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Abstract
Seizures are a common neurological disorder in the pediatric age group. They are a manifestation of abnormal hypersynchronous discharges of cortical neurons. Epilepsy is characterized by the occurrence of at least 2 unprovoked seizures. The life time likelihood of experiencing at least an epileptic seizure is about 9% and life time likelihood of being diagnosed as epileptic is almost 3%, however the prevalence of active epilepsy is 0.8%. Patients who fail to respond to two or more antiepileptic drugs at maximally tolerated doses are considered to be intractable seizures Although criteria for defining ‘intractable epilepsy‘ are elusive e.g number of drugs tried, doses of drugs, duration of treatment, etc .A hard core of 20–30% of patients continue to have seizures that appear to be resistant to all pharmacological protocols. These patients are usually treated with multiple AEDs, which, in combination, may produce sedative and behavioral toxicityand organ dysfunction High seizure frequency, prolonged seizures and episodes of status epilepticus can lead to cognitive decline. A long period of imperfect seizure control produces disturbed psychosocial functioning resulting, for instance, in poor academic achievement, diminished self-esteem restricted lifestyle, dependent behavior, and low rates of marriage, all are leading to unsatisfactory quality of life . In addition, intractable epilepsy is associated with excess mortality, particularly due to sudden unexpected death.