The Problem of the Drug-Resistant Epilepsies

  1. Gregory Bock and
  2. Jamie A. Goode
  1. J. W. Sander

Published Online: 7 OCT 2008

DOI: 10.1002/0470846356.ch2

Mechanisms of Drug Resistance in Epilepsy: Novartis Foundation Symposium 243

Mechanisms of Drug Resistance in Epilepsy: Novartis Foundation Symposium 243

How to Cite

Sander, J. W. (2002) The Problem of the Drug-Resistant Epilepsies, in Mechanisms of Drug Resistance in Epilepsy: Novartis Foundation Symposium 243 (eds G. Bock and J. A. Goode), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846356.ch2

Author Information

  1. Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK

Publication History

  1. Published Online: 7 OCT 2008
  2. Published Print: 25 MAR 2002

Book Series:

  1. Novartis Foundation Symposia

Book Series Editors:

  1. Novartis Foundation

ISBN Information

Print ISBN: 9780470841464

Online ISBN: 9780470846353

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Summary

For the majority of patients with epilepsy, the prognosis for seizure control is very good; however, refractory epilepsy develops in about 20–30% of patients and represents a significant challenge for both clinical management and for research. Physicians treating epilepsy are often asked to predict prognosis and make decisions about commencing and withdrawing treatment. Practice can be guided by epidemiological studies of prognosis. It seems that prognosis depends largely on the aetiology of the seizures and the clinical background of the patient rather than on the seizures themselves or the treatment prescribed. Aetiologies are, however, not the sole determinant of outcome and response to treatment and unknown factors must exit. It is likely that some of these unknown factors are genetically determined but this needs confirmation. The search for these unknown factors that may determine intractability in epilepsy is a very exciting prospect, which may prove to be multifactorial. In some patients, epilepsy may indeed become resistant to treatment whilst in others the propensity for intractability to the drugs currently available may be part and parcel of the condition. Further research is urgently needed to elucidate the full range of mechanisms that lead to drug resistant epilepsy.