[Drug resistant partial seizures. therapeutic strategies in adults]

Epilepsy affects 6.6 of every 1,000 inhabitants of the developed world. A third of these patients do not achieve satisfactory control of their condition with currently available antiepileptic drugs. Medical treatment of drug resistant epilepsy is complicated owing to the need to evaluate the clinical progress of the different types of epilepsy and to deal with many antiepileptic drugs.

We review the basic principles of satisfactory treatment of a patient with drug resistant epilepsy. We particularly emphasize the use of the new antiepileptic drugs, and evaluation of their efficacy and side effects. We also analyze the use of additional treatment of these patients and assess the pharmacokinetic and pharmacodynamic interactions of the drugs which are essential to determine which is the drug of choice in a particular patient. Finally, we consider the most suitable strategies for correct treatment of a patient with epilepsy which is difficult to control.