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Drug-resistant epilepsy: Definition, pathophysiology, and management
Boulenouar Mesraoua1, Francesco Brigo2, Simona Lattanzi3
1Neurosciences Department, Hamad Medical Corporation and Weill Cornell Medical College, Doha, Qatar.
Journal of the Neurological Sciences
|August 19, 2023
Summary
Drug-resistant epilepsy (DRE) affects one-third of people with epilepsy (PWE) globally. This review defines DRE, explores its biological basis and biomarkers, and proposes management strategies for better seizure control.
Area of Science:
- Neurology
- Clinical Medicine
- Pharmacology
Background:
- Epilepsy affects over 51 million people worldwide, with nearly 4.9 million new cases annually.
- Antiseizure medications (ASMs) are the primary treatment for people with epilepsy (PWE).
- Approximately one-third of PWE experience drug-resistant epilepsy (DRE), failing to achieve seizure control with ASMs.
Purpose of the Study:
- To define drug-resistant epilepsy (DRE).
- To elucidate the biological underpinnings and clinical biomarkers associated with DRE.
- To propose practical management strategies for DRE.
Main Methods:
- This study is a narrative review.
- Literature search on DRE definition, pathophysiology, biomarkers, and treatment.
- Synthesis of current knowledge and clinical guidelines.
Main Results:
- Drug-resistant epilepsy (DRE) is characterized by persistent seizures despite adequate trials of two or more ASMs.
- Biological factors and specific clinical biomarkers contribute to the understanding and potential prediction of DRE.
- Evidence-based management strategies can improve outcomes for individuals with DRE.
Conclusions:
- Accurate definition and understanding of DRE are crucial for effective patient care.
- Identifying biomarkers may aid in early diagnosis and personalized treatment approaches for DRE.
- Implementing targeted management strategies is essential to improve seizure control and quality of life for PWE with DRE.
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