drug resistance in adult patients with generalized epilepsy

By A. Voll, L.Hernandez-Ronquillo, S. Buckley, J.F. Tellez-Zenteno. Epilepsy & Behavior 53(2015):126-130.

Purpose

Epilepsy that does not respond to at least two appropriate seizure medications is called "drug resistant" epilepsy or refractory epilepsy. Research so far suggests that response to medication is best when appropriate treatment is started soon after diagnosis. Also, people with uncontrolled epilepsy are at greater risk of other health problems, injuries, cognitive problems, and emotional and social concerns.

This research explores differences in people with generalized epilepsy that is controlled and those that are considered "drug resistant." Factors that could predict whether a person would respond to seizure medicines were explored.

Description of Study

  • Medical records of adults with generalized epilepsy who were being seen at an epilepsy center were reviewed.
  • Of 118 people, 37% (44 people) had drug resistant or uncontrolled generalized epilepsy and 63% (74 people) had controlled epilepsy.

Summary of Study Findings

Risk factors for generalized epilepsy that does not respond to medications (drug resistance) found in this study include:

  • Seizures starting at a young age (less than 12 years old)
  • People who also had developmental delay
  • Unknown cause of epilepsy
  • Status epilepticus in the past
  • Lennox-Gastaut syndrome or other epilepsy syndromes
  • Frequent spike-wave discharges seen on the first EEG
  • More than one type of seizure
  • More than one seizure per month

Factors that may protect against drug resistance in this study included:

  • Good response to the first seizure medication tried
  • Unknown cause and idiopathic epilepsy (thought to be genetic)
  • Febrile seizures in the past

What does this mean?

The importance of getting seizures controlled as early as possible after diagnosis was reinforced in this study. The authors found a number of factors that may predict a person’s response to medications if they have generalized epilepsy. 

People with epilepsy and families can use this information to help them recognize the need for early treatment, understand their risks, and discuss all treatment options with their health care team.

Health care professionals should also use this information to recognize risks for drug resistance early and work closely with families to explore all options to improve seizure control and quality of life.

Abstract: December 2015

Article published in Epilepsy & Behavior, December 2015

Authored By: 
Patricia O. Shafer RN, MN | Associate Editor / Community Manager and Sloka Iyengar PhD | Basic Science Editor
Authored Date: 
11/2015