Epileptogenesis is the process that connects central nervous system damage to the development of epilepsy. Drug resistance presents a pressing challenge due to its unpredictable nature. The condition is diagnosed when a person fails to achieve lasting seizure control after trying at least two carefully selected and properly dosed antiepileptic drugs, either individually or in combination. This type of epilepsy affects around one-third of those diagnosed, presenting significant challenges in daily life and increasing the risks related to injuries, cognitive decline, and sudden unexpected death in epilepsy. In this review, we discuss various potential predictors of drug-resistant epilepsy and explore related factors that may play a significant role in future research and treatment strategies. A range of factors, including genetic, clinical, and pharmacological aspects, influence the development of drug resistance in epilepsy. Nevertheless, the exact mechanisms underlying drug resistance in epilepsy remain poorly understood. Further research is essential to elucidate the pathophysiology of this complex phenomenon.
Baimakhanova et al. (2025) studied this question.