[Pharmacoresistant epilepsy - epidemiology and current studies].

In the last years interest in epileptology has focused on determining the cause and pathomechanism of farmacoresistance in epilepsy. According to epidemiology, the problem of pharmacoresistance concerns about 30% of patients suffering from epilepsy, mainly temporal epilepsy coexisting with hippocampal sclerosis. Drug-resistant epilepsy is frequently based on static or dynamic organic brain damage. Furthermore, those morphological changes and related clinical/psychological dysfuctions lead to intellectual and social consequences as well as to an increase of the mortality rate. Pharmacoresistant epilepsy afflicts various patients with the same form of epilepsy and concerns many antiepileptic drugs with different mechanisms of action. Thus, the genetic conditioning of this state was considered. So far, the multidirectional investigations have proved the importance of interleukin IL-1Beta gene polymorphism, prodynorphin, GABA receptors and the APOEZeta4 allele in pharmaco-resistant epilepsy. Moreover, further factors such as transport protein gene polymorphism (ACB(1), RLIP76/RALBP(1)), genetically modifying receptor changes within the activating/inhibiting system (SCN1A - sodium channels, KV(7) - potassium channels) and drug metabolizing enzyme gene polymorphism (UG T1 A1*28) are also considered important.