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Título del libro: Pharmacoresistance In Epilepsy: From Genes And Molecules To Promising Therapies
Título del capítulo: Genes involved in pharmacoresistant epilepsy

Autores UNAM:
IRIS ENRIQUETA MARTINEZ JUAREZ;
Autores externos:

Idioma:
Inglés
Año de publicación:
2013
Palabras clave:

Drug resistant; Drug transporter; Epilepsy; Genes; Pharmacoresistant; Target hypothesis


Resumen:

This chapter is devoted to resistance to antiepileptic drugs (AEDs) and its genetic mechanisms. There are three general hypothesis proposed for pharmacoresistant epilepsy: (1) Target hypothesis, (2) Drug transporter hypothesis, and the (3) Intrinsic Severity Hypothesis (Gorter and Potschka, Jasper's basic mechanisms of the epilepsies, 4th ed. National Center for Biotechnology Information (USA), Bethesda, MD, 2012). In diagnosing poor response to treatment, it is also important to separate drug resistance from incorrect diagnosis of epilepsy syndrome for example: (a) Epilepsy caused by mutations in Glucose transporter gene 1 (GLUT1) being treated with valproate (VPA) worsens the seizures in this disease whereas replacement of glucose with ketogenic diet alleviates seizures and the glucose deficit in the central nervous system. (Klepper, Epilepsia 49(Suppl 8):46-49, 2008; Klepper et al., Neuropediatrics 40(5):207-210, 2009) (b) Genetic or idiopathic epilepsies such as Childhood Absence Epilepsy (CAE), Juvenile Myoclonic Epilepsy (JME) and Dravet's Syndrome can be aggravated when treated with Na+ channel blockers (Genton, Brain Dev 22(2):75-80, 2000; Guerrini et al., Epilepsia 39(5):508-512, 1998; Thomas et al., Brain 129(Pt 5):1281-1292, 2006; Martínez-Juárez et al., Brain 129(Pt 5):1269-1280, 2006) and (c) Mitochondrial disorders can also be aggravated by VPA (Finsterer and Zarrouk Mahjoub, Expert Opin Drug Metab Toxicol 8(1):71-79, 2012). Herein, we describe the three general hypothesis; we also summarize the difficult to treat genetic epilepsies. © 2013 Springer Science+Business Media, LLC. All rights are reserved.


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