Abstract
Epilepsy is one of the most common neurological disorders to affect children, and has its highest incidence in infancy. Approximately one-quarter of children have seizures which are drug-resistant, and place the child at increased risk of cognitive delays, attention, behavior and psychiatric disorders, injury, sudden unexpected death and poor quality of life. This article presents a rational approach to the investigation and management of children with drug-resistant epilepsy.
 
Highlights
Epilepsy is one of the most common neurological disorders seen in children with an estimated incidence of approximately 44 per 100,000 per year [1, 2]
In addition to ongoing seizures, those with drug-resistant epilepsy are at greater risk for intellectual disability and learning problems, attention and behavioural problems, and emotional difficulties such as anxiety and depression, injury and sudden unexpected death in epilepsy, and poor quality of life
Factors that have been quite consistent include certain syndromes, high initial seizure frequency, neonatal seizures, onset prior to or greater than age 12 years, associated intellectual disability or abnormal neurologic examination, abnormal neuroimaging, and failure to respond to the first antiseizure medication [5]
Summary
Epilepsy is one of the most common neurological disorders seen in children with an estimated incidence of approximately 44 per 100,000 per year [1, 2]. One quarter of children have seizures which are drug resistant and place the child at increased risk of cognitive delays, as well as attention, behaviour and psychiatric disorders, injury, sudden unexpected death, and poor quality of life. Structural etiologies are amongst the most common causes of drug-resistant epilepsy in children [16, 17, 18, 19].
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