As many as two out of three patients treated for epilepsy have seizures that are refractory to therapy, either because they have incomplete control of their seizures or they experience treatment-related side effects that interfere with their quality of life. This section provides a practical approach to the evaluation and treatment of these patients.

The overview provides a working definition of refractory seizures, and discusses the goals of therapy as well as the importance of seizure freedom.

The scope of the problem of refractory seizures and in-depth information about forms of epilepsy that are particularly resistant to treatment are then presented.

Potentially correctable causes of refractory seizures, such as noncompliance and psychogenic nonepileptic seizures, are discussed next.

Finally, actions that you can take to help your patients with refractory seizures are highlighted in the last section.

Authored by: Steven C. Schachter MD on 5/2008
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