Hello, Thanks for posting your query on Healthcaremagic. I understand that your brother has seizures for the past 20 years. Any one who has seizures not controlled with adequate medications tried atleast for 2 years is said to be suffering from Drug resistant Epilepsy . There are many cause for this to happen. Choosing a wrong medications for the kind of epilepsy, inadequate dose of medications, non-compliance with medications and psychogenic issues are some of the common reasons for failure to achieve cure in epilepsy. You need to see a Epileptologist who is specilaized in treating difficult epilepsy like your brother for the possibility of epilepsy surgery and achieve cure and good quality of life. Let him continue on the current medications, maintain a seizure diary and undergo detailed pre-surgical evaluation in the form of video-eeg, MRI and neuropsychology evaluation for the possibility of epilepsy surgery. I hope this helps you. If you have any further query, I would be glad to help you. Dr Shiva Kumar R Consultant Epileptologist Bangalore