Polymorphism of the multidrug resistance 1 gene MDR1 G2677T/A (rs2032582) and the risk of drug-resistant epilepsy in the Polish adult population

The review is dedicated to the problems of current neurosurgical treatment for drug-resistant epilepsy in the adult population of Russia and foreign countries. The literature published in the period 2010–2017 was sought in Russian and foreign databases. This review included 58 only full-text publications. The search results have shown that despite advances in neurosurgery for drug-resistant epilepsy and the development of new surgical procedures, the problem of this disease has not yet been fully resolved today. This is evidenced by fairly high global prevalence rates in patients with postoperative epilepsy resistant to antiepileptic therapy. The literature analysis has revealed that the mean prevalence of postoperative epilepsy is 69%. This indicator may vary according to the type of an epileptogenic structural lesion and its location in the brain. However, despite the rapid development of epilepsy surgery, currently there is still a low surgical activity in the treatment of patients with drugresistant epilepsy. Of importance is also the presence of postoperative complications, including various infectious complications and neurological deficit. Taking into account the high rate of postoperative epilepsy, it is concluded that it is appropriate to develop postoperative rehabilitation methods for patients with drug-resistant epilepsy.

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Unsatisfactory results of a drug resistant epilepsy surgical treatment: reasons analysis and treatment optimization way

Translational Medicine ◽

10.18705/2311-4495-2018-5-4-60-68 ◽

2018 ◽

Vol 5 (4) ◽

pp. 60-68

Author(s):

G. V. Odintsova ◽

M. V. Aleksandrov ◽

A. U. Ulitin ◽

V. G. Nezdorovina ◽

A. A. Chuchlovin ◽

...

Keyword(s):

Surgical Treatment ◽

Adult Population ◽

Drug Resistant ◽

Treatment Optimization ◽

Unsatisfactory Result ◽

Open Research ◽

High Prevalence ◽

Low Efficiency ◽

Structural Epilepsy ◽

Drug Resistant Epilepsy

The relevance of the studied problem was caused by high prevalence of drug resistant epilepsy, an increased structural epilepsy detection and extension indications for a surgical treatment.The purpose of article consisted in a research of the reasons of low efficiency of epilepsy surgical treatment in adult population with a cross-disciplinary approach position.Material and methods.The leading approach was the retrospective open research of the failure factors at 14 patiens.Results.It was revealed unsatisfactory result of epilepsy surgical treatment was caused by a complex of the reasons. The disease features have been the main reason for a failure in 100% of cases, additional reasons: irrational pharmacotherapy -in 86%, the surgical reasons — in 36% of cases.Conclusions.The unsatisfactory result of epilepsy surgical treatment was caused by a complex of the reasons. Cross-disciplinary approach to a problem, improvement of the epilepsy managment, further researches are required. Materials of article can be useful for the personified approach at surgical treatment of epilepsy.

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Multidrug resistance 1 (MDR1) 3435C/T genotyping in childhood drug-resistant epilepsy

Brain and Development ◽

10.1016/j.braindev.2013.01.016 ◽

2014 ◽

Vol 36 (2) ◽

pp. 137-142 ◽

Cited By ~ 13

Author(s):

Semra Saygi ◽

Fusun Alehan ◽

Fatma Belgin Atac ◽

Ilknur Erol ◽

Hasibe Verdi ◽

...

Keyword(s):

Multidrug Resistance ◽

Drug Resistant ◽

Drug Resistant Epilepsy

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Multidrug Resistance 1 (MDR1) Gene Polymorphisms in Childhood Drug-Resistant Epilepsy

Journal of Child Neurology ◽

10.1177/0883073810368997 ◽

2010 ◽

Vol 25 (12) ◽

pp. 1485-1490 ◽

Cited By ~ 19

Author(s):

Asude Alpman ◽

Ferda Ozkinay ◽

Hasan Tekgul ◽

Sarenur Gokben ◽

Sacide Pehlivan ◽

...

Keyword(s):

Multidrug Resistance ◽

Gene Polymorphisms ◽

Mdr1 Gene ◽

Drug Resistant ◽

Drug Resistant Epilepsy

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Curative and palliative MRI-guided laser ablation for drug-resistant epilepsy

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2017-316003 ◽

2017 ◽

Vol 89 (4) ◽

pp. 425-433 ◽

Cited By ~ 8

Author(s):

Mesha-Gay Brown ◽

Cornelia Drees ◽

Lidia M Nagae ◽

John A Thompson ◽

Steven Ojemann ◽

...

Keyword(s):

Adult Population ◽

Surgical Approaches ◽

Seizure Freedom ◽

Drug Resistant ◽

Seizure Reduction ◽

The Us ◽

Reduction Measure ◽

Mri Guided ◽

Drug Resistant Epilepsy ◽

Traditional Approaches

Epilepsy is a common neurological disorder occurring in 3% of the US adult population. It is characterised by seizures resulting from aberrant hypersynchronous neural activity. Approximately one-third of newly diagnosed epilepsy cases fail to become seizure-free in response to antiseizure drugs. Optimal seizure control, in cases of drug-resistant epilepsy, often requires neurosurgical intervention targeting seizure foci, such as the temporal lobe. Advances in minimally invasive ablative surgical approaches have led to the development of MRI-guided laser interstitial thermal therapy (LITT). For refractory epilepsy, this surgical intervention offers many advantages over traditional approaches, including real-time lesion monitoring, reduced morbidity, and in some reports increased preservation of cognitive and language processes. We review the use of LITT for epileptic indications in the context of its application as a curative (seizure freedom) or palliative (seizure reduction) measure for both lesional and non-lesional forms of epilepsy. Furthermore, we address the use of LITT for a variety of extratemporal lobe epilepsies. Finally, we describe clinical outcomes, limitations and future applications of LITT for epilepsy.

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CYP3A5*3 and C3435T MDR1 Polymorphisms in Prognostication of Drug-Resistant Epilepsy in Children and Adolescents

BioMed Research International ◽

10.1155/2013/526837 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 15

Author(s):

Ewa Emich-Widera ◽

Wirginia Likus ◽

Beata Kazek ◽

Paweł Niemiec ◽

Anna Balcerzyk ◽

...

Keyword(s):

Drug Resistance ◽

Multidrug Resistance ◽

Cytochromes P450 ◽

Mdr1 Gene ◽

Drug Resistant ◽

Pharmacoresistant Epilepsy ◽

Glycoprotein P ◽

C3435t Polymorphism ◽

Transporter Protein ◽

Drug Resistant Epilepsy

Drug-resistant epilepsies still remain one of the most profound problems of contemporary epileptology. Several mechanisms of drug resistance are possible; among them, genetic factors have a prominent place. Much importance is attached to genes, which encode enzymes that metabolize antiepileptic drugs CYP 3A, which belong to the family of cytochromes P450 and the genome of multidrug resistance, such as multidrug resistance 1 (MDR1) that expresses P-glycoprotein (P-gp), a drug transporter protein. The aim of the study was to assess the relation between polymorphism of gene CYP3A5 and polymorphism C3435T of MDR1 gene with the occurrence of focal, drug-resistant epilepsy in children and youths up to 18 years of age. The study comprised 85 patients, and their age range was from 33 months to 18 years of age, suffering from epilepsy, partly responding well to treatment, partly drug resistant. The polymorphism of both genes has been analysed using the PCR-RFLP method. The study failed to corroborate association between polymorphism CYP3A5*3 and C3435T polymorphism in MDR1 gene and pharmacoresistant epilepsy. The results of our research do not confirm the prognostic value of the polymorphisms examined in the prognostication of drug resistance in epilepsies.

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