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Fifteen-minute consultation: When medicines don’t work—the child with poorly controlled seizures
  1. Pooja Harijan1,2,
  2. Arnab Kumar Seal3,
  3. Manish Prasad4,
  4. William P Whitehouse4,5
  1. 1 Department of Paediatrics, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UK
  2. 2 Department of Paediatric Neurology, Cambridge University Hospitals NHS Trust, Cambridge, UK
  3. 3 Department of Community Paediatrics, Leeds Community Healthcare NHS Trust, Leeds, UK
  4. 4 Department of Paediatric Neurology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
  5. 5 School of Medicine, University of Nottingham, Nottingham, UK
  1. Correspondence to Dr Pooja Harijan, Department of Paediatrics, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough PE3 9GZ, UK; drpharijan{at}


Drug-resistant epilepsy (DRE) occurs in 20%–30% of children with epilepsy with significant impact on their quality of life. Management of this group of children has greatly improved in the recent years with streamlining of epilepsy surgery services and associated quaternary multimodal evaluation. This article provides a review of DRE in children and management based on recent evidence and published opinion. We have also presented an algorithmic approach to the child with possible DRE.

  • drug-resistant epilepsy
  • refractory epilepsy
  • intractable epilepsy
  • antiepileptic drugs
  • epilepsy management

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  • Contributors PH wrote the first draft, and all authors critically reviewed and edited the manuscript and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.