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Chapter 3 - International League Against Epilepsy’s Definition of Medication-Resistant Epilepsy

Published online by Cambridge University Press:  20 August 2020

By
Colin B. Josephson  and
Samuel Wiebe
Edited by
John M. Stern ,
Raman Sankar  and
Michael Sperling
John M. Stern
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Raman Sankar
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Michael Sperling
Affiliation:
Jefferson Hospital for Neurosciences, Philadelphia, PA
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Summary

Epilepsy is a common condition affecting people of all ages, sex and socioeconomic status. Many patients with epilepsy, once diagnosed, can be successfully managed with anti-seizure medication (ASMs) [1]. However, up to 30–40% of patients will continue to have seizures despite optimal medical management [1]. Thus, the World Health Organization (WHO) estimates that 15 million people (of 50 million worldwide with epilepsy) will not achieve complete seizure freedom despite appropriate ASM therapy [2]. These patients consume more health care resources than those with well-controlled epilepsy, as the 15% who are most refractory account for ≥50% of the total costs of the disease [3].

Type
Chapter
Information
Medication-Resistant Epilepsy
Diagnosis and Treatment
 , pp. 20 - 26
Publisher: Cambridge University Press
Print publication year: 2020

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References

Kwan, P, Brodie, MJ. Early identification of refractory epilepsy. N Engl J Med 2000;342:314–319CrossRefGoogle ScholarPubMed
Banerjee, PN, Filippi, D, Allen Hauser, W. The descriptive epidemiology of epilepsy – a review. Epilepsy Res 2009;85:31–45Google Scholar
Begley, CE, Annegers, JF, Lairson, DR, et al. Cost of epilepsy in the United States: a model based on incidence and prognosis. Epilepsia 1994;35:1230–1243CrossRefGoogle Scholar
Derby, LE, Tennis, P, Jick, H. Sudden unexplained death among subjects with refractory epilepsy. Epilepsia 1996;37:931–935Google Scholar
Siddiqui, A, Kerb, R, Weale, ME, et al. Association of multidrug resistance in epilepsy with a polymorphism in the drug-transporter gene ABCB1. N Engl J Med 2003;348:1442–1448CrossRefGoogle ScholarPubMed
Kwan, P, Arzimanoglou, A, Berg, AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010;51:1069–1077CrossRefGoogle Scholar
Marson, AG, Al-Kharusi, AM, Alwaidh, M, et al. The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial. Lancet 2007;369:1000–1015CrossRefGoogle ScholarPubMed
Schmidt, D, Schachter, SC. Drug treatment of epilepsy in adults. BMJ 2014;348:g254Google Scholar
Marson, AG, Al-Kharusi, AM, Alwaidh, M, et al. The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial. Lancet 2007;369:1016–1026Google Scholar
Glauser, TA, Cnaan, A, Shinnar, S, et al. Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy. N Engl J Med 2010;362:790–799CrossRefGoogle ScholarPubMed
Brodie, MJ, Barry, SJ, Bamagous, GA, et al. Effect of dosage failed of first antiepileptic drug on subsequent outcome. Epilepsia 2013;54:194–198Google Scholar
Hanley, JA, Lippman-Hand, A. If nothing goes wrong, is everything all right?: interpreting zero numerators. JAMA 1983;249:1743–1745Google Scholar
Jacoby, A, Gamble, C, Doughty, J, et al. Quality of life outcomes of immediate or delayed treatment of early epilepsy and single seizures. Neurology 2007;68:1188–1196CrossRefGoogle ScholarPubMed
Baker, GA, Jacoby, A, Buck, D, et al. Quality of life of people with epilepsy: a European study. Epilepsia 1997;38:353–362Google Scholar
Carreno, M, Gil-Nagel, A, Sanchez, JC, et al. Strategies to detect adverse effects of antiepileptic drugs in clinical practice. Epilepsy Behav 2008;13:178–183Google Scholar
Callaghan, B, Schlesinger, M, Rodemer, W, et al. Remission and relapse in a drug-resistant epilepsy population followed prospectively. Epilepsia 2011;52:619–626Google Scholar
Berg, AT, Langfitt, J, Shinnar, S, et al. How long does it take for partial epilepsy to become intractable? Neurology 2003;60:186–190Google Scholar
Wiebe, S, Jette, N. Pharmacoresistance and the role of surgery in difficult to treat epilepsy. Nat Rev Neurol 2012;8:669–677Google Scholar
Kwan, P, Brodie, MJ. Early identification of refractory epilepsy. N Engl J Med 2000;342:314–319Google Scholar
Mohanraj, R, Brodie, MJ. Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur J Neurol 2006;13:277–282CrossRefGoogle ScholarPubMed
Berg, AT, Levy, SR, Testa, FM, et al. Remission of epilepsy after two drug failures in children: a prospective study. Ann Neurol 2009;65:510–519CrossRefGoogle ScholarPubMed
Schiller, Y, Najjar, Y. Quantifying the response to antiepileptic drugs: effect of past treatment history. Neurology 2008;70:54–65Google Scholar
Hao, XT, Wong, IS, Kwan, P. Interrater reliability of the international consensus definition of drug-resistant epilepsy: a pilot study. Epilepsy Behav 2011;22:388–390Google Scholar
Tellez-Zenteno, JF, Hernandez-Ronquillo, L, Buckley, S, et al. A validation of the new definition of drug-resistant epilepsy by the International League Against Epilepsy. Epilepsia 2014;55:829–834CrossRefGoogle ScholarPubMed
Ramos-Lizana, J, Rodriguez-Lucenilla, MI, Aguilera-Lopez, P, et al. A study of drug-resistant childhood epilepsy testing the new ILAE criteria. Seizure 2012;21:266–272Google Scholar

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