Drug-resistant epilepsy is a complex neurological disorder with a significant impact on the lives of affected children and their families. A child is diagnosed with drug-resistant epilepsy if seizure control is not achieved despite receiving the maximally optimised doses of two appropriately chosen antiepileptic medications. 1 Kwan P Arzimanoglou A Berg AT et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010; 51: 1069-1077 Crossref PubMed Scopus (2851) Google Scholar Mortality risk is seven times higher in children with epilepsy than in the general population. 2 Callenbach PM Westendorp RG Geerts AT et al. Mortality risk in children with epilepsy: the Dutch study of epilepsy in childhood. Pediatrics. 2001; 107: 1259-1263 Crossref PubMed Scopus (98) Google Scholar One contributor to the mortality associated with drug-resistant epilepsy is sudden unexpected death in epilepsy (SUDEP); ie, unexpected death with no obvious cause. 3 Nashef L So EL Ryvlin P Tomson T Unifying the definitions of sudden unexpected death in epilepsy. Epilepsia. 2012; 53: 227-233 Crossref PubMed Scopus (397) Google Scholar One in 833 children with drug-resistant epilepsy is estimated to die from SUDEP every year. 4 Ryvlin P Rheims S Lhatoo SD Risks and predictive biomarkers of SUDEP. Curr Opin Neurol. 2019; 32: 205-212 Crossref PubMed Scopus (0) Google Scholar The most common risk factors for SUDEP are high seizure frequency, early age of seizure onset, and multiple antiseizure drugs. 5 Abdel-Mannan O Taylor H Donner EJ Sutcliffe AG A systematic review of sudden unexpected death in epilepsy (SUDEP) in childhood. Epilepsy Behav. 2019; 90: 99-106 Summary Full Text Full Text PDF PubMed Scopus (46) Google Scholar Other causes of death include status epilepticus, injury related to seizures, and suicide. Comparison of long-term survival with continued medical therapy, vagus nerve stimulation, and cranial epilepsy surgery in paediatric patients with drug-resistant epilepsy in the USA: an observational cohort studyPaediatric patients with drug-resistant epilepsy who underwent cranial epilepsy surgery or VNS had a higher survival rate than those who received only medical treatment. These findings highlight the importance of a multidisciplinary comprehensive team approach to the treatment of epilepsy, which includes tailored evaluation and deployment of medical and surgical treatment options for patients with this challenging disease. Full-Text PDF