{"id":1063,"date":"2021-03-10T16:47:54","date_gmt":"2021-03-10T16:47:54","guid":{"rendered":"https:\/\/ring20researchsupport.co.uk\/?page_id=1063"},"modified":"2021-05-12T14:30:12","modified_gmt":"2021-05-12T13:30:12","slug":"how-to-treat-r20","status":"publish","type":"page","link":"https:\/\/ring20researchsupport.co.uk\/fr\/for-medics-researchers\/how-to-treat-r20\/","title":{"rendered":"Comment traiter r(20)"},"content":{"rendered":"
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Les convulsions ne r\u00e9pondent g\u00e9n\u00e9ralement pas \u00e0 la stimulation m\u00e9dicale, di\u00e9t\u00e9tique ou neurostimulante et il n'existe actuellement aucun traitement recommand\u00e9 pour le syndrome r(20). Il existe des rapports sur l'efficacit\u00e9 du r\u00e9gime c\u00e9tog\u00e8ne et de la stimulation du nerf vague dans des cas individuels, mais d'autres cas ne r\u00e9pondent pas \u00e0 ces traitements et les preuves sont insuffisantes.<\/p>

La polyth\u00e9rapie doit \u00eatre \u00e9vit\u00e9e car elle augmente le risque d'effets secondaires et n'est pas susceptible d'am\u00e9liorer le contr\u00f4le des crises.<\/p>

Il est souvent inutile de traiter tous les \u00e9pisodes de NCSE qui peuvent durer des minutes, des heures ou m\u00eame des jours, car les patients se r\u00e9tablissent g\u00e9n\u00e9ralement spontan\u00e9ment. L'utilisation de m\u00e9dicaments de secours (d'urgence) peut \u00eatre inefficace et, si elle est utilis\u00e9e r\u00e9guli\u00e8rement, peut provoquer une s\u00e9dation et alt\u00e9rer consid\u00e9rablement la qualit\u00e9 de vie.<\/p>

Une mort subite et inattendue a \u00e9t\u00e9 rapport\u00e9e dans ce syndrome et, par cons\u00e9quent, les d\u00e9cisions de ne pas prescrire de m\u00e9dicaments doivent en tenir compte.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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RECOMMANDATIONS<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Protocoles d'urgence individualis\u00e9s<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Des plans de traitement individualis\u00e9s doivent \u00eatre \u00e9tablis pour :<\/p>

  • crises prolong\u00e9es<\/li>
  • \u00e9tat de mal \u00e9pileptique convulsif<\/li>
  • \u00e9tat de mal \u00e9pileptique non convulsif (NCSE)<\/li><\/ul><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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    Fournir au patient et\/ou au soignant\u00a0:<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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    • Conseils de s\u00e9curit\u00e9, en particulier concernant \u00abl'\u00e9tat confusionnel\u00bb associ\u00e9 aux \u00e9pisodes de NCSE<\/li>
    • Gestion des risques SUDEP<\/li>
    • Conseil g\u00e9n\u00e9tique<\/li>
    • Besoins de soutien du patient, de l'aidant et de l'employeur (\u00e9valuation neuropsychologique, orientation, \u00e9ventuel soutien psychiatrique)<\/li><\/ul><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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      Examiner l\u2019impact des crises, des m\u00e9dicaments et des comorbidit\u00e9s sur :<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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      • Activit\u00e9s au quotidien<\/li>
      • Bien-\u00eatre g\u00e9n\u00e9ral<\/li>
      • Sant\u00e9 mentale<\/li>
      • Sant\u00e9 physique<\/li>
      • Ind\u00e9pendance<\/li>
      • Sant\u00e9 biologique et psychiatrique Comportement<\/li><\/ul><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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        Comorbidit\u00e9s<\/h3>

        Jusqu'au d\u00e9but des crises, le d\u00e9veloppement de l'enfant semble \u00eatre normal, mais il s'ensuit souvent un d\u00e9clin rapide de la fonction intellectuelle. Les comp\u00e9tences pr\u00e9c\u00e9demment acquises peuvent \u00eatre perdues. Cette baisse de capacit\u00e9 varie de la perte de certaines comp\u00e9tences, mais en restant dans la plage normale de la fonction intellectuelle, \u00e0 une perte importante de comp\u00e9tences, y compris des difficult\u00e9s de mobilit\u00e9 et une perte des fonctions de la parole et du langage. Le syndrome r(20) est associ\u00e9 \u00e0 une enc\u00e9phalopathie \u00e9pileptique en cas de mauvais contr\u00f4le des crises.<\/p>

        Un soutien sera probablement n\u00e9cessaire \u00e0 l'\u00e9cole\/au coll\u00e8ge et sur le lieu de travail. Des probl\u00e8mes de comportement tels que des \u00e9pisodes d'agression avant et\/ou apr\u00e8s une crise sont signal\u00e9s. De nombreuses personnes d\u00e9veloppent des caract\u00e9ristiques autistiques. Il est impossible de pr\u00e9dire la gravit\u00e9 des probl\u00e8mes d'apprentissage et de comportement \u00e0 l'avenir au d\u00e9but de l'\u00e9pilepsie.<\/p>

        Dans l'ensemble, environ la moiti\u00e9 des patients peuvent avoir un quotient intellectuel \u00e9valu\u00e9 comme \u00e9tant dans la fourchette normale \u00e0 l'\u00e2ge adulte, mais nombre d'entre eux peuvent avoir connu un d\u00e9clin relatif de leurs capacit\u00e9s cognitives pendant l'enfance.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

        Seizures do not typically respond to medical, dietary or neurostimulation and there is currently no recommended treatment for r(20) syndrome. There are reports of efficacy of the ketogenic diet and vagal nerve stimulation in individual cases however other cases do not respond to these treatments and there is insufficient evidence. Polytherapy should be avoided as […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":76,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-1063","page","type-page","status-publish","hentry"],"yoast_head":"\nHow to treat r(20) - Ring20 Research and Support UK CIO<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ring20researchsupport.co.uk\/fr\/for-medics-researchers\/how-to-treat-r20\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How to treat r(20) - Ring20 Research and Support UK CIO\" \/>\n<meta property=\"og:description\" content=\"Seizures do not typically respond to medical, dietary or neurostimulation and there is currently no recommended treatment for r(20) syndrome. 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