Before considering any changes to pharmacologi-cal treatment in a patient with refractory seizures,
confirmation that the events are epileptic in origin is
essential. It is estimated that up to 30% of patients
seen in specialist epilepsy clinics present with non-epileptic attacks alone or in combination with epi-leptic seizures.
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In these patients, the prescription of
AEDs is often inappropriate and can lead to signifi-cant side effects, in addition to the financial burden to
the health services. In many patients with refractory
seizures, video-electroencephalography (video-EEG)
monitoring is essential to characterize the events and