Ultimately, more than one third of patients with epilepsy have seizures refractory to anti-seizure medications (ASMs), and the likelihood of treatment response diminishes exponentially with sequential unsuccessful medication trials. [1–3] These outcomes remain unchanged, despite the introduction of more than a dozen new ASMs in the past twenty years.3] Accordingly, the International League Against Epilepsy (ILAE) defined drug-resistant epilepsy (DRE) as ‘failure of adequate trials of two tolerated and appropriately chosen and used ASM schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom’.[4]
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