refractory epilepsy
Epilepsy that does not respond to adequate trials of two appropriately chosen antiepileptic medications.
Full Definition
Refractory epilepsy, also termed drug-resistant epilepsy, is defined as failure to achieve seizure freedom despite trials of two tolerated and appropriately chosen antiepileptic drugs, either as monotherapy or in combination. This definition, established by the International League Against Epilepsy, applies when medications are used at maximum tolerated doses for adequate durations. Approximately 30% of pediatric epilepsy patients develop refractory epilepsy, which may prompt consideration of alternative treatments including epilepsy surgery, dietary therapy, or neurostimulation devices.
Usage
Usage note: Use 'drug-resistant epilepsy' as the preferred ILAE term; document specific medications trialed.
In Context
- "The patient met criteria for refractory epilepsy after failing trials of levetiracetam and lamotrigine." — Epilepsy clinic assessment
- "Surgical evaluation was initiated given the refractory nature of the patient's epilepsy." — Multidisciplinary team meeting note