title: Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies.
abstract: To improve patient care and facilitate clinical research, the International League Against Epilepsy (ILAE) appointed a Task Force to formulate a consensus definition of drug resistant epilepsy. The overall framework of the definition has two "hierarchical" levels: Level 1 provides a general scheme to categorize response to each therapeutic intervention, including a minimum dataset of knowledge about the intervention that would be needed; Level 2 provides a core definition of drug resistant epilepsy using a set of essential criteria based on the categorization of response (from Level 1) to trials of antiepileptic drugs. It is proposed as a testable hypothesis that drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom. This definition can be further refined when new evidence emerges. The rationale behind the definition and the principles governing its proper use are discussed, and examples to illustrate its application in clinical practice are provided.
authors.affiliation: Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China. patrickkwan@cuhk.edu.hk
authors.forename: Patrick
authors.initials: P
authors.lastname: Kwan
authors.forename: Alexis
authors.initials: A
authors.lastname: Arzimanoglou
authors.forename: Anne T
authors.initials: AT
authors.lastname: Berg
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Brodie
authors.forename: W
authors.initials: W
authors.lastname: Allen Hauser
authors.forename: Gary
authors.initials: G
authors.lastname: Mathern
authors.forename: Solomon L
authors.initials: SL
authors.lastname: Moshé
authors.forename: Emilio
authors.initials: E
authors.lastname: Perucca
authors.forename: Samuel
authors.initials: S
authors.lastname: Wiebe
authors.forename: Jacqueline
authors.initials: J
authors.lastname: French
mesh_terms: D026683:Advisory Committees; D000927:Anticonvulsants / Q000627:therapeutic use*; D032921:Consensus; D004351:Drug Resistance; D004827:Epilepsy / Q000145:classification* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D038622:Internationality; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants