Potential mechanisms of drug resistance in epilepsy

Various potential mechanisms of antiseizure medication resistance or factors predicting poor outcome have been implicated in patients with epilepsy and in animal models of drug-resistant seizures, which indicates that intrinsic or acquired resistance to drug therapy is a multifactorial phenomenon. Based on these findings, various hypotheses have been proposed to explain antiseizure medication resistance, including the target, transporter, and network hypotheses. These hypotheses are not mutually exclusive but may be relevant for the same patient, thus complicating any strategy to counteract or reverse pharmacoresistance.