Intractable Epilepsy
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What do I have?
Intractable epilepsy is a seizure disorder in which a patient’s seizures fail to come under control with treatment. These seizures are sometimes also called “uncontrolled” or “refractory.”
What does it do?
Frequently intractable epilepsy interferes with a patient’s quality of life. People who are not seizure-free need to be careful about possible accidents during a seizure. Patients with intractable epilepsy need to take caution while in water, near busy streets or railway platforms, and often are unable to drive.
Can it be cured?
Intractable epilepsy does not always remain intractable. First, one of the treatments listed below may prove effective. Second, individuals may be able to modify precipitating factors or their lifestyle to help to control the seizures. But even in the absence of specific therapies or life changes, there is hope for improvement for spontaneous regression which is reported to occur in about 5% of patients with this condition.
What caused it?
Difficulty controlling seizures can result from seizures that are “too strong” to be controlled by medication, or by intolerance of medication.
How is it treated?
When confronted with refractory seizures, various courses of action become available to physicians and to patients. The doctor can reevaluate the diagnosis and the medication therapy. The person with epilepsy can consider strategies for remembering to take medications and reduction of precipitating factors, if any. When medications do not work, then non-medication therapy for the epilepsy can be considered, including epilepsy surgery or vagal nerve stimulation.
Surgery is a reasonable option for people with refractory epilepsy, provided that the seizure origin in the brain can be localized to one region, and that region is safe to remove. Success rates for cessation or near-cessation of seizures ranges from about 50-90%, depending upon the cause of seizures and their brain location. Epilepsy surgery is elective surgery, meaning that it is a matter of personal choice, not necessity.