This Hidden Epidemic 'Drug-Resistant Epilepsy' Is On The Rise: What Parents Should Know

Epilepsy is a condition that has been affecting millions worldwide for decades now and for many, this condition doesn’t get developed later on but the journey begins in childhood. While there are some children who respond well to timely treatment, there are also many others who face lifelong challenges. Today, doctors have increasingly been demanding that concerns be raised about drug-resistant epilepsy (DRE), a condition where standard anti-seizure medications fail to control seizures. Recently, during National Epilepsy Day on November 17, Dr. Atampreet Singh of ShardaCare Healthcity explained all about the condition and why early intervention is critical. He says “Drug-resistant epilepsy means the epilepsy is not responding to the usual anti-seizure medications.”

He explains the child’s condition by adding “If a child does not respond to two trials of a single drug, or a single trail of double drug duo therapy for a period of six months, we consider it drug-resistant.”

But what exactly is it that causes DRE in children at such an early age? Dr. Singh explains that the factors are many and can appear from birth, infancy or early childhood. Neonatal complications like hypoxia during delivery, hypoglycemia, or brain injuries can predispose a child to resistant epilepsy. Childhood illnesses, such as encephalitis, prolonged ICU stays (for a period of a week or ten days), or structural brain abnormalities, can also play a role. “Sometimes, a child may start having seizures at six or seven years old, and scans may reveal abnormalities like cortical dysplasia or malformations present since birth,” Dr. Singh adds.Now in this case, early detection is very important. There are also warning signs that include frequent, sudden-onset seizures, often multiple times a day. “Children with structural or genetic epilepsy may show explosive seizures or clusters of multiple seizures in a short period. These cases should be evaluated early for drug resistance,” says Dr. Singh.

How is DRE treated?

Diagnosis involves comprehensive evaluation, including video EEG monitoring and MRI scans, to understand the cause and type of epilepsy. Treatment options extend beyond medications. Presurgical evaluation is often the first step for children with identifiable lesions and then get really good MRI scans to correctly identify the areas with issues. Then one can do a neuropsychology assessing the IQ of the child, followed by a good speech assessment. “Our goal with surgery is to make the child seizure-free without major deficits or side-effects,” he explains.Other effective treatments include the ketogenic diet and nerve stimulation for children who are not surgical candidates. “Early referral to a comprehensive pediatric epilepsy center is essential. Long-standing uncontrolled epilepsy can lead to brain atrophy, impaired cognition, school performance issues, and behavioral problems,” Dr. Singh warns.Parents should be vigilant. Any child showing poor response to medications, frequent seizures, or cognitive or behavioral changes should be evaluated promptly. “Early intervention can significantly improve long-term outcomes and quality of life,” concludes Dr. Singh.Drug-resistant epilepsy may be challenging, but with awareness, timely evaluation, and proper treatment, children have a real chance at better seizure control and healthier development.