[Drug-resistant partial epilepsy: pharmacological criteria].
Despite the number of new antiepileptic drugs marketed in the last decade, one third of epilepsies have remained refractory to medical treatment. The term of pharmacoresistance remains controversial and a diagnosis algorithm should be proposed to distinguish pseudoresistance related to the pathology and patient or to the treatment. Beyond resistance to the first prescribed antiepileptic, a lack of response to the sequential use of several monotherapies or antiepileptic drug associations should lead to the diagnosis of drug-resistance, when all causes of pseudoresistance have been ruled out. The presence of predicting factors or etiological factors should also be integrated into this decisional algorithm. Such a diagnostic process identifying real drug-resistant epilepsy is necessary to progress in knowledge of the pathophysiology and in treatment strategy of this category of epilepsy.
Bordet
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EA1046-Laboratoire de Pharmacologie, Faculté de Médecine de Lille, 2 place de Verdun, 59045 Lille Cedex, France. bordet@univ-lille2.fr
D000927:Anticonvulsants / Q000008:administration & dosage / Q000145:classification / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D012307:Risk Factors
D000927:Anticonvulsants