[Diagnosis and treatment of drug-resistant epilepsy]

Important progress has been made in the treatment of drug-resistant epilepsy in recent years as the result of the introduction of new antiepileptic drugs and surgical procedures. Drug resistance can be the result of a variety of factors: incorrect diagnosis, lack of compliance with treatment, inappropriate antiepileptic therapy, as well as drug resistance per se. Appropriate drug therapy for epileptic syndromes, or symptomatic treatment of the type of seizure, are in general the most effective treatments for the patients whose conditions remain uncontrolled. Dose should be the highest tolerated by the patients without side effects, regardless of plasma levels reached. New antiepileptic drugs are indicated as alternatives for complementary therapy in drug-resistant patients, though their use is still experimental. Surgery is not the last option, but rather constitutes yet another valid alternative. In certain cases of temporal mesial syndrome, for example, early surgery may be indicated.