by Robert S. Fisher, M.D., Ph.D.
Professor of Neurology Stanford
Editor-in-Chief, epilepsy.com

Acknowledgement: This section was sponsored by a generous unrestricted educational grant from Lundbeck and Eisai, Inc. The text was written without knowledge of the sponsoring agency.

Definition of uncontrolled (refractory) seizures

Seizures sometimes fail to come under control with treatment, in which case they are called by one of many possible terms: “uncontrolled,” “intractable,” or “refractory.” How often does this happen? Studies suggest that epilepsy fails to come quickly under control with medicines in about one-third of cases, but the true frequency depends upon the definition of uncontrolled (French 2006). Most epilepsy specialists agree that refractory epilepsy is epilepsy for which seizures are frequent and severe enough, or the required therapy for them troublesome enough, to seriously interfere with quality of life. How can this concept be made specific? Does refractory mean any breakthrough seizure over the years, or a steady stream of seizures, say at least one a month? Unfortunately, there is no common standard, so any discussion of uncontrolled epilepsy has to define what is meant by uncontrolled.

Continue on to Reasons for Intractable Seizures

Topic Editor: Robert S. Fisher, MD, PhD
Last Reviewed: April 21, 2009

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