Causes and Management of Drug Resistant Epilepsy

Epilepsy is a disorder of the Central Nervous System which causes the brain to act differently or abnormally. In this disorder one may experience seizures, loss of awareness and certain sensations. It is one of the most common neurological disorders and can affect people of any age or race. In most cases, Epilepsy can be managed and controlled using anti-epileptic drugs but in some cases, patients fail to gain from these. This type of epilepsy is known as Drug Resistant Epilepsy or Refractory Epilepsy.

Drug Resistant Epilepsy (DRE), as the name suggests is that form of epilepsy in which the patient doesn’t respond to drug therapy as expected. Some other names by which this treatment is known are medically refractory epilepsy, intractable or pharmacoresistent epilepsy. It is rather surprising to know that as many as 20-40% cases of Epilepsy are refractory Epilepsy. However, it is recommended that a patient takes a few drug trials before DRE is established just to be sure so that the further treatment can be hence recommended by the doctors.

Treatment options for Drug Resistant Epilepsy patients:

–   Once DRE is established, doctors may refer the patient for a presurgical evaluation that is generally done at an Epilepsy center or healthcare facility. This is done in order to find out whether or not the patient is suitable for epilepsy operation.

–   If surgery is the way to go, then two options are available-resective procedure and disconnective procedure.

–   In case, the patient is not a suitable candidate for surgery or if the patient declines epilepsy surgery, the next step could be either a proper diet program or vagus nerve stimulation.

–   Vagus nerve stimulation is a procedure in which a pacemaker type of a device is implanted in the chest area to send electrical impulses to the vagus nerve. This inhibits the generation of seizures through the brain.

–   It has been a known fact that diet can help with Epilepsy and may reduce the occurrence of seizures. Those who do not benefit from medication or drugs thus rely on a high fat content low carbohydrate content diet. Some diets which epilepsy patients swear by include ketogenic diet, MCT-ketogenic diet, modified Atkins diet and others.

DRE or refractory epilepsy is not totally incurable but one has to undergo trials and different forms of treatments to be able to identify which fits best in their case. Deep brain stimulation as well as responsive neuro-stimulation is approved in certain countries and may prove beneficial for Drug resistant epilepsy patients.

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