Drug Resistant Epilepsy

Epileptic condition in which adequate trials of two tolerated and appropriately chosen and used ANTIEPILEPTIC DRUGS schedules to achieve sustained seizure freedom failed.

Also Known As:

Drug Refractory Epilepsy; Epilepsy, Drug Refractory; Epilepsy, Drug Resistant; Epilepsy, Intractable; Intractable Epilepsy; Medication Resistant Epilepsy; Refractory Epilepsy; Drug Refractory Epilepsies; Drug Resistant Epilepsies; Epilepsies, Drug Refractory; Epilepsies, Drug Resistant; Epilepsies, Intractable; Epilepsies, Medication Resistant; Epilepsies, Refractory; Epilepsy, Medication Resistant; Epilepsy, Refractory; Intractable Epilepsies; Medication Resistant Epilepsies; Refractory Epilepsies; Refractory Epilepsies, Drug; Refractory Epilepsy, Drug; Resistant Epilepsies, Drug; Resistant Epilepsies, Medication; Resistant Epilepsy, Drug; Resistant Epilepsy, Medication

Networked: 5070 relevant articles (558 outcomes, 751 trials/studies)

Relationship Network

Disease Context: Research Results

Nervous System Diseases: 14178
- Central Nervous System Diseases: 4213
  - Brain Diseases: 15694
    - Epilepsy: 37791
      - Drug Resistant Epilepsy: 5070

Related Diseases

1.	Epilepsy (Aura)
2.	Seizures (Absence Seizure)
3.	Tuberous Sclerosis (Bourneville's Disease)
4.	Status Epilepticus (Complex Partial Status Epilepticus)
5.	Intellectual Disability (Idiocy)

Experts

1.	Boon, Paul: 45 articles (04/2022 - 04/2002)
2.	Vonck, Kristl: 37 articles (04/2022 - 04/2002)
3.	Peltola, Jukka: 30 articles (06/2022 - 04/2008)
4.	Kossoff, Eric H: 26 articles (07/2022 - 12/2003)
5.	Raedt, Robrecht: 23 articles (04/2022 - 06/2006)
6.	Kwan, Patrick: 23 articles (01/2022 - 03/2002)
7.	Marson, Anthony G: 23 articles (01/2022 - 07/2008)
8.	Löscher, Wolfgang: 22 articles (01/2022 - 04/2002)
9.	Snead, O Carter: 21 articles (10/2022 - 08/2003)
10.	Sperling, Michael R: 21 articles (10/2022 - 03/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Drug Resistant Epilepsy:

1.	Anticonvulsants (Antiepileptic Drugs)IBA 08/11/2016 - "Although antiepileptic medications produce clinical improvement in most individuals, nearly a third of individuals have drug-resistant epilepsy that carries significant morbidity and mortality. " 12/01/2012 - "Surgery is a highly effective treatment for some specific types of refractory epilepsy and once seizure freedom is achieved many patients and clinicians have to ponder whether to taper or discontinue antiepileptic drugs (AEDs). " 01/03/2012 - "We retrospectively examined treatment records of developmentally disabled adults with highly refractory epilepsy to determine whether any combinations of 8 of the most commonly used antiepileptic drugs (AEDs) possessed superior efficacy. " 03/01/2006 - "The availability of ten new antiepileptic drugs since the late 1980s has not dramatically improved the outcome of refractory epilepsy. " 01/01/2021 - "Although antiepileptic medications produce clinical improvement in many individuals, nearly a third of individuals have drug-resistant epilepsy that carries significant morbidity and mortality, and even individuals who have clinical improvement from antiepileptic medications often report iatrogenic symptoms. "
2.	Levetiracetam (Keppra)FDA LinkGeneric 03/01/2017 - "Our findings suggest that even for intractable pediatric cases with symptomatic etiology (i.e., MRI lesion and ID), levetiracetam has favorable efficacy for refractory epilepsy with tolerable adverse effects." 08/01/2005 - "Fast and sustained efficacy of levetiracetam during titration and the first 3 months of treatment in refractory epilepsy." 05/01/2010 - "Therefore, the authors conclude that levetiracetam treatment is effective and safe in young children with refractory epilepsy." 01/01/2013 - "The purpose of this study was to determine the efficacy of levetiracetam (LEV) on SBS, seizure frequency, and neuropsychological impairments in children with refractory epilepsy. " 08/01/2010 - "Efficacy of levetiracetam in children with refractory epilepsy as an add-on trial."
3.	CannabidiolIBA 11/01/2023 - "Highly purified cannabidiol (CBD) has a broad spectrum of action and could be useful for the treatment of drug resistant epilepsy regardless of etiology or syndrome. " 01/01/2021 - "Long-term safety and efficacy of highly purified cannabidiol for treatment refractory epilepsy." 01/01/2019 - "Over a 4-year period, cannabidiol was effective in 26.9% of children with otherwise refractory epilepsy. " 11/01/2022 - "Artisanal cannabidiol-enriched cannabis may be an effective and safe long-term treatment for refractory epilepsy." 09/21/2021 - "During a phase II expanded access program (EAP) study to evaluate the safety and efficacy of using cannabidiol (CBD) for the long-term treatment of children with drug-resistant epilepsy, secondary outcome measures were also performed, including quality of life (QOLCE), behavior (aberrant behavior checklist ABC), and sleep (children's sleep habit questionnaire, CSHQ). "
4.	trans-sodium crocetinate (crocetin)IBA 12/01/2022 - "Overall, satisfaction was high, even among patients who did not achieve remission; 13/15 tuberectomy responders recommended surgery to others with TSC and refractory epilepsy. " 05/01/2021 - "We demonstrated the efficacy of surgical treatment for patients with TSC and intractable epilepsy. " 11/01/2020 - "Patients with TSC were more likely to have a diagnosis code for refractory epilepsy (38.7% vs. 10.2%, p < 0.001) and more likely to have used an AED (89.5% vs. 71.2%, p < 0.001) than patients without TSC over the study period. " 07/01/2020 - "This study examines the volumes of SGCTs and renal AMLs in patients with TSC during treatment with purified CBD for refractory epilepsy. " 01/01/2020 - "This study included 31 patients with intractable epilepsy and TSC who were treated with the KD, and an intention-to-treat analysis was performed. "
5.	Vigabatrin FDA Link 02/01/1993 - "Vigabatrin has been effective in patients with refractory epilepsy. " 09/01/1994 - "To determine the efficacy of a new anti-epileptic medication vigabatrin in adults and children with drug-resistant epilepsy. " 12/01/2013 - "This study evaluated the efficacy of Vigabatrin in children with intractable epilepsy. " 12/01/2013 - "This study confirms the short-term efficacy and safety of Vigabatrin in children with refractory epilepsies." 12/01/1997 - "Children, 47, with various types of severe drug-resistant epilepsy were entered into a prospective, add-on, open trial with vigabatrin. "
6.	Lamotrigine (Lamictal)FDA LinkGeneric 02/01/1998 - "Lamotrigine as add-on treatment (500 mg per day) is effective in patients with refractory epilepsy, but its high cost requires a pharmacoeconomic analysis. " 12/01/2012 - "Overall, lamotrigine is effective and safe in children with refractory epilepsy." 07/01/1999 - "To evaluate the efficacy of lamotrigine as single agent in patients with refractory epilepsy. " 05/01/2006 - "The aim of this study was to investigate the effects of adjunctive lamotrigine (LTG) in refractory epilepsy in Taiwan, especially including patients who had undergone ineffective epileptic surgeries. " 05/01/2001 - "The study was designed to evaluate optimal use of add-on lamotrigine in the treatment of children and adults with refractory epilepsy of any type. "
7.	CarbohydratesIBA 01/01/2012 - "The most notable example of a dietary treatment with proven efficacy against a neurological condition is the high-fat, low-carbohydrate ketogenic diet (KD) used in patients with medically intractable epilepsy. " 08/01/2007 - "Although highly effective for the treatment of intractable epilepsy, the ketogenic diet is not always included in the treatment option hierarchy presented to families, in part due to perceptions that children will find the high-fat/low-carbohydrate regimen unpalatable. " 01/01/2022 - "The high-fat, low-carbohydrate ketogenic diet (KD) is an established treatment for refractory epilepsy with a proven efficacy. " 11/01/2020 - "The high-fat, low-carbohydrate ketogenic diet (KD) is an established treatment for drug-resistant epilepsy with a proven efficacy. " 06/01/2016 - "The high-fat, low-carbohydrate ketogenic diet (KD) is effective in many cases of drug-resistant epilepsy, particularly in children. "
8.	perampanelIBA 11/01/2017 - "Perampanel was fairly effective in a heterogeneous group of 96 children and adolescents with very refractory epilepsy. " 10/01/2022 - "We evaluated the safety and efficacy of perampanel for adolescent patients (aged 12-17 years) with drug-resistant, refractory epilepsy in real-world settings. " 02/01/2020 - "The efficacy of perampanel in young children with drug-resistant epilepsy." 01/01/2017 - "Tolerability and efficacy of perampanel in children with refractory epilepsy." 06/10/2023 - "This study aimed to develop a population pharmacokinetic (PopPK) model to be further used in initial dose optimization of perampanel in patients diagnosed with refractory epilepsy. "
9.	Intravenous Immunoglobulins (IVIG)FDA Link 04/01/2002 - "In this view, IVIg with its broad immunomodulatory mechanism of action could be effective in different forms of immune-dysregulated intractable epilepsies. " 12/01/1994 - "They suggest that IVIg might be effective in some patients with intractable epilepsy, and may be considered as a safe add-on medication in various types of idiopathic and symptomatic intractable epilepsy. " 01/01/2017 - "This case underscores the efficacy of intravenous immunoglobulin in the treatment of refractory epilepsy in children. " 05/01/2015 - "Efficacy of intravenous immunoglobulin in a cohort of children with drug-resistant epilepsy." 12/02/2019 - "The included study was a randomised, double-blind, placebo-controlled, multicentre trial which compared the treatment efficacy of IVIg as an add-on with a placebo add-on in patients with drug-resistant epilepsy. "
10.	rufinamide FDA Link 01/01/2018 - "Efficacy of rufinamide in childhood refractory epilepsy. " 01/01/2018 - "Efficacy of rufinamide in childhood refractory epilepsy." 11/01/2012 - "The aim of this prospective study was to evaluate the safety and efficacy of add-on Rufinamide in the treatment of childhood focal drug resistant epilepsy. " 05/01/2011 - "Efficacy of rufinamide in drug-resistant epilepsy: a meta-analysis." 12/01/2020 - "Rufinamide efficacy and association with phenotype and genotype in children with intractable epilepsy: A retrospective single center study."

Therapies and Procedures

1.	Ketogenic Diet 11/01/2017 - "The ketogenic diet (KD) has been proven to be effective in children with refractory epilepsy and is recommended by the National Institute of Health and Care Excellence (NICE). " 01/01/2017 - "Ketogenic diet (KD) can be a very effective treatment for intractable epilepsy. " 11/01/1999 - "Previous work has identified several criteria that may be important in determining the efficacy of the ketogenic diet as a treatment for intractable epilepsy in children. " 01/01/2021 - "The classic ketogenic diet (KD) can be used successfully to treat medically refractory epilepsy. " 10/01/2020 - "The ketogenic diet (KD) has been used successfully to treat children with drug-resistant epilepsy. "
2.	Therapeutics 06/01/2007 - "These results indicate that VNS is a safe and effective alternative therapy for pediatric refractory epilepsy, without significant adverse events." 01/01/2004 - "This may be a hint for the efficacy of a holistic treatment approach to increase the patient's resources for a successful psychosocial adjustment to therapy refractory epilepsy." 08/01/1984 - "Surgical therapy may be beneficial in some patients with medically intractable epilepsy." 11/01/2016 - "With the clinical need to develop more precise and effective therapies for patients with drug-resistant epilepsy, these tools have recently been explored as a novel treatment for halting seizure activity in various animal models. " 02/01/2008 - "Therefore VNS is safe and effective therapy and has a long-term sustained effect in refractory epilepsy."
3.	Vagus Nerve Stimulation 07/01/2015 - "Since approved by the FDA in 1997, vagus nerve stimulation (VNS) has proven to be a safe and effective treatment for refractory epilepsy and resistant depression. " 05/01/2017 - "Vagus nerve stimulation (VNS) has shown to be an effective treatment for drug resistant epilepsy, with achieving more than 50% seizure reduction in one third of the treated patients. " 01/01/2022 - "Vagus nerve stimulation (VNS) is an effective treatment for drug-resistant epilepsy (DRE). " 10/01/2021 - "Vagus nerve stimulation (VNS) has been widely used as an effective treatment for patients with drug-resistant epilepsy (DRE). " 12/01/2020 - "Elucidating the mechanism of therapeutic efficacy of vagal nerve stimulation in intractable epilepsy: An electroencephalographic analysis."
4.	Deep Brain Stimulation 07/01/2014 - "Deep brain stimulation, specifically high-frequency stimulation (HFS), is an alternative and promising treatment for intractable epilepsies; however, the optimal targets are still unknown. " 01/01/2019 - "Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a promising treatment for refractory epilepsy; however, it remains challenging to successfully target the ANT. " 12/01/2016 - "Deep brain stimulation of the anterior nuclei of the thalamus has been used for the treatment of refractory epilepsy with good results. " 10/01/2007 - "Chronic high-frequency deep brain stimulation (DBS) may also be effective in patients with refractory epilepsy. " 09/01/2023 - "Deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) is an effective treatment for refractory epilepsy; however, seizure outcome varies among individuals. "
5.	High-Protein Low-Carbohydrate Diet (Atkins Diet) 03/01/2013 - "The modified Atkins diet was found to be effective and well tolerated in children with drug-refractory epilepsy." 04/16/2016 - "The modified Atkins diet is a useful treatment for patients with intractable epilepsy. " 03/01/2013 - "The aim of this study was to evaluate the efficacy of the modified Atkins diet in a randomized controlled trial in children with refractory epilepsy. " 09/15/2021 - "To compare the efficacy of the modified Atkins diet (mAD) and low glycemic index treatment (LGIT) among children with drug-resistant epilepsy. " 09/01/2008 - "At Ghent University Hospital, the feasibility and efficacy of the modified Atkins' diet was evaluated in adult patients with refractory epilepsy. "