistent sleep. It is important to avoid factors that could trigger seizures. Emergency medical attention is required if a seizure lasts longer than 5 minutes, if multiple seizures occur consecutively without the child regaining consciousness, or if the child experiences difficulty breathing or injury during a seizure.

ThS.BS Vu Thi Hinh

Department of Neurology - Stroke

Tam Anh Hanoi Hospital

Tam Anh Cau Giay Polyclinic