1Department of Neurology, Dubrava University Hospital, Zagreb, Croatia; 2Department of Psychiatry and Neurology, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University, Osijek, Croatia; 3Department of Neurology, Zadar General Hospital, Zadar, Croatia.
Acta Clin Croat. 2021 Dec;60(Suppl 3):9-15. doi: 10.20471/acc.2021.60.s3.01.
Pharmacoresistant epilepsy poses a great burden to patients, their families, and the whole healthcare system, with numerous social, economic, physical, and psychical consequences. Hence, it is a diagnosis that has to be made only in cases of high certainty, after all potential causes of epilepsy have been evaluated. One of the important causes of pharmacoresistant epilepsy is false pharmacoresistance, an entity that implies a condition in which poor disease control is not a consequence of the biology of the disease itself, antiepileptic drug inefficacy, and/or patient specificity. It is a consequence of human error and strongly depends on the experience of the treating physician, as well as on the attitude of the patient. Despite its 'falseness', this entity is accompanied by real consequences for the patient and his family, and at the same time, it delays appropriate treatment of the actual disease from which the patient is suffering. In order to introduce appropriate treatment and avoid unnecessary and harmful diagnostic procedures, false pharmacoresistance is a condition that has to be ruled out in any patient with difficult-to-treat seizures.
耐药性癫痫给患者、他们的家庭和整个医疗保健系统带来了巨大的负担,带来了众多的社会、经济、身体和心理后果。因此,只有在高度确定的情况下才能做出这种诊断,即在评估了癫痫的所有潜在病因之后。耐药性癫痫的一个重要原因是假性耐药性,这是一种意味着疾病控制不佳不是疾病本身的生物学、抗癫痫药物无效和/或患者特异性的结果的情况。它是人为错误的结果,很大程度上取决于治疗医生的经验,以及患者的态度。尽管它是“虚假的”,但这种情况会给患者及其家人带来真正的后果,同时也会延迟对患者所患实际疾病的适当治疗。为了引入适当的治疗方法并避免不必要和有害的诊断程序,在任何治疗困难的癫痫发作患者中,都必须排除假性耐药性。