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Quality in Sport

Modern approaches to treating drug-resistant epilepsy - ketogenic diet, innovative drugs and neurosurgery
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  4. Medical Sciences

Modern approaches to treating drug-resistant epilepsy - ketogenic diet, innovative drugs and neurosurgery

Authors

  • Robert Rzenno Independent Public Health Care Facility in Myślenice Szpitalna 2, 32-400 Myślenice, Poland https://orcid.org/0009-0003-3838-3262
  • Monika Brzozowska Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Jagiellońska 13/15, 85-067 Bydgoszcz, Poland https://orcid.org/0009-0006-5574-0059
  • Wiktoria Wardal Pediatric Hospital in Bielsko-Biała Sobieskiego 83, 43-300 Bielsko-Biała, Poland https://orcid.org/0009-0008-6665-2374
  • Natalia Furlepa Independent Public Health Care Facility in Łuków, Doktora Andrzeja Rogalińskiego 3 21-400 Łuków, Poland https://orcid.org/0009-0002-8163-2087
  • Karolina Wojciechowska Dr. Władysław Biegański Regional Specialized Hospital in Grudziądz, Doktora Ludwika Rydygiera 15/17 86-300 Grudziądz, Poland https://orcid.org/0009-0004-4535-0327
  • Marcelina Matuszewska Independent Public Clinical Hospital named prof. W. Orlowski CMKP ul. Czerniakowska 231, 00-416 Warszawa, Poland https://orcid.org/0009-0002-2301-669X
  • Katarzyna Wicha 1 Military Clinical Hospital with Polyclinic of Independent Public Health Care Unit in Lublin, Aleje Racławickie 23 20-049 Lublin, Poland https://orcid.org/0000-0001-8822-2182
  • Natalia Sidz University Clinical Center in Gdansk, Debinki 7 80-952 Gdansk, Poland https://orcid.org/0009-0005-0685-4175
  • Magdalena Tomaszewska Norbert Barlicki University Clinical Hospital No. 1 in Łódź, Stefana Kopcińskiego 22 90-153 Łódź, Poland https://orcid.org/0009-0009-4567-394X
  • Wiktoria Jedlikowska Heliodor Swiecicki Clinical Hospital, Poznań, Poland https://orcid.org/0009-0002-7874-9911

DOI:

https://doi.org/10.12775/QS.2025.39.58901

Keywords

drug-resistance epilepsy, CBD, ketogenic diet

Abstract

Introduction and objective

Drug-resistant epilepsy (DRE) is a type of epilepsy where seizures persist despite treatment with multiple antiepileptic drugs being implemented. This condition severely affects the quality of life of those impacted, often leading to difficulties in daily functioning and associated mental health issues such as anxiety and depression. The goal of this study is to investigate the mechanisms behind drug-resistant epilepsy and review the current approaches to its diagnosis and treatment.

 

Review methods

A thorough literature review was carried out using the PubMed database to explore studies focused on drug-resistant epilepsy. Key search terms included "drug-resistant epilepsy", “DRE”,. The review concentrated on the latest research examining the pathophysiology, diagnostic tools, and treatment strategies for individuals with DRE.

 

Description of the state of knowledge

Drug-resistant epilepsy is often associated with disruptions in neuronal activity, changes in protein expression, and imbalances in neurotransmitters. These factors contribute to the lack of response to standard antiepileptic medications. Diagnostic procedures currently involve electroencephalography (EEG) to assess brain activity, along with advanced imaging techniques like MRI and CT scans to detect any structural abnormalities. Available treatments encompass a range of drug therapies, surgical options, neurostimulation, and dietary interventions.

 

Conclusions

The review highlights that, despite notable progress in understanding drug-resistant epilepsy, there are still significant challenges in developing effective treatments. Continued research into the molecular mechanisms and advancements in diagnostic tools are essential for improving the management of this condition and creating more targeted treatment options.

 

References

1. Jiao D, Xu L, Gu Z, Yan H, Shen D, Gu X. Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation-mediated neuromodulation therapy and new technologies. Neural Regen Res. 2025;20(4):917-935. doi:10.4103/NRR.NRR-D-23-01444

2. Löscher W, Potschka H, Sisodiya SM, Vezzani A. Drug Resistance in Epilepsy: Clinical Impact, Potential Mechanisms, and New Innovative Treatment Options. Pharmacol Rev. 2020;72(3):606-638. doi:10.1124/pr.120.019539

3. Auvin S, Galanopoulou AS, Moshé SL, et al. Revisiting the concept of drug-resistant epilepsy: A TASK1 report of the ILAE/AES Joint Translational Task Force. Epilepsia. 2023;64(11):2891-2908. doi:10.1111/epi.17751

4. Laxer KD, Trinka E, Hirsch LJ, et al. The consequences of refractory epilepsy and its treatment. Epilepsy Behav. 2014;37:59-70. doi:10.1016/j.yebeh.2014.05.031

5. Muthaffar OY, Alyazidi AS, Alsowat D, et al. Short-term effectiveness and side effects of ketogenic diet for drug-resistant epilepsy in children with genetic epilepsy syndromes. Front Neurol. 2024;15:1484752. Published 2024 Sep 18. doi:10.3389/fneur.2024.1484752

6. Denton A, Thorpe L, Carter A, Angarita-Fonseca A, Waterhouse K, Hernandez Ronquillo L. Definitions and Risk Factors for Drug-Resistant Epilepsy in an Adult Cohort. Front Neurol. 2021;12:777888. Published 2021 Dec 13. doi:10.3389/fneur.2021.777888

7. Benoist C, Boccaletti S, Leach JP, et al. Characterising people with focal drug-resistant epilepsy: A retrospective cohort study. Epilepsy Behav. 2023;149:109540. doi:10.1016/j.yebeh.2023.109540

8. Assenza G. Diagnosis and Treatment of Drug-Resistant Epilepsy: Present and Future Perspectives. Brain Sci. 2020;10(11):779. Published 2020 Oct 26. doi:10.3390/brainsci10110779

9. Guery D, Rheims S. Clinical Management of Drug Resistant Epilepsy: A Review on Current Strategies. Neuropsychiatr Dis Treat. 2021;17:2229-2242. Published 2021 Jul 12. doi:10.2147/NDT.S256699

10. Taylor DC, Falconer MA, Bruton CJ, Corsellis JA. Focal dysplasia of the cerebral cortex in epilepsy. J Neurol Neurosurg Psychiatry. 1971;34(4):369-387. doi:10.1136/jnnp.34.4.369

11. DiSabato DJ, Quan N, Godbout JP. Neuroinflammation: the devil is in the details. J Neurochem. 2016;139 Suppl 2(Suppl 2):136-153. doi:10.1111/jnc.13607

12. Alawieh A, Langley EF, Weber S, Adkins D, Tomlinson S. Identifying the Role of Complement in Triggering Neuroinflammation after Traumatic Brain Injury. J Neurosci. 2018;38(10):2519-2532. doi:10.1523/JNEUROSCI.2197-17.2018

13. Coulthard LG, Hawksworth OA, Woodruff TM. Complement: The Emerging Architect of the Developing Brain. Trends Neurosci. 2018;41(6):373-384. doi:10.1016/j.tins.2018.03.009

14. Choi J, Koh S. Role of brain inflammation in epileptogenesis. Yonsei Med J. 2008;49(1):1-18. doi:10.3349/ymj.2008.49.1.1

15. Pernhorst K, Herms S, Hoffmann P, et al. TLR4, ATF-3 and IL8 inflammation mediator expression correlates with seizure frequency in human epileptic brain tissue. Seizure. 2013;22(8):675-678. doi:10.1016/j.seizure.2013.04.023

16. Bazhanova ED, Kozlov AA, Litovchenko AV. Mechanisms of Drug Resistance in the Pathogenesis of Epilepsy: Role of Neuroinflammation. A Literature Review. Brain Sci. 2021;11(5):663. Published 2021 May 19. doi:10.3390/brainsci11050663

17. Serrano-Castro PJ, Ramírez-García T, Cabezudo-Garcia P, Garcia-Martin G, De La Parra J. Effect of Cenobamate on Cognition in Patients with Drug-Resistant Epilepsy with Focal Onset Seizures: An Exploratory Study. CNS Drugs. 2024;38(2):141-151. doi:10.1007/s40263-024-01063-6

18. Polster T. Individualized treatment approaches: Fenfluramine, a novel antiepileptic medication for the treatment of seizures in Dravet syndrome. Epilepsy Behav. 2019;91:99-102. doi:10.1016/j.yebeh.2018.08.021

19. Schoonjans AS, Marchau F, Paelinck BP, et al. Cardiovascular safety of low-dose fenfluramine in Dravet syndrome: a review of its benefit-risk profile in a new patient population. Curr Med Res Opin. 2017;33(10):1773-1781. doi:10.1080/03007995.2017.1355781

20. Falip M, López González FJ, Martín-Herranz I, et al. Value contribution of cenobamate for the treatment of Focal-Onset Seizures (FOS) in patients with drug-resistant epilepsy (DRE) in Spain through reflective Multi-Criteria Decision Analysis (MCDA). Epilepsy Behav. 2023;145:109350. doi:10.1016/j.yebeh.2023.109350

21. Liu S, He Z, Li J. Long-term efficacy and adverse effects of cannabidiol in adjuvant treatment of drug-resistant epilepsy: a systematic review and meta-analysis. Ther Adv Neurol Disord. 2023;16:17562864231207755. Published 2023 Oct 30. doi:10.1177/17562864231207755

22. Reddy DS. Therapeutic and clinical foundations of cannabidiol therapy for difficult-to-treat seizures in children and adults with refractory epilepsies. Exp Neurol. 2023;359:114237. doi:10.1016/j.expneurol.2022.114237

23. Chico SFV, Diaz DAM, Contreras-Puentes N. Use of cannabidiol in the treatment of drug-refractory epilepsy in children and young adults: A systematic review. J Neurosci Rural Pract. 2024;15(2):203-210. doi:10.25259/JNRP_618_2023

24. Mishra P, Singh SC, Ramadass B. Drug resistant epilepsy and ketogenic diet: A narrative review of mechanisms of action. World Neurosurg X. 2024;22:100328. Published 2024 Feb 25. doi:10.1016/j.wnsx.2024.100328

25. Westmark CJ. Diet in the Treatment of Epilepsy. Nutrients. 2021;13(3):917. Published 2021 Mar 12. doi:10.3390/nu13030917

26. Manral M, Dwivedi R, Gulati S, et al. Safety, Efficacy, and Tolerability of Modified Atkins Diet in Persons With Drug-Resistant Epilepsy: A Randomized Controlled Trial. Neurology. 2023;100(13):e1376-e1385. doi:10.1212/WNL.0000000000206776

27. Borowicz-Reutt K, Krawczyk M, Czernia J. Ketogenic Diet in the Treatment of Epilepsy. Nutrients. 2024;16(9):1258. Published 2024 Apr 24. doi:10.3390/nu16091258

28. Gouveia FV, Warsi NM, Suresh H, Matin R, Ibrahim GM. Neurostimulation treatments for epilepsy: Deep brain stimulation, responsive neurostimulation and vagus nerve stimulation. Neurotherapeutics. 2024;21(3):e00308. doi:10.1016/j.neurot.2023.e00308

29. Révész D, Rydenhag B, Ben-Menachem E. Complications and safety of vagus nerve stimulation: 25 years of experience at a single center. J Neurosurg Pediatr. 2016;18(1):97-104. doi:10.3171/2016.1.PEDS15534

30. Engel J Jr. The current place of epilepsy surgery. Curr Opin Neurol. 2018;31(2):192-197. doi:10.1097/WCO.0000000000000528

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Published

2025-03-08

How to Cite

1.
RZENNO, Robert, BRZOZOWSKA, Monika, WARDAL, Wiktoria, FURLEPA, Natalia, WOJCIECHOWSKA, Karolina, MATUSZEWSKA, Marcelina, WICHA, Katarzyna, SIDZ, Natalia, TOMASZEWSKA, Magdalena and JEDLIKOWSKA, Wiktoria. Modern approaches to treating drug-resistant epilepsy - ketogenic diet, innovative drugs and neurosurgery. Quality in Sport. Online. 8 March 2025. Vol. 39, p. 58901. [Accessed 29 June 2025]. DOI 10.12775/QS.2025.39.58901.
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Issue

Vol. 39 (2025)

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Medical Sciences

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Copyright (c) 2025 Robert Rzenno, Monika Brzozowska, Wiktoria Wardal, Natalia Furlepa, Karolina Wojciechowska, Marcelina Matuszewska, Katarzyna Wicha, Natalia Sidz, Magdalena Tomaszewska, Wiktoria Jedlikowska

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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