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

Summary 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...

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Published in:Epilepsia (Copenhagen) Vol. 51; no. 6; pp. 1069 - 1077
Main Authors: Kwan, Patrick, Arzimanoglou, Alexis, Berg, Anne T., Brodie, Martin J., Allen Hauser, W., Mathern, Gary, Moshé, Solomon L., Perucca, Emilio, Wiebe, Samuel, French, Jacqueline
Format: Journal Article
Language:English
Published: Oxford, UK Blackwell Publishing Ltd 01.06.2010
Subjects:
Advisory Committees
Anticonvulsants - therapeutic use
Consensus
Definition
Drug Resistance
Epilepsy
Epilepsy - classification
Epilepsy - drug therapy
Epilepsy - epidemiology
Humans
ILAE
Internationality
Intractable
Refractory
Treatment Outcome
ISSN:0013-9580, 1528-1167, 1528-1167
Online Access:Get full text
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Summary:Summary 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.
Bibliography:Chair of Task Force.
Co‐chairs of Commission on Therapeutic Strategies.
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ISSN:0013-9580
1528-1167
1528-1167
DOI:10.1111/j.1528-1167.2009.02397.x