Abstract

Approach to refractory childhood seizures

Author(s): Blathnaid McCoy and Selim R Benbadis

Up to 40% of children with epilepsy will not achieve seizure freedom with antiepileptic drugs. Refractory epilepsy has devastating consequences, both for the child and their carers. Early recognition of those with refractory epilepsy, in order to minimize these consequences, has proven difficult. Currently, most patients with refractory epilepsy wait many years before being referred for evaluation at a specialist center. The clinicians taking care of children with epilepsy must have a clear approach to both the diagnosis and appropriate pathways for investigation of patients with refractory seizures. We present a structured approach to both the diagnosis and evaluation of refractory seizures; we review the current therapeutic options available to treat those suffering from refractory seizures and explore potential therapeutic options for the future.