Drug-resistant epilepsy: Definition, pathophysiology, and management

There are currently >51 million people with epilepsy (PWE) in the world and every year >4.9 million people develop new-onset epilepsy. The cornerstone of treatment in PWE is drug therapy with antiseizure medications (ASMs). However, about one-third of PWE do not achieve seizure control and do not respond well to drug therapy despite the use of appropriate ASMs [drug-resistant epilepsy (DRE)]. The aims of the current narrative review are to discuss the definition of DRE, explain the biological underpinnings and clinical biomarkers of this condition, and finally to suggest practical management strategies to tackle this issue appropriately, in a concise manner.

Automated summary

There are over 51 million people with epilepsy worldwide, with more than 4.9 million new cases each year. Although drug therapy is the main treatment for epilepsy, approximately one-third of patients do not respond well to medication (drug-resistant epilepsy). This review aims to discuss the definition of drug-resistant epilepsy, explore its biological underpinnings and clinical biomarkers, and suggest practical management strategies to address this issue effectively.