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Panel Discussion

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Abstract

Dr. Dreifuss: We heard this morning about two well-defined syndromes of so-called idiopathic epilepsy, which carry a very benign outlook, and about two syndromes, which are referred to as either cryptogenic or symptomatic epilepsy, where the outlook is less certain and where the response to therapy is probably less favorable.

It is extremely important, I think, to attempt to define these syndromes in order to be able to predict, when one first sees a patient, whether the outcome will be sufficiently favorable to avoid the use of antiepileptic drugs altogether or, if one has to use them, whether one can predict a termination point for such treatment, or whether the syndrome is, like the Janz syndrome, one in which continuous long-term medication is going to be necessary. This is one of the practical uses of being able to classify patients into these various syndromes. Dr. Janz has given us a further look at what I think the future holds for identification of the individual syndromes: that is, a discussion of what is ultimately going to prove to be the fons et origo—namely the gene itself. Juvenile myoclonic epilepsy is perhaps offering us the very first glimpse into the nirvana of being able to identify the underlying cause of some of the problems that are at the present time referred to as the epilepsies.

Question: I want to ask Dr. Aicardi one question. We all have the same experience of that particular group of children who start with what appear. . .


 

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