What is Refractory Epilepsy?
Epilepsy is a condition characterized by recurrent episodes of involuntary shaking (seizures) that occur due to abnormal electrical activity in the brain. It is usually treated with medication, but sometimes patients do not respond adequately to treatment with medications. In such cases, seizures continue, affecting the activities of your daily living. This is a drug-resistant form of epilepsy called refractory epilepsy.
You are considered to have refractory epilepsy when your doctor orders at least two different types of medication and you do not respond to them. Refractory epilepsy can also occur when you are more prone to potential side effects or non-tolerant to epileptic medication, which makes it difficult for your doctor to prescribe them. Hence, easily treatable seizures can become hard to treat.
Symptoms of Refractory Epilepsy?
If you have refractory epilepsy, you have a greater risk of injuries, cognitive problems, social issues, and fear of when your next attack will interfere with your daily activities.
Diagnosis of Refractory Epilepsy?
To diagnose your epilepsy as refractory, your doctor may review in detail your medical history and perform a physical examination. The nature of your seizures and your existing medication regimen will be reviewed. An electroencephalogram (EEG) may be ordered to study the electrical activity of your brain, and CT or MRI scans may be performed to look for abnormalities.
Treatment for Refractory Epilepsy
At first, your doctor may try altering your medications or trying a combination of drugs. If this does not show improvement, non-medication approaches may be suggested. Your doctor may recommend a ketogenic diet (low-carbohydrate, high-fat). Your surgeon may perform surgical resection of a region of your brain where seizures arise. If you do not respond to surgery, vagus nerve stimulation may be suggested, where a device implanted in your chest stimulates the vagus nerve in the neck, which sends impulses to your brain, reducing the incidence of seizures.