Barriers of the CNS and Their Contribution to Drug-Resistant Epilepsy

Despite the development of new antiseizure drugs (ASDs), drug resistance is a health problem for 30% of patients with epilepsy. Different hypotheses try to explain the mechanisms associated with drug-resistant epilepsy (DRE). The present chapter contains mechanisms involved in the disfunction of the blood–brain barrier, such as neuroinflammation, excitotoxicity, oxidative stress, and overexpression of enzymes and drug transporters. It is also pointed out the relevance to evaluate these mechanisms in the arachnoid barrier and the blood–cerebrospinal fluid barrier of patients with DRE. It is important to mention that this chapter includes information obtained from subjects with DRE that supports the disfunction of central nervous system barriers.