Guía terapéutica en epilepsia de la Sociedad Andaluza de Epilepsia 2005: I. Criterios de inicio y cese y bases farmacológicas del tratamiento antiepiléptico / The Andalusia epilepsy society’s guide to epilepsy therapy 2005: I. criteria for starting and discontinuing and the pharmacological bases of antiepileptic treatment

RESUMEN

Objetivo. Elaborar una guía de práctica clínica basada en la evidencia científica que aborde las cuestiones básicas acerca del tratamiento de la epilepsia. Desarrollo. Un comité de 11 expertos pertenecientes a la Sociedad Andaluza de Epilepsia, en el que se incluían seis neurólogos, tres neuropediatras, un neurocirujano y una farmacóloga, todos con especial dedicación y competencia en epilepsia, realizó una revisión bibliográfica exhaustiva en busca de las evidencias disponibles relacionadas con el tema propuesto. Se utilizaron las siguientes bases de datos MEDLINE, Cochrane Library y bases de datos de guías de práctica clínica (National Guideline Clearinghouse, National Institute of Clinical Excellence y Guías Clínicas de la Academia Americana de Neurología). La guía se estructuró en siete secciones y se dividió para su publicación en cuatro partes. Se identificaron 187 documentos relevantes de los que se extrajeron un total de 63 evidencias científicas y 91 recomendaciones terapéuticas, que se tabularon y clasificaron según los criterios de elaboración de Guías de Práctica Clínica de la Federación Europea de Sociedades Neurológicas. Conclusión. Los resultados de esta revisión proveen unas guías de práctica clínica basadas en la evidencia científica útiles, sencillas y aplicables en los diferentes niveles asistenciales

ABSTRACT

Aims. The objective of this work was to produce a scientific evidence-based guide to clinical practice dealing with the basic questions concerning the treatment of epilepsy. Development. A committee of 11 experts belonging to the Andalusia Epilepsy Society, made up of six neurologists, three neuropaediatricians, one neurosurgeon and a pharmacologist, all of whom were deeply involved and experienced in epilepsy, conducted a thorough review of the literature in search of all the evidence available on the proposed subject matter. The following databases were used MEDLINE, Cochrane Library and the databases of several clinical practice guidelines (National Guideline Clearinghouse, National Institute of Clinical Excellence and the American Academy of Neurology’s Clinical Guidelines). The Guide was set out in seven sections and was published in four parts. From a total number of 187 relevant documents, the committee found 63 examples of scientific evidence and 91 therapeutic recommendations. These were tabulated and classified according to the European Federation of Neurological Societies’ criteria for producing Clinical Practice Guidelines. Conclusions. The results of this survey provide scientific evidence-based clinical guidelines that are useful, simple and applicable at different levels of health careAims. The objective of this work was to produce a scientific evidence-based guide to clinical practice dealing with the basic questions concerning the treatment of epilepsy. Development. A committee of 11 experts belonging to the Andalusia Epilepsy Society, made up of six neurologists, three neuropaediatricians, one neurosurgeon and a pharmacologist, all of whom were deeply involved and experienced in epilepsy, conducted a thorough review of the literature in search of all the evidence available on the proposed subject matter. The following databases were used MEDLINE, Cochrane Library and the databases of several clinical practice guidelines (National Guideline Clearinghouse, National Institute of Clinical Excellence and the American Academy of Neurology’s Clinical Guidelines). The Guide was set out in seven sections and was published in four parts. From a total number of 187 relevant documents, the committee found 63 examples of scientific evidence and 91 therapeutic recommendations. These were tabulated and classified according to the European Federation of Neurological Societies’ criteria for producing Clinical Practice Guidelines. Conclusions. The results of this survey provide scientific evidence-based clinical guidelines that are useful, simple and applicable at different levels of health care