Intractable epilepsy
Epilepsy that fails to respond adequately to appropriate antiseizure medication trials.
Full Definition
Intractable epilepsy, also known as drug-resistant or refractory epilepsy, is defined as failure to achieve sustained seizure freedom despite trials of two appropriately chosen and well-tolerated antiseizure medications, either alone or in combination. This condition affects approximately one-third of people with epilepsy and significantly impacts quality of life, cognitive function, and mortality risk. Patients with intractable epilepsy should be evaluated for non-pharmacological interventions including epilepsy surgery, neurostimulation devices, or dietary therapies. The definition requires proper medication trials with adequate dosing and duration.
Usage
Usage note: Preferred term is 'drug-resistant epilepsy' per ILAE guidelines; ensure proper medication trials before applying this label.
In Context
- "After failing trials of three different antiseizure medications, the patient was diagnosed with intractable epilepsy." — Neurology consultation note
- "Patients with intractable epilepsy should be referred for presurgical evaluation within two years of diagnosis." — Clinical practice guideline