ReviewFrontiers in neurology2017
Drug-Resistant Epilepsy: Multiple Hypotheses, Few Answers.
Review in Frontiers in neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 212 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
212 citing papers in PubMed, 7 syntheses or guidelines pooled it, 473 citations in OpenAlex.
- A Systematic Review of ABCB1 Polymorphisms and Antiseizure Medication Resistance: Insights from Effect Size and Study Power Analysis.International journal of molecular sciences · 2025Pooled it
- Genome-wide association meta-analyses of drug-resistant epilepsy.EBioMedicine · 2025Pooled it
- The efficacy and safety of third-generation antiseizure medications and non-invasive brain stimulation to treat refractory epilepsy: a systematic review and network meta-analysis study.Frontiers in neurology · 2023Pooled it
- Chinese Herbal Medicine Combined With Antiepileptic Drugs for Intractable Epilepsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Frontiers in pharmacology · 2022Pooled it
- Fruits for Seizures? A Systematic Review on the Potential Anti-Convulsant Effects of Fruits and their Phytochemicals.Current neuropharmacology · 2022Pooled it
- Clinical Characteristics of BRAF V600E Gene Mutation in Patients of Epilepsy-Associated Brain Tumor: a Meta-analysis.Journal of molecular neuroscience : MN · 2021Pooled it
- MicroRNAs in temporal lobe epilepsy: a systematic review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Pooled it
- Effect on Satisfactory Seizure Control and Heart Rate Variability of Thread-Embedding Acupuncture for Drug-Resistant Epilepsy: A Patient-Assessor Blinded, Randomized Controlled Trial.Behavioural neurology · 2023Trial
- The gut microbiome and drug-resistant epilepsy: Microbiome-antiseizure medication interactions and implications for pharmacoresistance.Epilepsia open · 2026Review
- Evaluation of serum irisin and meteorin-like (METRNL) levels in people with drug-resistant and drug-responsive temporal lobe epilepsy.Epileptic disorders : international epilepsy journal with videotape · 2026Article
- Targeted Sequencing and Haplotype Analysis of Voltage-Gated Potassium Channel Genes Reveal a Potential Association ofPharmaceuticals (Basel, Switzerland) · 2026Article
- Beneficial Modulation of the Microbiota-Gut-Brain Axis by Supplementation with Modified Kodo Millet Bran and a GABA-Producing Bacterium in PTZ-Induced Kindling.Probiotics and antimicrobial proteins · 2026Article
- Article
- Novel 3-Methoxypropanamide Derivatives as Potential Antiseizure and Antinociceptive Agents: Experimental Evidence from In Vitro and In Vivo Studies.Journal of medicinal chemistry · 2026Article
- Genetic Polymorphisms inPharmaceuticals (Basel, Switzerland) · 2026Article
- Parishin B Attenuates PTZ-Induced Seizures in Zebrafish and Is Associated with Neurotransmitter Balance and ACLY-Related Metabolic Pathways.Metabolites · 2026Article
- Audiogenic Kindling Stimulation Fails to Induce Cerebral Overexpression of P-Glycoprotein and Limbic Crises in the GASH/Sal Model of Epilepsy.International journal of molecular sciences · 2026Article
- Genome-wide rare copy number variations potentially associated with drug resistance in epilepsy.Scientific reports · 2026Article
- Computational Design of Drugs for Epilepsy using a Novel Guided Evolutionary Algorithm for Enhanced Blood Brain Barrier Permeability.Central nervous system agents in medicinal chemistry · 2026Article
- Breaking the resistance: a narrative review of the evolution from traditional drugs to precision therapies in epilepsy.Annals of medicine and surgery (2012) · 2026Review
152 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
Epilepsy is a common neurological disorder that affects over 70 million people worldwide. Despite the recent introduction of new antiseizure drugs (ASDs), about one-third of patients with epilepsy have seizures refractory to pharmacotherapy. Early identification of patients who will become refractory to ASDs could help direct such patients to appropriate non-pharmacological treatment, but the complexity in the temporal patterns of epilepsy could make such identification difficult. The target hypothesis and transporter hypothesis are the most cited theories trying to explain refractory epilepsy, but neither theory alone fully explains the neurobiological basis of pharmacoresistance. This review summarizes evidence for and against several major theories, including the pharmacokinetic hypothesis, neural network hypothesis, intrinsic severity hypothesis, gene variant hypothesis, target hypothesis, and transporter hypothesis. The discussion is mainly focused on the transporter hypothesis, where clinical and experimental data are discussed on multidrug transporter overexpression, substrate profiles of ASDs, mechanism of transporter upregulation, polymorphisms of transporters, and the use of transporter inhibitors. Finally, future perspectives are presented for the improvement of current hypotheses and the development of treatment strategies as guided by the current understanding of refractory epilepsy.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.