Intractable Epilepsy

Epilepsy is a neurological disorder in which the nerve cell activity in your brain is impaired, causing a seizure which can affect a variety of physical functions. A seizure can cause abnormal functioning of nerve cells in the brain.

Intractable epilepsy is the epilepsy that is hard to cure. It can be called refractory as it is resistant to treatment.

Intractable epilepsy may need to be treated with surgery if Antiepileptic drugs found ineffective.


Intractable epilepsy can cause certain harmful effects on your life.

The possible effects include:

  • Interfere learning and cognition in children
  • Brain injury
  • Loss of concentratation
  • Loss of memory and attention
  • Emotional difficulties
  • Abnormal physical functioning
  • Behavioral changes
  • Reproductive disorders


  • Focal cortical dysplasia- It is the malformation of cortical formation and development.
  • Mesial temporal sclerosis is the condition of losing neurons and scarring in the inner portions of temporal lobe in the brain due to brain trauma or infections. It is also called hippocampal sclerosis.
  • Glioneuronal tumors and cavernous angioma of central nervous system
  • Head injuries
  • Improper diagnosis and treatment
  • Epilepsy do not respond to drugs


Intractable epilepsy may show signs and symptoms like:

  • Convulsions
  • Loss of consciousness
  • Staring into space
  • Loss of concentration
  • Loss of memory
  • Imbalanced cognition
  • Unintended changes in emotion and mood.
  • Muscle stiffness

If your seizures persist even after the antiepileptic drug medication for two times, your seizure may be refractory.


Your doctor will diagnose intractable epilepsy based on medical history, neurological or physical examination, clues from the patient and diagnostic tests.

Electroencephalogram (EEG) is the most common method to diagnose intractable epilepsy. Here electrodes are attached to your scalp to check brain’s activity.

High resolution MRI brain scan can detect the lesions or seizures in your brain.


Intractable epilepsy can be cured. Treatment options include medications, epilepsy surgery, Vagus nerve stimulation and ketogenic diet.


Medications used for the treatment of intractable epilepsy are called Antiepileptic drugs. The most commonly prescribed drugs are,

  • Carbamazepine
  • Clobazam
  • Clonazepam
  • Phenobarbital
  • Phenytoin
  • Primidone
  • Valproate
  • Lamotrigine
  • Oxcarbazepine
  • Phenobarbital

Antiepileptic medications may produce certain side effects such as fatigue, dizziness or weight gain. If these medications produce no improvements, you may have to undergo surgical procedures for treatment.


In resective surgery, the part of brain that causes seizures or lesions will be removed. Resective surgery may be lesionectomy, lobectomy, or hemispherectomy. This will cause no any functional abnormalities in your body as the removing part is not functioning.


A small implantable device called vagus nerve stimulator will be placed under the skin of your chest area. It is a device with wires which can be connected to the vagus nerve in your brain. It can send current to the nerve and destroy lesions and seizures. Side effects like throat pain and coughing may result from this procedure.


Ketogenic diet is a special fat-rich diet given to children with intractable epilepsy. This diet is low in carbohydrate and protein content. Ketonic diet causes the production of ketones in the body. Increased concentration of ketones in the body can control refractory seizures.

You can lead a better life if you follow your surgeon’s instructions and advices strictly along with taking medication correctly, doing healthy exercises, sleeping enough and taking other necessary personal cares.