Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies
2009/11/03 by Patrick Kwan, Alexis Arzimanoglou, Anne T. Berg +9 · 4,805 citations
Medicine · Psychology · #Artificial intelligence #Categorization #Clinical trial #Computer science #Drug Resistant Epilepsy #Drug Transport and Resistance Mechanisms #Epilepsy #Epilepsy research and treatment #Intensive care medicine #Intervention (counseling) #Medicine #Pharmacological Effects and Toxicity Studies #Psychiatry #Psychology #Set (abstract data type) #Task (project management)
paper · doi:10.1111/j.1528-1167.2009.02397.x
published in Epilepsia 51(6), 1069-1077 (Wiley)
openalex publication_date 2009/11/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/05
Abstract
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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