High risk factors for refractory epilepsy Partial seizures are indicative of “refractory” epilepsy: 1. acquired brain injury; 2. neurological deficits; 3. mental retardation; 4. early age of onset; 5. seizure type, or combination of seizure types: West syndrome, Lennox-Gastaut syndrome, complex partial seizures, or combination of tonic clonic seizures; 6. high seizure frequency, long duration, and history of persistent status epilepticus; 7. generalized epileptiform activity on EEG.