Most patients with seizures can control them with medications and lifestyle changes. However, as many as one in three patients with epilepsy may still continue to have seizures.

Seizures can be uncontrolled for four broad reasons:

• The diagnosis is wrong
• The treatment is wrong
• Despite the best treatment, triggers or lifestyle factors may affect seizure control
• Properly diagnosed seizures do not respond to the best medical treatment

Not all uncontrolled seizures are considered refractory or drug-resistant. For example:

• If the diagnosis is corrected and seizures can be brought under control with a different treatment, then they would not be considered refractory.
• If triggers can be avoided or modified to prevent breakthrough seizures, then medication therapy may work better. A person in this situation would not be considered drug-resistant, but different drug trials may be considered, and non-drug treatments may be considered to help control seizures.

If your seizures remain uncontrolled through medication and lifestyle modifications, surgical treatment may be an option, including minimally invasive procedures.

Some of these surgical options may include:

• Removal of brain tissue in the area where the seizures originate
• Use of laser ablation as an alternative to open surgery

To determine if surgery is an option for you, and which procedure would be best, our seizure experts will conduct inpatient evaluations. Advanced, minimally invasive stereo EEG and other diagnostic tools may be used to help identify the area of the brain where your seizures are originating.

Neurostimulation can be effective for patients with uncontrolled seizures. Options include:

• Responsive neurostimulation (RNS)
• Vagus nerve stimulation (VNS)
• Deep brain stimulation (DBS)