Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.
CNS Drugs. 2022 Jun;36(6):555-568. doi: 10.1007/s40263-022-00922-4. Epub 2022 May 20.
Drug-resistant epilepsy is associated with poor health outcomes and increased economic burden. In the last three decades, various new antiseizure medications have been developed, but the proportion of people with drug-resistant epilepsy remains relatively unchanged. Developing strategies to address drug-resistant epilepsy is essential. Here, we define drug-resistant epilepsy and emphasize its relationship to the conceptualization of epilepsy as a symptom complex, delineate clinical risk factors, and characterize mechanisms based on current knowledge. We address the importance of ruling out pseudoresistance and consider the impact of nonadherence on determining whether an individual has drug-resistant epilepsy. We then review the principles of epilepsy drug therapy and briefly touch upon newly approved and experimental antiseizure medications.
耐药性癫痫与健康状况不佳和经济负担增加有关。在过去的三十年中，已经开发出了各种新型抗癫痫药物，但耐药性癫痫患者的比例相对不变。制定解决耐药性癫痫的策略至关重要。在这里，我们定义了耐药性癫痫，并强调了它与癫痫作为一种症状复杂的概念化之间的关系，描述了临床危险因素，并根据现有知识描述了机制。我们讨论了排除假性耐药的重要性，并考虑了不依从性对确定个体是否患有耐药性癫痫的影响。然后，我们回顾了癫痫药物治疗的原则，并简要介绍了新批准的和实验性的抗癫痫药物。
