Do seizures in POLG1-related mitochondrial disorder become refractory due to mitochondrion-toxic anti-seizure drugs?

With interest we read the article by Menon et al. about a 28 years old female, with a non-syndromic mitochondrial disorder (MID) due to the compound heterozygous variants c.2070+2T>C and c.2243G>C in POLG1, which manifested phenotypically with mild intellectual disability and epilepsy since age 10 years [1]. She was admitted for fever and serial focal tonic-clonic seizures, which did not respond to phenytoin (PHT), carbamazepine (CBZ), and clobazam (CLB), why levetirazetam (LEV), lacosamide (LCM), and topirmate (TPM) were given, but also without benefit [1].