[Drug resistance in partial epilepsy: epidemiology, mechanisms, pharmacogenetics and therapeutical aspects].
It has been established that 20-30% of epilepsies are not controlled by antiepileptic drugs. Drug resistance is associated with several major problems, including prognosis, cognitive function, behavior, mortality, cost and quality of life. Apart from classic risk factors for drug resistance, such as neurological, psychiatric, imaging, EEG abnormalities, a high frequency of seizures before medical therapy and complex febrile convulsions, the potential role of multidrug transporters as well as their genetic control and the altered sensitivity of neuronal drug receptors has gained growing attention. In the future, pharmaceutical engineering may bypass these factors. To a certain extent, drug resistance may develop progressively in a neurobiological process and the control of this process could limit its development.
Mann
M W
MW
Service de neurochirurgie, centre hospitalier Sainte-Anne, université Paris-Descartes, 1, rue Cabanis, 75014 Paris, France. m.mann@ch-sainte-anne.fr
Pons
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G
D018435:ATP Binding Cassette Transporter, Subfamily B / Q000235:genetics / Q000378:metabolism; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D004351:Drug Resistance; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology* / Q000235:genetics; D006801:Humans; D010597:Pharmacogenetics; D011955:Receptors, Drug / Q000187:drug effects / Q000235:genetics
D018435:ATP Binding Cassette Transporter, Subfamily B; D000927:Anticonvulsants; D011955:Receptors, Drug