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Intermediate Technical IVT

pharmacoresistance

Failure of seizures to respond to adequate trials of at least two tolerated antiseizure medications.

Full Definition

Pharmacoresistance, also known as drug-resistant epilepsy, is defined by the International League Against Epilepsy as failure of seizures to respond adequately to trials of at least two tolerated, appropriately chosen, and adequately dosed antiseizure medications, whether as monotherapy or in combination. This definition requires that the medications were appropriate for the seizure type and syndrome, administered at adequate doses, and tolerated by the patient. Recognition of pharmacoresistance is crucial as it identifies patients who may benefit from alternative treatments such as epilepsy surgery, neurostimulation devices, or specialized dietary therapies.

Usage

Usage note: Preferred term over 'intractable' or 'medically refractory'; requires specific documentation of adequate trials.

In Context

  • "After failing three appropriate antiseizure medications, the patient was classified as having pharmacoresistance." — Epilepsy surgery evaluation
  • "Early identification of pharmacoresistance prompted referral to a comprehensive epilepsy center." — Treatment decision documentation

Also known as

drug-resistant epilepsy refractory epilepsy intractable epilepsy

Contrasted with

drug-responsive epilepsy seizure freedom

Don't confuse with

treatment failure breakthrough seizures

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