Epilepsja z drgawkami miokloniczno-atonicznymi: przegląd z naciskiem na obecne i nowe leki
PubMed➕ 20.09.2026Expert Rev Neurother
Epilepsy with myoclonic-atonic seizures: a comprehensive review with emphasis on current and emerging pharmacotherapies
W skrócie
Epilepsja z drgawkami miokloniczno-atonicznymi (zwana też syndromem Doose'a) to rzadka forma epilepsji u małych dzieci, którą charakteryzują nagłe i wielokrotne napady drgawek. W artykule opisano objawy, sposoby rozpoznania choroby, badania genetyczne oraz leki stosowane w leczeniu - od najprostszych leków pierwszego rzędu (jak walproinian sodu) po zaawansowane terapie (jak dieta ketogeniczna czy kannabidiol) dla pacjentów opornych na leczenie. Autorzy podkreślają, że chociaż większość dzieci osiąga remisję drgawek, ważne jest wczesne rozpoznanie i odpowiednie leczenie, szczególnie dostosowanie do genetycznej przyczyny choroby.
Oryginalny abstract (angielski)
INTRODUCTION: Epilepsy with myoclonic-atonic seizures (EMAtS), historically termed Doose syndrome, is a developmental and epileptic encephalopathy characterized by the usually abrupt onset of multiple generalized seizure types, including myoclonic-atonic seizures, in early childhood. Advances in genetic diagnostics, antiseizure treatments, and precision therapies have reshaped understanding and management of EMAtS. AREAS COVERED: This review synthesizes the clinical spectrum of EMAtS, including core clinical features and diagnostic approach based on a literature search of PubMed, Embase, and OVID/MEDLINE. The genetic landscape is discussed to contextualize emerging precision therapies. Treatment is reviewed hierarchically, from valproate, clobazam, levetiracetam and ethosuximide as commonly used first- and second-line agents to the ketogenic diet, cannabidiol, felbamate, and sulthiame for drug-resistant disease. Precision approaches for key genetic etiologies, including,and, are also reviewed. EXPERT OPINION: Although approximately two-thirds of patients with EMAtS achieve seizure remission, a substantial minority experience drug-resistant seizure, intellectual disability, and behavioral comorbidities, underscoring the importance of timely diagnosis, appropriate pharmacotherapy, and early consideration of the ketogenic diet in drug-resistant cases. As precision therapeutics advance, syndrome-based care will increasingly be complemented by treatments tailored to the specific genetic etiology.