Are patients referred for presurgical evaluation drug resistant according to the new consensus definition? A study in a tertiary center

We performed a retrospective chart review of the last consecutive 40 patients admitted in our Epilepsy Unit for presurgical evaluation to find out if they met criteria for drug resistant epilepsy according to the recently published consensus definition. 276 drug trials had been performed in the 40 patients. In total, 196 trials were considered “uninformative” versus 80 informative and adequate trials. Finally, a firm diagnosis of drug resistant epilepsy could be made only in 13/40 patients (32.5%, 90% confidence interval for proportion 21.7-45.5%), due to insufficient information regarding previous drug trials. The definition should be spread among general neurologists for earlier and more complete referrals.