[Contemporary opinions on classification, pathogenesis and treatment of drug-resistant epilepsy].
Epilepsy is one of the most frequent neurological disorders, both in children and adult persons. About 0.5-1% of general population suffer from epilepsy, which means that about 50 million people in the world are affected. First years of life and very late adulthood are periods in human's life particularly predisposing to epilepsy. Repetitive epileptic seizures may cause many life-threatening situations and significantly lower patient's quality of life. To the most serious complications belong status epilepticus and sudden unexpected deaths due to epilepsy (SUDEP). Absences from work or school caused by seizures, difficulties in social life, frequent injuries and necessity of polytherapy are also important for patients. All these factors result in low self-esteem and poor quality of life. The main aim of the treatment was control of epileptic seizures. However, despite of new antiepileptic drugs developed almost every year, in one third of all patients with epilepsy seizures remain out of control. Those patients are regarded to have "drug-resistant epilepsy". Despite of significant scale of the problem, there is no one definition of the phenomenon. In the presented review the authors outline current definitions, recent opinions on pathogenesis and risk factors, and provide practical rules of pharmacotherapy of epilepsy, which should help to restrict drug-resistancy.
Jóźwiak
Sergiusz
S
Kliniki Neurologii i Epileptologii, Instytutu Pomnik-Centrum Zdrowia Dziecka w Warszawie. s.jozwiak@czd.pl
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000502:physiology; D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D003645:Death, Sudden / Q000453:epidemiology / Q000517:prevention & control; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000145:classification* / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D004833:Epilepsy, Temporal Lobe / Q000145:classification / Q000188:drug therapy* / Q000401:mortality; D004830:Epilepsy, Tonic-Clonic / Q000145:classification / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012640:Seizures / Q000188:drug therapy / Q000517:prevention & control; D013226:Status Epilepticus / Q000145:classification / Q000188:drug therapy* / Q000401:mortality
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000927:Anticonvulsants