The most important criteria of severity of intractable focal epilepsies are th e high frequency of seizure and the type of seizure, in particular seizures with fall. However, the presence of a brain lesion and its localization, handicap, n umber of antiepileptic drugs, poor social integration, history of status epilept icus, mortality, traumas, cognitive impairments, depressive symptoms and alterat ion of quality of life are also criteria of gravity. In this article, we propo se a review of these various elements limiting our discussion to adults. The most important criteria of severity of intractable focal epilepsies are th e high frequency of seizure and the type of seizure, in particular seizures with fall. However, the presence of a brain lesion and its localization, handicap, number of antiepileptic drugs, poor social integration, history of status epilept icus, mortality, traumas, Cognitive impairments, depressive symptoms and alteration of quality of life are also criteria of gravity. In this article, we propo se a review of these various elements limiting our discussion to adults.