الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Epilepsy constitutes a major public health problem both in developing and developed countries . In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, behavior or sometimes convulsions and loss of consciousness . As many as 70-80% of persons with newly diagnosed epilepsy will eventually achieve remission, a majority of them within two years of the’ onset of epilepsy. Patients who continue to exhibit uncontrolled seizures or those who develop intolerable side effects that interfere with their quality of life, despite maximally tolerated trials of one or more AEDs for a minimum of 2 years are considered to have refractory epilepsy . Our findings offer support for the hypothesis that some patients have refractory epilepsy at the outset. Refractory epilepsy may be present from the beginning rather than evolve over time, since the clinical characteristics of this type of epilepsy are apparent early in the course of the disease. Such patients are more likely to have underlying structural cerebral abnormalities, to have had more seizures before therapy has initiated, and to have an inadequate response to the first antiepileptic drug prescribed. Therefore, our observations may be useful when those patients with a medically refractory seizure disorder are diagnosed as early , in the course of the illness, as possible devising more appropriate and effective therapy ; surgery should be considered as soon as treatment with two first-line drugs fails.