drug resistant epilepsy


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

Top Publications

  1. Zhang G, Chen G, Meng D, Liu Y, Chen J, Shu L, et al. Stereoelectroencephalography based on the Leksell stereotactic frame and Neurotech operation planning software. Medicine (Baltimore). 2017;96:e7106 pubmed publisher
    ..The L-SEEG system with Neurotech operation planning software can be used for safe, accurate, and reliable intracranial electrode implantation for SEEG. ..
  2. Du V, Gandhi S, Rekate H, Mehta A. Laser interstitial thermal therapy: A first line treatment for seizures due to hypothalamic hamartoma?. Epilepsia. 2017;58 Suppl 2:77-84 pubmed publisher
    ..Although morbidity appears to be lower than other open approaches, complications related to LITT and their avoidance should be considered carefully. ..
  3. Helen Cross J, Spoudeas H. Medical management and antiepileptic drugs in hypothalamic hamartoma. Epilepsia. 2017;58 Suppl 2:16-21 pubmed publisher
    ..Careful assessment and monitoring by specialist centers with discussion of optimal intervention is required for individual cases. ..
  4. Cohen A, Jones L, Parisi J, Klaas J. Intractable Epilepsy and Progressive Cognitive Decline in a Young Man. JAMA Neurol. 2017;74:737-740 pubmed publisher
    ..Results of subsequent electroencephalography and brain imaging were unchanged, and a fluorodeoxyglucose F 18 positron emission tomographic scan was normal. ..
  5. Cukiert A, Cukiert C, Burattini J, Mariani P, Bezerra D. Seizure outcome after hippocampal deep brain stimulation in patients with refractory temporal lobe epilepsy: A prospective, controlled, randomized, double-blind study. Epilepsia. 2017;58:1728-1733 pubmed publisher
    ..Fifty-percent of the patients in the active group became seizure-free. The present study is the larger prospective, controlled, double-blind study to evaluate the effects of Hip-DBS published to date. ..
  6. Carpentier N, Cecchin T, Koessler L, Louis Dorr V, Jonas J, Vignal J, et al. Stereo-electroencephalography identifies N2 sleep and spindles in human hippocampus. Clin Neurophysiol. 2017;128:1696-1706 pubmed publisher
    ..Distinct N2 sleep, fast spindles and homeostatic profile are all common properties shared by hippocampus and cortex during sleep. The close functional link between hippocampus and cortex may have various sleep-related substrates. ..
  7. Jiménez Arredondo R, Brambila Tapia A, Mercado Silva F, Magaña Torres M, Figuera L. Determination of SCN1A genetic variants in Mexican patients with refractory epilepsy and Dravet syndrome. Genet Mol Res. 2017;16: pubmed publisher
    ..The frequency of pathogenic variants was 4.17% in all the patients and 11.1% in DS patients, which, together with other publications, emphasize that specific and more severe phenotypes are associated with SCN1A mutations. ..
  8. Lim Z, Wong K, Olson H, Bergin A, Downs J, Leonard H. Use of the ketogenic diet to manage refractory epilepsy in CDKL5 disorder: Experience of >100 patients. Epilepsia. 2017;58:1415-1422 pubmed publisher
    ..However, poor long-term efficacy remains as a significant barrier. In view of its side effect profile, KD administration should be supervised by a pediatric neurologist and specialist dietician. ..
  9. Brazdil M, Pail M, Halamek J, Plešinger F, Cimbalnik J, Roman R, et al. Very high-frequency oscillations: Novel biomarkers of the epileptogenic zone. Ann Neurol. 2017;82:299-310 pubmed publisher
    ..Interictal VHFOs are relatively frequent abnormal phenomena in patients with epilepsy, and appear to be more specific biomarkers for epileptogenic zone when compared to traditional HFOs. Ann Neurol 2017;82:299-310. ..

More Information


  1. Böttcher S, Lutz M, Mayer T. Lacosamide in the treatment of patients with epilepsy and intellectual disabilities: A long-term study of 136 patients. Epilepsia. 2017;58:1749-1754 pubmed publisher
    ..It has been shown that concomitant SCB use is a key factor in increasing the risk of LCM failure in children with epilepsy. This finding has not been replicated in our predominantly adult sample of patients with IDs. ..
  2. UNG H, Cazares C, Nanivadekar A, Kini L, Wagenaar J, Becker D, et al. Interictal epileptiform activity outside the seizure onset zone impacts cognition. Brain. 2017;140:2157-2168 pubmed publisher
    ..These results suggest that seizure onset regions are dysfunctional at baseline, and support the idea that interictal spikes disrupt cognitive processes related to the underlying tissue...
  3. Giulioni M, Marucci G, Pelliccia V, Gozzo F, Barba C, Didato G, et al. Epilepsy surgery of "low grade epilepsy associated neuroepithelial tumors": A retrospective nationwide Italian study. Epilepsia. 2017;58:1832-1841 pubmed publisher
    ..Timely surgery, regardless of pharmacoresistance and oriented to optimize epileptologic, neuropsychological, and oncologic outcomes should be warranted. ..
  4. Mazzola L, Royet J, Catenoix H, Montavont A, Isnard J, Mauguiere F. Gustatory and olfactory responses to stimulation of the human insula. Ann Neurol. 2017;82:360-370 pubmed publisher
    ..It also indicates that dysfunction in this region should be considered during the evaluation of gustatory and olfactory epileptic seizures. Ann Neurol 2017;82:360-370. ..
  5. Qu J, Lu S, Lu Z, Xu P, Xiang D, Qu Q. Pharmacogenetic and case-control study on potassium channel related gene variants and genetic generalized epilepsy. Medicine (Baltimore). 2017;96:e7321 pubmed publisher
    ..Further multicenter, multiethnic, and large sample size pharmacogenetic and case-control studies are warranted to confirm our negative results. ..
  6. Iimura Y, Jones K, Hattori K, Okazawa Y, Noda A, Hoashi K, et al. Epileptogenic high-frequency oscillations skip the motor area in children with multilobar drug-resistant epilepsy. Clin Neurophysiol. 2017;128:1197-1205 pubmed publisher
    ..This is the first study demonstrating that the electrophysiological phenotype of multifocal epilepsy specifically skips the MA using OR(HFO) and MI(3-4 Hz). ..
  7. Bourdillon P, Ryvlin P, Isnard J, Montavont A, Catenoix H, Mauguiere F, et al. Stereotactic Electroencephalography Is a Safe Procedure, Including for Insular Implantations. World Neurosurg. 2017;99:353-361 pubmed publisher
    ..52%), acute pneumocephalus (0.38%), and local cutaneous infection (0.19%). SEEG is a safe procedure. Insular trajectories cannot be considered an additional risk of intracranial bleeding. ..
  8. Jobst B, Kapur R, Barkley G, Bazil C, Berg M, Bergey G, et al. Brain-responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia. 2017;58:1005-1014 pubmed publisher
    ..Brain-responsive stimulation represents a safe and effective treatment option for patients with medically intractable epilepsy, including adults with seizures of neocortical onset, and those with onsets from eloquent cortex. ..
  9. van t Klooster M, van Klink N, Zweiphenning W, Leijten F, Zelmann R, Ferrier C, et al. Tailoring epilepsy surgery with fast ripples in the intraoperative electrocorticogram. Ann Neurol. 2017;81:664-676 pubmed publisher
    ..These findings hold for different tailoring approaches. FRs can thus be used for tailoring epilepsy surgery with repeated intraoperative ECoG measurements. Ann Neurol 2017;81:664-676. ..
  10. Taskin B, Tanji K, Feldstein N, McSwiggan Hardin M, Akman C. Epilepsy surgery for epileptic encephalopathy as a sequela of herpes simplex encephalitis: case report. J Neurosurg Pediatr. 2017;20:56-63 pubmed publisher
    ..Following a right temporal lobectomy, chronic granulomatous encephalitis was diagnosed. The patient's clinical course improved with the resolution of seizures and EEG abnormalities. ..
  11. Nogueira M, Yasuda C, Coan A, Kanner A, Cendes F. Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE. Epilepsia. 2017;58:1268-1276 pubmed publisher
    ..Identification of comorbid MD/AD and of family psychiatric history is of the essence in patients with MTLE, as they appear to be associated with worse seizure control. ..
  12. Bauer J, Becker A, Elyaman W, Peltola J, Ruegg S, Titulaer M, et al. Innate and adaptive immunity in human epilepsies. Epilepsia. 2017;58 Suppl 3:57-68 pubmed publisher
    ..Thus the identification of new immunomodulatory compounds remains of utmost importance. ..
  13. Gaxiola Valdez I, Singh S, Perera T, Sandy S, Li E, Federico P. Seizure onset zone localization using postictal hypoperfusion detected by arterial spin labelling MRI. Brain. 2017;140:2895-2911 pubmed publisher
    ..This technique may be incorporated into the battery of conventional investigations for presurgical evaluation of patients with drug resistant focal epilepsy...
  14. Striano S, Striano P. Clinical features and evolution of the gelastic seizures-hypothalamic hamartoma syndrome. Epilepsia. 2017;58 Suppl 2:12-15 pubmed publisher
    ..Early suspicion, timely diagnosis, and appropriate treatment are mandatory to reverse a potential catastrophic evolution of this condition. ..
  15. Tousseyn S, Krishnan B, Wang Z, Wongwiangjunt S, Nayak C, Mosher J, et al. Connectivity in ictal single photon emission computed tomography perfusion: a cortico-cortical evoked potential study. Brain. 2017;140:1872-1884 pubmed publisher
    ..In trying to understand a patient's epilepsy, one should consider the contribution of all hyperperfused regions, as these are likely not random, but represent an electrically connected epileptic network. ..
  16. Sampaio L, Takakura C, Manreza M. The use of a formula-based ketogenic diet in children with refractory epilepsy. Arq Neuropsiquiatr. 2017;75:234-237 pubmed publisher
    ..The ketogenic formula tested herein caused only mild KD-related adverse events and adequate adherence. Moreover, 60% of patients had more than 50% seizure frequency reduction and 10% were seizure-free. ..
  17. Hanai S, Sukigara S, Dai H, Owa T, Horike S, Otsuki T, et al. Pathologic Active mTOR Mutation in Brain Malformation with Intractable Epilepsy Leads to Cell-Autonomous Migration Delay. Am J Pathol. 2017;187:1177-1185 pubmed publisher
    ..We suspect cell-autonomous migration arrest on the radial glial foot by the active MTOR mutation and offer potential explanations for why this may lead to cortical malformations such as HME. ..
  18. Karvigh S, Motamedi M, Arzani M, Roshan J. HD-tDCS in refractory lateral frontal lobe epilepsy patients. Seizure. 2017;47:74-80 pubmed publisher
    ..Changes of EDs and mean seizure frequency caused by HD-tDCS were not statistically significant for the whole group; however, this method could improve the patients' working memory scores. ..
  19. Ivanovic J, Larsson P, Østby Y, Hald J, Krossnes B, Fjeld J, et al. Seizure outcomes of temporal lobe epilepsy surgery in patients with normal MRI and without specific histopathology. Acta Neurochir (Wien). 2017;159:757-766 pubmed publisher
    ..Typical ictal seizure semiology and localised ictal discharges on scalp EEG were predictors of Engel class I outcome. ..
  20. Morris S, Rollo M, Rollo P, Johnson J, Grant G, Friedman E, et al. Prolonged Blood-Brain Barrier Disruption Following Laser Interstitial Ablation in Epilepsy: A Case Series with a Case Report of Postablation Optic Neuritis. World Neurosurg. 2017;104:467-475 pubmed publisher
  21. Wagner K, Wethe J, Schulze Bonhage A, Trippel M, Rekate H, Prigatano G, et al. Cognition in epilepsy patients with hypothalamic hamartomas. Epilepsia. 2017;58 Suppl 2:85-93 pubmed publisher
    ..Higher levels of presurgical performance were significant predictors of cognitive decline after surgery. These results are highly relevant for patient consultation and may help with therapeutic decisions. ..
  22. Wyatt S, Witt T, Barbaro N, Cohen Gadol A, Brewster A. Enhanced classical complement pathway activation and altered phagocytosis signaling molecules in human epilepsy. Exp Neurol. 2017;295:184-193 pubmed publisher
    ..Future studies will investigate whether altered complement signaling contributes to the hyperexcitability that result in epilepsy. ..
  23. Puligheddu M, Melis M, Pillolla G, Milioli G, Parrino L, Terzano G, et al. Rationale for an adjunctive therapy with fenofibrate in pharmacoresistant nocturnal frontal lobe epilepsy. Epilepsia. 2017;58:1762-1770 pubmed publisher
    ..Our preclinical and clinical studies suggest PPAR? as a novel disease-modifying target for antiepileptic drugs due to its ability to regulate dysfunctional nAChRs. ..
  24. Barker Haliski M, Loscher W, White H, Galanopoulou A. Neuroinflammation in epileptogenesis: Insights and translational perspectives from new models of epilepsy. Epilepsia. 2017;58 Suppl 3:39-47 pubmed publisher
    ..Utilization of these models may facilitate the identification of age-specific, syndrome- or etiology-specific therapies for the epilepsies and attendant comorbidities, including the drug-resistant forms. ..
  25. Aronica E, Bauer S, Bozzi Y, Caleo M, Dingledine R, Gorter J, et al. Neuroinflammatory targets and treatments for epilepsy validated in experimental models. Epilepsia. 2017;58 Suppl 3:27-38 pubmed publisher
    ..Finally, we suggest future directions to accelerate preclinical to clinical translation of these recent discoveries. ..
  26. Caciagli L, Bernasconi A, Wiebe S, Koepp M, Bernasconi N, Bernhardt B. A meta-analysis on progressive atrophy in intractable temporal lobe epilepsy: Time is brain?. Neurology. 2017;89:506-516 pubmed publisher
    ..Longitudinal multicohort studies are needed to unequivocally differentiate aging from disease progression. ..
  27. Centeno M, Tierney T, Perani S, Shamshiri E, St Pier K, Wilkinson C, et al. Combined electroencephalography-functional magnetic resonance imaging and electrical source imaging improves localization of pediatric focal epilepsy. Ann Neurol. 2017;82:278-287 pubmed publisher
    ..EEG-fMRI combined with ESI provides a simple unbiased localization that may predict surgery better than each individual test, including in MRI-negative patients. Ann Neurol 2017;82:278-287. ..
  28. Harrison V, Oatman O, Kerrigan J. Hypothalamic hamartoma with epilepsy: Review of endocrine comorbidity. Epilepsia. 2017;58 Suppl 2:50-59 pubmed publisher
    ..Diabetes insipidus is commonly encountered postoperatively, but is not observed with HH prior to surgical intervention. ..
  29. Regis J, Lagmari M, Carron R, Hayashi M, McGonigal A, Daquin G, et al. Safety and efficacy of Gamma Knife radiosurgery in hypothalamic hamartomas with severe epilepsies: A prospective trial in 48 patients and review of the literature. Epilepsia. 2017;58 Suppl 2:60-71 pubmed publisher
  30. Smyth M, Vellimana A, Asano E, Sood S. Corpus callosotomy-Open and endoscopic surgical techniques. Epilepsia. 2017;58 Suppl 1:73-79 pubmed publisher
    ..The extent of callosal disconnection performed varies according to indications and surgeon preference. In this article, we describe both open and endoscopic surgical techniques for anterior and complete corpus callosotomy. ..
  31. Cukiert A, Lehtimäki K. Deep brain stimulation targeting in refractory epilepsy. Epilepsia. 2017;58 Suppl 1:80-84 pubmed publisher
    ..We describe the current targeting techniques for the structures presently most often implanted, namely the anterior nucleus of the thalamus, the centromedian nucleus of the thalamus, and the hippocampus. ..
  32. Ghosh C, Hossain M, Solanki J, Najm I, Marchi N, Janigro D. Overexpression of pregnane X and glucocorticoid receptors and the regulation of cytochrome P450 in human epileptic brain endothelial cells. Epilepsia. 2017;58:576-585 pubmed publisher
    ..Our results indicate increased PXR and GR in primary ECs derived from human epileptic brains. PXR or GR may be responsible for a local drug brain metabolism sustained by abnormal CYP regulation. ..
  33. Hardies K, Cai Y, Jardel C, Jansen A, Cao M, May P, et al. Loss of SYNJ1 dual phosphatase activity leads to early onset refractory seizures and progressive neurological decline. Brain. 2016;139:2420-30 pubmed publisher
    ..These findings further expand the clinical spectrum of synaptic dysregulation in patients with severe epilepsy, and emphasize the importance of this biological pathway in seizure pathophysiology. ..
  34. Alves M, Gomez Villafuertes R, Delanty N, Farrell M, O Brien D, Miras Portugal M, et al. Expression and function of the metabotropic purinergic P2Y receptor family in experimental seizure models and patients with drug-refractory epilepsy. Epilepsia. 2017;58:1603-1614 pubmed publisher
  35. Freri E, Matricardi S, Gozzo F, Cossu M, Granata T, Tassi L. Perisylvian, including insular, childhood epilepsy: Presurgical workup and surgical outcome. Epilepsia. 2017;58:1360-1369 pubmed publisher
    ..However, tailored resections based on a careful presurgical evaluation, including SEEG recording, may lead to a good seizure control and to a better overall outcome. ..
  36. Guaita M, van Eendenburg C, Donaire A, Aparicio J, Setoain X, Bargallo N, et al. Ictal bruxism treated with temporal lobectomy. Sleep Med. 2015;16:1429-1431 pubmed publisher
  37. Jiang Y, Mao L, Yan X, Fan M, Wang X, Ding J, et al. Investigation of altered microstructure in patients with drug refractory epilepsy using diffusion tensor imaging. Neuroradiology. 2017;59:597-608 pubmed publisher
    ..Our current study may shed light on the pathophysiology of DRE. ..
  38. Liu H, Yang Z, Huang L, Qu W, Hao H, Li L. Heart-rate variability indices as predictors of the response to vagus nerve stimulation in patients with drug-resistant epilepsy. Epilepsia. 2017;58:1015-1022 pubmed publisher
    ..Thus the measurements show promise for predicting the reduction of seizure frequency after VNS treatment. ..