What causes epilepsy to become “intractable” The mechanisms that lead to “intractable” epilepsy are not well understood. (1) 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 intractable epilepsy. (2) Age of onset, the younger the age of onset (e.g., within 1 year of age), especially symptomatic epilepsy with organic lesions, the easier it is to become refractory epilepsy. (3) Epilepsy with frequent seizures, long duration of each seizure, and abnormal EEG background activity is generally refractory. Pseudo-refractory epilepsy is mostly of “medical origin”, due to wrong diagnosis, inappropriate classification, inappropriate drug selection, inappropriate 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.