Abstract
Between January 1980 and June 1985 105 patients were referred to our hospital for refractory seizures. Most of them had frequent seizures belonging to secondary generalized epilepsy or partial epilepsy. The obvious reason for difficulty in seizure control were an error in the diagnosis of seizure types and/or inappropriate use of antiepileptic drugs, such as error of the choice of drugs, polypharmacy, or suboptimal dosage. These errors were seen in about 15% of referred patients. As to the problem on the part of patients, non-compliance, insufficient understanding about treatment of epilepsy, or hypersensitivity to drugs was noted in a few cases. More than 50% of referred patients had no definite reasons for difficulty in seizure control.
Reduction of multiple drugs, intermittent serial rectal or oral administration of diazepam, or high-dose therapy of carbamazepine, henytoin, valproate or others resulted in more than 50% reduction of seizure frequency in 62 out of 105 patients (59.0%) referred for refractory seizures.
