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Pathophysiology of Antiepileptic Drug Refractoriness

  • Heidrun Potschka
  • Eleonora Aronica
Reference work entry

Introduction and Definitions

Drug refractoriness is a serious problem in the treatment of patients with epilepsy with devastating consequences on the patient’s quality of life. In about one-third of epileptic patients severe seizures persist despite syndrome-appropriate medical treatment (French 2007). Prediction of refractory epilepsy is a complex issue for the physician managing patients with epilepsy, because multiple mechanisms appear to contribute to this clinical phenomenon (Löscher and Potschka 2005; Löscher et al. 2009). Thus, understanding drug refractoriness in epilepsy represents a challenge for both experimental and clinical research.

This chapter will briefly address the experimental and clinical evidence on mechanisms underlying drug refractoriness and factors that regulate them. The emphasis will be on the two major concepts that have been put forward to explain drug refractoriness: the target- and the transporter-hypothesis (Loscher and Potschka 2005; Remy and Beck 2006...

Keywords

GABAA Receptor Temporal Lobe Epilepsy Efflux Transporter Focal Cortical Dysplasia Refractory Epilepsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations

AED

Antiepileptic drugs

BBB

Blood–brain barrier

BCRP

Breast-cancer resistance protein

FCD

Focal cortical dysplasia

HS

Hippocampal sclerosis

MCD

Malformations of cortical development

MR

Magnetic resonance

MRPs

Multidrug resistance-associated proteins

TLE

Temporal lobe epilepsy

VOIs

Volumes of interest

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Copyright information

© Springer-Verlag London Limited 2010

Authors and Affiliations

  • Heidrun Potschka
    • 1
  • Eleonora Aronica
    • 2
    • 3
  1. 1.Institute of Pharmacology, Toxicology, and PharmacyLudwig-Maximilians-UniversityMunichGermany
  2. 2.Department of (neuro)pathologyAcademic Medical CenterAmsterdamThe Netherlands
  3. 3.Epilepsy Institute in The Netherlands (SEIN)HeemstedeThe Netherlands

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