Oros M. Clinical and pharmacogenetic factors influencing of drug resistance epilepsy, their role in the individualisation of treatment

In theoretically grounded and practically urgent scientific problem of developing criterion prediction drug resistance individual and treatment of epilepsy, based on the study of clinical and genetic and pharmacogenetic parameters that characterize the individual characteristics of the pharmacokinetics and pharmacodynamics of antiepileptic drugs. This will set the criteria for early effectiveness of anticonvulsants. It is shown that the genetic polymorphisms of genes AVSV1 P-glycoprotein rs1045642, P-glycoprotein rs1128503 and SCN1A rs3812718 affects the efficiency of antiepileptic drug treatment in patients with epilepsy. Determined that the combination of SS gene polymorphism P-glycoprotein rs1045642, P-glycoprotein rs1128503 and TT gene SCN1A rs3812718 polymorphism may serve as a prognostic criteria of drug resistance epilepsy in this patient. Based on clinical and pharmacogenetic and clinical and electrophysiological has developed criteria for the effectiveness of antiepileptic drugs and proposed a new algorithm for clinical management of patients with epilepsy. This algorithm makes it possible to significantly reduce time drug resistance definition, which in turn, reduces the time progression epileptogenesis. Therefore, the use of alternative methods of treatment of epilepsy (including surgery), it is possible even before the patient irreversible changes in the central nervous system.