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Review
. 2021 Jun 22:12:674483.
doi: 10.3389/fneur.2021.674483. eCollection 2021.

The Pharmacoresistant Epilepsy: An Overview on Existant and New Emerging Therapies

Antonella Fattorusso  1 , Sara Matricardi  2 , Elisabetta Mencaroni  1 , Giovanni Battista Dell'Isola  1 , Giuseppe Di Cara  1 , Pasquale Striano  3   4 , Alberto Verrotti  1
Affiliations
Review

The Pharmacoresistant Epilepsy: An Overview on Existant and New Emerging Therapies

Antonella Fattorusso et al. Front Neurol. .

Abstract

Epilepsy is one of the most common neurological chronic disorders, with an estimated prevalence of 0. 5 - 1%. Currently, treatment options for epilepsy are predominantly based on the administration of symptomatic therapy. Most patients are able to achieve seizure freedom by the first two appropriate drug trials. Thus, patients who cannot reach a satisfactory response after that are defined as pharmacoresistant. However, despite the availability of more than 20 antiseizure medications (ASMs), about one-third of epilepsies remain drug-resistant. The heterogeneity of seizures and epilepsies, the coexistence of comorbidities, and the broad spectrum of efficacy, safety, and tolerability related to the ASMs, make the management of these patients actually challenging. In this review, we analyze the most relevant clinical and pathogenetic issues related to drug-resistant epilepsy, and then we discuss the current evidence about the use of available ASMs and the alternative non-pharmacological approaches.

Keywords: antiseizure medications (ASMs); cannabidiol; drug resistant epilepsy; fenfluramine; pharmacoresistance; rational polytherapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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