The mechanisms responsible for “refractory” epilepsy are not well understood. Seizure types and syndromes, such as infantile spasms, Lennox syndrome, temporal lobe epilepsy, and complex partial seizures of frontal lobe epilepsy, constitute the bulk of refractory epilepsy. 2, age of onset, the younger the age of onset (e.g., within 1 year), especially symptomatic epilepsy with organic lesions are prone to become refractory epilepsy. 3. Epilepsy with frequent seizures, long duration of each seizure, and abnormal EEG background activity is generally refractory. The most common cause of refractory epilepsy is “medical origin”, due to wrong diagnosis, improper classification, inappropriate drug selection, improper dosage or no regular treatment at all. These patients are treated with rational and individualized protocols, and some have remarkable results. Therefore, even if a patient is diagnosed with “refractory epilepsy”, he or she should not give up any opportunity for active treatment and should be treated by a specialist at a major hospital.