• Refractory epilepsy or difficult-to-treat epilepsy is not uncommon; it is a known entity even in the best medical treating hands. • It is better to revise the whole history before labeling a case as refractory epilepsy. If possible, it should be reviewed by a different specialist. Pseudoseizures should be excluded. • Alternatives to medical treatment like vagal nerve stimulation and surgery can be tried. • Each and every disease is not 100% treatable or curable so dont lose your heart (advice to the treating doctor). • Do not hesitate in referring to your colleague, may be he can do better though the chances are rare. • Education program for patient and/or relatives is important.