INTRODUCTION:
Epilepsy is a common neurological condition affecting people of all ages, gender and socioeconomic status. Once diagnosed, many patients with epilepsy can be successfully treated with anti-seizure drugs. Those who continue to have seizures despite adequate treatment with at least two anti-epileptic drugs are diagnosed as having drug resistant epilepsy according to the ILAE definition.
Management of DRE remains a challenge and requires early identification of those at risk to prevent social and health- related negative consequences of poorly controlled seizures.
The exact mechanisms underpinning DRE are not completely understood and remain hypothetical. However, several factors have been correlated with the risk of evolution to DRE.

AIM OF THE WORK:
The aim of this study was to:
1- Identify the prevalence of drug-resistant epilepsy in adult patients attending Alexandria university hospitals.
2- Determine different risk factors associated with drug-resistant epilepsy.

SUBJECTS AND METHODS:
Subjects: Patients were recruited through hospitalization and outpatient clinics at Alexanderia university hospitals over a six-month period, from March 2021 to August 2021.
Methods: An interview questionnaire was used to gather the data from each patient and the following data were obtained:
- Demographic data - Seizure history
- History of anti-epileptic drugs (AED) - Family history of epilepsy and consanguinity.
- History of developmental delay. - Medical and surgical history.
- Comorbid psychiatric conditions. - A complete neurological examination
- All relevant investigations - Information regarding the etiology of epilepsy
- Epilepsy syndromes - Drug response classification