Epilepsy is a common brain disease affecting people at different ages and in all countries. It is caused by abnormal or excessive activity from cells in the brain called neurons. Neurons control most activities in the brain and the body using chemical and electrical signals. When the signals are irregular or abnormal, the person may have epilepsy, which means that they have repetitive seizures.
Epilepsy can be treated successfully with antiepileptic medications, but not all people with epilepsy respond favorably to these medications initially or over time. These uncontrolled seizures can be caused by the following reasons:
When the patient has other medical conditions that mimic seizures such as fainting or irregular activity of the heart.
When the medication is not the right one for the type of seizure or because it cannot work appropriately due to the use of other medications (drug interaction).
When the dose of the medication is too low or because the concentration of the medication needs to be adjusted.
When the patient takes the medication irregularly or because of sleep problems and stress. Alcohol and recreational drugs can be associated with seizures as well.
It is critical to rule out all the previous reasons for uncontrolled seizures and determine if the person with epilepsy is not responding to the medications.
Clinicians will evaluate the condition carefully by selecting the most appropriate and tolerable medications to keep the person free from seizures. If this treatment fails and seizures cannot be controlled, this condition is known as drug-resistant epilepsy. Drug-resistant epilepsy is also known as “uncontrolled”, “pharmacoresistant” or “refractory” epilepsy.
People who have progressed to drug-resistant epilepsy have a low chance to become seizure controlled. Therefore, early evaluation and detection are key to providing the best treatment possible in order to reduce injuries and risk of complications and to improve quality of life.
Currently, people with epilepsy who are drug-resistant have other treatment options thanks to continued brain and clinical research. For that reason, if seizures cannot be controlled with the medications, it is important to be evaluated by a clinician trained in epilepsy or, even better, to be referred to a center with all the healthcare and clinical experts in epilepsy.