Refractory Epilepsy

What is Refractory Epilepsy?

Refractory epilepsy is a form of seizure disorder that does not respond to traditional seizure medications. Also known as “drug-resistant” or “intractable seizures,” refractory epilepsy affects an estimated one-third of the three million Americans with epilepsy. People with refractory epilepsy often experience seizures that occur frequently or are resistant to treatment, both of which substantially impair quality of life.

Causes of Refractory Epilepsy

Seizure disorders are caused by abnormal electrical activity in the brain. In some cases, seizures can be caused by abnormalities with structures of the brain—such as an abnormal brain cyst, displacement of tissue, or other structural defects. In people with refractory epilepsy, however, the cause is often unknown. A small number of patients may have genetic causes for epilepsy or other metabolic abnormalities.

Types of Refractory Epilepsy

There are two types of refractory epilepsy—idiopathic and symptomatic. Idiopathic refractory epilepsy is defined as an epilepsy that does not have an identifiable cause, while symptomatic refractory epilepsy is caused by an underlying disorder or physiological abnormality. The most common form of refractory epilepsy is idiopathic. Other conditions that can be associated with refractory epilepsy include genetic disorders, head injury, developmental disorders, and infectious diseases.

Treatments for Refractory Epilepsy

Despite the fact that refractory epilepsy is difficult to control, there are several treatments available. These include:

  • Medication: Several drugs can be used to control seizures in people with refractory epilepsy. These medications may include anticonvulsants, antiseizure medications, antiepileptic drugs, and other agents that affect the brain and nervous system.
  • Epilepsy Surgery: In some cases, epilepsy surgery can be done to identify the part of the brain causing the seizures and correct it. This can be done through an open neurosurgical procedure or with less invasive techniques.
  • Neuromodulation: Neuromodulation is a new treatment option for refractory epilepsy. This involves the use of a device to stimulate specific areas of the brain--in this case, the regions that control seizures. It is a promising therapy for some patients with refractory epilepsy.
  • Alternative therapies: Some complementary and alternative therapies, such as massage, acupuncture, and meditation, may be beneficial in controlling seizures for some patients with refractory epilepsy.


Refractory epilepsy is a challenging condition for patients and healthcare providers alike. Although there is no cure, there are several treatments available that can help control seizures and improve quality of life. If you or someone you know is living with refractory epilepsy, it is important to speak with your healthcare provider to find out what treatments are right for you.