[General principles of treatment and effects of childhood intractable epilepsy].

Intractable epilepsy can be defined as (1) refractory to the treatment, (2) with frequent and severe seizures, and (3) with association of mental disability. Main disorders of childhood intractable epilepsy include Ohtahara syndrome, West syndrome, Lennox-Gastaut syndrome, severe myoclonic epilepsy in infancy, and symptomatic localization related epilepsy. Our results of long-term prognosis of West syndrome showed seizure free patients were 11 of 14 (79%) in cryptogenic and 10 of 29 (34%) in symptomatic cases. Intelligence was normal in 9 of cryptogenic (64%) and only 1 of symptomatic cases. Evolutional changes of West syndrome showed seizure free in 21, localization related epilepsy in 10, secondary generalized epilepsy in 10, unclassified epilepsy in 2. None of Lennox-Gastaut type was observed. A 13-year-old boy of tuberous sclerosis with frequent drop attacks was treated by anterior 3/4 callosotomy. Although the tonic seizures remained, drop attacks were completely abolished. The measures to the intractable epilepsy should be targeted to the symptoms or conditions to which the patients and guardians want to be eliminated.