Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies
Correction(s) for this article
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Erratum
- Volume 51Issue 9Epilepsia
- pages: 1922-1922
- First Published online: September 2, 2010
Patrick Kwan
Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
Chair of Task Force.
Search for more papers by this authorAlexis Arzimanoglou
Institute for Children and Adolescents with Epilepsy-IDEE, University Hospital of Lyon (HCL) and Inserm U821, Lyon, France
Search for more papers by this authorAnne T. Berg
Department of Biology, Northern Illinois University, DeKalb, Illinois, U.S.A.
Search for more papers by this authorMartin J. Brodie
Epilepsy Unit, Western Infirmary, Glasgow, United Kingdom
Search for more papers by this authorW. Allen Hauser
GH Sergievsky Center, Columbia University, New York, New York, U.S.A.
Search for more papers by this authorGary Mathern
Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, California, U.S.A.
Co-chairs of Commission on Therapeutic Strategies.
Search for more papers by this authorSolomon L. Moshé
The Saul R. Korey Department of Neurology, Dominick P. Purpura Department of Neuroscience and Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, U.S.A.
Search for more papers by this authorEmilio Perucca
Clinical Trial Center, Institute of Neurology IRCCS C. Mondino Foundation, and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
Search for more papers by this authorSamuel Wiebe
Department of Clinical Neurosciences, University of Calgary, and Hotchkiss Brain Institute, Calgary, Alberta, Canada
Search for more papers by this authorJacqueline French
NYU Comprehensive Epilepsy Center, New York, New York, U.S.A.
Co-chairs of Commission on Therapeutic Strategies.
Search for more papers by this authorPatrick Kwan
Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
Chair of Task Force.
Search for more papers by this authorAlexis Arzimanoglou
Institute for Children and Adolescents with Epilepsy-IDEE, University Hospital of Lyon (HCL) and Inserm U821, Lyon, France
Search for more papers by this authorAnne T. Berg
Department of Biology, Northern Illinois University, DeKalb, Illinois, U.S.A.
Search for more papers by this authorMartin J. Brodie
Epilepsy Unit, Western Infirmary, Glasgow, United Kingdom
Search for more papers by this authorW. Allen Hauser
GH Sergievsky Center, Columbia University, New York, New York, U.S.A.
Search for more papers by this authorGary Mathern
Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, California, U.S.A.
Co-chairs of Commission on Therapeutic Strategies.
Search for more papers by this authorSolomon L. Moshé
The Saul R. Korey Department of Neurology, Dominick P. Purpura Department of Neuroscience and Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, U.S.A.
Search for more papers by this authorEmilio Perucca
Clinical Trial Center, Institute of Neurology IRCCS C. Mondino Foundation, and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
Search for more papers by this authorSamuel Wiebe
Department of Clinical Neurosciences, University of Calgary, and Hotchkiss Brain Institute, Calgary, Alberta, Canada
Search for more papers by this authorJacqueline French
NYU Comprehensive Epilepsy Center, New York, New York, U.S.A.
Co-chairs of Commission on Therapeutic Strategies.
Search for more papers by this authorSummary
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.
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