Neurológia pre prax 5/2024

Drug resistant epilepsy in childhood

We refer to drug resistant epilepsy when seizures persist despite the use of two appropriately chosen antiseizure medications, administered at therapeutic doses, either as monotherapy or in combination. Although several new medications have been developed, its prevalence remains high, affecting approximately one-third of patients. In comparison to adults, drug resistant epilepsy in childhood presents specific challenges, mainly due to negative impact of epilepsy itself and antiseizure medications on the developing brain. Managing pediatric drug resistant epilepsy requires a complex, multi-step approach, including exclusion of non-epileptic seizures and pseudoresistance, as well as consideration of curative epilepsy surgery or eventually other non-pharmacological treatments (ketogenic diet, vagus nerve stimulation, callosotomy). Proper management can significantly influence the course of epilepsy and positively impact the cognitive development of the child.

Keywords: drug resistant epilepsy, children, epilepsy surgery, pseudoresistence