When is epilepsy is considered "refractory"? Tried couple of meds that work 4 for a bit but then seizures & migraines again. Getting frustrated.

FLEXIBLE DEFINITION. In fact, full control is the goal, but "refractory" could imply just a few seizures monthly. Whenever using epilepsy medication, need to dose to maximum level, if tolerated. Then add second medicine if first is inadequate. A third medication has only a 3-4% chance of controlling seizures, and if this develops, consider a Vagal Nerve Stimulator. We have well over 20 AEDs, and one may be best.