PECEM (MD/PhD), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
Pharmacobiology Department, Center of Research and Advanced Studies, Mexico City, Mexico.
Epilepsy Behav. 2021 Aug;121(Pt B):106430. doi: 10.1016/j.yebeh.2019.07.031. Epub 2019 Aug 2.
Drug-resistant epilepsy affects approximately one-third of the patients with epilepsy. The pharmacoresistant condition in epilepsy is mainly explained by six hypotheses. In addition, several experimental models have been used to understand the mechanisms involved in pharmacoresistant epilepsy and to identify novel therapies to control this condition. However, the global prevalence of this disease persists without changes. Several factors can explain this situation. First of all, the pharmacoresistant epilepsy is explained by different and independent hypotheses. Each hypothesis indicates specific mechanisms to explain the drug-resistant condition in epilepsy. However, there are different findings suggesting common mechanisms between the different hypotheses. Other important situation is that the experimental models designed for the screening of drugs with potential anticonvulsant effect do not consider factors such as age, gender, type of epilepsy, and comorbid disorders. The present review focuses on indicating the limitations for each hypothesis and the relationships among them. The relevance to consider central and peripheral phenomena associated with the drug-resistant condition in different types of epilepsy is also indicated. The necessity to establish a global hypothesis that integrates all the phenomena associated with the pharmacoresistant epilepsy is proposed. This article is part of the Special Issue "NEWroscience 2018".
耐药性癫痫影响约三分之一的癫痫患者。癫痫的药物难治性主要由六个假说解释。此外，还使用了几种实验模型来了解与耐药性癫痫相关的机制，并确定控制这种疾病的新疗法。然而，这种疾病的全球患病率仍然没有变化。有几个因素可以解释这种情况。首先，耐药性癫痫是由不同的、独立的假说解释的。每个假说都表明了特定的机制来解释癫痫的耐药性。然而，有不同的发现表明不同假说之间存在共同的机制。另一个重要的情况是，为筛选具有潜在抗惊厥作用的药物而设计的实验模型没有考虑年龄、性别、癫痫类型和合并症等因素。本综述重点指出了每个假说的局限性及其之间的关系。还指出了考虑与不同类型癫痫的耐药性相关的中枢和外周现象的相关性。提出了建立一个综合所有与耐药性癫痫相关现象的全球假说的必要性。本文是《NEWroscience 2018》特刊的一部分。
