title: Drug-resistant epilepsy: current recommendations for diagnosis and treatment in Spain.
abstract: BACKGROUND
  Drug-resistant epilepsy (DRE) is a top-priority social health problem which requires early individual treatment due to its dramatic repercussions for the patient and society.
  
  
  METHODS
  The International League Against Epilepsy (ILAE) has recently defined DRE as that in which the seizures are not controlled after having correctly taken two appropriate and well tolerated anti-epileptic drugs, with lack of control being understood as the appearance of seizures within one year or in a period less than three times the inter-seizure interval before starting treatment. This International Society recommends a rapid and detailed assessment of all patients in an Epilepsy Unit. A Clinical Epilepsy Unit (CEU) is understood as a group of professionals who, acting in collaboration, have the diagnosis and treatment of the patient with epilepsy as their primary objective. CEUs in Spain may be stratified into different levels depending on the activity carried out in each of them. The specific epilepsy clinic is considered the fundamental type of CEU and includes the necessary figure of an expert in epilepsy. Prolonged video-monitoring is performed in medical CEUs. In medical-surgical CEUs epilepsy surgery with varying degrees of difficulty is also performed.
  
  
  CONCLUSIONS
  All CEUs must cooperate with consensus protocols, and there must be a two-way flow between them. Stratification of CEUs increases efficacy and efficiency, due to there being a sufficient number of them to ensure easy access by all patients with epilepsy.
authors.affiliation: Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico Universitario San Cecilio, Granada, España. jucasan9@gmail.com
authors.forename: J C
authors.initials: JC
authors.lastname: Sánchez-Álvarez
authors.forename: A
authors.initials: A
authors.lastname: Gil-Nagel
authors.forename: C
authors.initials: C
authors.lastname: Casas-Fernández
authors.forename: J A
authors.initials: JA
authors.lastname: Mauri-Llerda
authors.forename: J
authors.initials: J
authors.lastname: Salas-Puig
authors.forename: J
authors.initials: J
authors.lastname: Sancho-Rieger
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D004351:Drug Resistance; D004827:Epilepsy / Q000175:diagnosis* / Q000628:therapy*; D006301:Health Services Needs and Demand; D006757:Hospital Units; D006801:Humans; D013030:Spain; D009626:Terminology as Topic
chemical_list: D000927:Anticonvulsants