Labate A, et al. - In order to obtain an alternative diagnosis in patients referred for refractory epilepsy (rE), the clinicians identified key clinical/laboratory factors. In this prospective cohort study, refractory epilepsy mimics were identified, who were at high risk of morbidity and mortality. Refractory epilepsy starting in adulthood ought to raise a high suspicion of cardiac syncope. In differentiating rE from other conditions, brain MR was accurate.