Most childhood seizures can be controlled by the appropriate antiepileptic drugs. When seizures remain intractable in a normally developing child with an intact neurologic examination, it is usually possible to identify a clear reason, and the physician, like a detective, needs to investigate and reveal it. In this article we will describe cases that were encountered during a lifetime at a pediatric epilepsy clinic, which will illustrate the different reasons seizures remain intractable in patients who do not have structural abnormalities or resistant epileptic syndromes.
