intractable epilepsy
Epilepsy that remains uncontrolled despite adequate trials of multiple appropriate antiepileptic medications.
Full Definition
Intractable epilepsy, also known as refractory or medication-resistant epilepsy, refers to epilepsy that fails to respond to adequate trials of two or more appropriately chosen antiepileptic drugs (AEDs), whether used individually or in combination. The definition requires that medications be tolerated at adequate doses and used for sufficient duration. Approximately 30% of epilepsy patients have intractable epilepsy, which is associated with increased morbidity, mortality, and psychosocial complications. Management may involve additional AEDs, epilepsy surgery evaluation, vagus nerve stimulation, ketogenic diet, or other non-pharmacological interventions.
Usage
Usage note: Preferred over "intractable" alone; specify criteria met when documenting.
In Context
- "The patient met criteria for intractable epilepsy after failing four different antiepileptic drugs." — Epilepsy surgery referral
- "Intractable epilepsy prompted evaluation for alternative treatments including ketogenic diet." — Treatment planning meeting