Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies

Patrick Kwan, Alexis Arzimanoglou, Anne T. Berg, Martin J. Brodie, W. Allen Hauser, Gary Mathern, Solomon L. Moshé, Emilio Perucca, Samuel Wiebe, Jacqueline French

Research output: Contribution to journalReview articlepeer-review

1878 Scopus citations

Abstract

To improve patient care and facilitate clinical research, the International League Against Epilepsy (ILAE) appointed a Task Force to formulate a consensus definition of drug resistant epilepsy. The overall framework of the definition has two "hierarchical" levels: Level 1 provides a general scheme to categorize response to each therapeutic intervention, including a minimum dataset of knowledge about the intervention that would be needed; Level 2 provides a core definition of drug resistant epilepsy using a set of essential criteria based on the categorization of response (from Level 1) to trials of antiepileptic drugs. It is proposed as a testable hypothesis that drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom. This definition can be further refined when new evidence emerges. The rationale behind the definition and the principles governing its proper use are discussed, and examples to illustrate its application in clinical practice are provided.

Original languageEnglish (US)
Pages (from-to)1069-1077
Number of pages9
JournalEpilepsia
Volume51
Issue number6
DOIs
StatePublished - Jul 21 2010

Keywords

  • Definition
  • Drug resistance
  • Epilepsy
  • ILAE
  • Intractable
  • Refractory

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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