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Pathogenesis of drug resistant epilepsy

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Pharmacotherapy is the first-line treatment modality for epilepsy. However, in 20-40% of patients, epilepsy is resistant to pharmacotherapy. These numbers have not changed for decades despite the development and use of antiepileptic drugs with novel mechanisms of action. Drug-resistant epilepsy is now considered a separate pathophysiologic and clinical entity. The existing hypotheses on its pathogenesis could be divided in two groups. Firstly, drug-resistance might be caused by an abnormal pharmacokinetics or pharmacodynamics of antiepileptic drugs as a result of congenital or acquired dysfunction of the transporter or receptor proteins. Secondly, it might be a consequence of inherent features of epilepsy per se, such as the so-called “intrinsic severity” or some disorder of the connectome. Taking into account the complexity of this phenomenon, the issue of drug resistance continues to remain in the focus of the current research efforts.

About the Authors

S. M. Malyshev
VA Almazov National Medical Research Center
Russian Federation

MD, PhD student, Department of Neurology and Psychiatry, Institute of Medical Education

2 Akkuratova Str., St Petersburg 197341, Russia

Scopus Author ID: 57192810951. Researcher ID: N-7251-2016.

T. M. Alekseeva
VA Almazov National Medical Research Center
Russian Federation

Professor, Head of the Department of Neurology and Psychiatry, Institute of Medical Education

2 Akkuratova Str., St Petersburg 197341, Russia

Scopus Author ID: 57200808136. Researcher ID: S-8806-2017

W. A. Khachatryan
VA Almazov National Medical Research Center
Russian Federation

Professor, Scientific Supervisor at the Department of Neurosurgery for Children # 7

2 Akkuratova Str., St Petersburg 197341, Russia

Scopus Author ID: 55633841500. Researcher ID: G-4002-2018

M. M. Galagudza
VA Almazov National Medical Research Center
Russian Federation

Corresponding Member of the RAS, Head of the Institute of Experimental Medicine

2 Akkuratova Str., St Petersburg 197341, Russia

Scopus Author ID: 6507925726. Researcher ID: C-8479-2011


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For citations:

Malyshev S.M., Alekseeva T.M., Khachatryan W.A., Galagudza M.M. Pathogenesis of drug resistant epilepsy. Epilepsy and paroxysmal conditions. 2019;11(1):79-87. (In Russ.)

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ISSN 2311-4088 (Online)