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What is Intractable Epilepsy?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 26 May 2020
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Intractable epilepsy is a form of epilepsy that is resistant to treatment. The patient can experience side effects of medications or seizures that consistently interfere with quality of life and ability to function. It takes time to arrive at this diagnosis, as a number of different treatment options need to be explored and the initial diagnosis of epilepsy also needs to be verified. In some cases, people may be diagnosed with intractable epilepsy because the original diagnosis was incorrect and their seizures weren't responding to treatment because they were being given the wrong treatment.

Several characteristics can be observed in intractable epilepsy. Some cases involve an unacceptably high number of seizures. Many forms of epilepsy can be so well controlled with medication that the patient rarely, if ever, has seizures, and seizures can be directly traced to unusual sources of stress and other circumstances. In patients with intractable epilepsy, the medication doesn't work, or does not work as effectively as it should, leading to repeat episodes of seizures.

Other cases involve a medication intolerance. Patients may have abnormally high or debilitating side effects on seizure medications. If several medications are tried and the patient reacts badly to all of them or doesn't respond to them, it may be a case of intractable epilepsy. Patients with this condition can end up on a rotating series of medication regimens as a doctor attempts to find a combination of drugs for the patient. In some cases, patients experience what is known as “honeymooning,” where a medication will be effective for a brief period of time before the patient's epilepsy becomes resistant to it.

If a diagnosis of intractable epilepsy is proposed by a neurologist, it is advisable to receive evaluation by another physician. There are a number of factors involved in the development of intractable epilepsy and a doctor new to the case might be able to identify problems the original doctor did not recognize, or might be able to correct an erroneous diagnosis. If the form of epilepsy is not diagnosed correctly, the treatment provided will not be beneficial, and getting the right diagnosis will allow a doctor to provide the appropriate treatment.

In true cases of intractable epilepsy, patients can work with their doctors on the development of a drug regimen with the fewest side effects and the most control over the seizures. Periodic reevaluations are recommended to identify any changes in the patient's status. Patients can also explore the possibility of participating in clinical trials and other research. These will provide access to new forms of epilepsy treatment.

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