Mozart's Sonata for two pianos in D major, K.448 (Mozart K.448), has been shown 
to improve mental function, leading to what is known as the Mozart effect. Our 
previous work revealed that epileptiform discharges in children with epilepsy 
decreased during and immediately after listening to Mozart K.448. In this study, 
we evaluated the long-term effects of Mozart K.448 on children with refractory 
epilepsy. Eleven children with refractory epilepsy were enrolled. All of the 
patients were diagnosed as having had refractory epilepsy for more than 1 year 
(range =1 year to 6 years 4 months, mean =3 years 11 months) and had been 
receiving at least two antiepileptic drugs (AED). During the study period, they 
listened to Mozart K.448 once a day before bedtime for 6 months. Seizure 
frequencies were recorded 6 months before they started listening to this music 
and monthly during the study period. All of the patients remained on the same 
AEDs during the 6-month study period. Frequencies of seizures were compared 
before and after listening to Mozart K.448. Eight of eleven patients were 
seizure free (N=2) or had very good responses (N=6) after 6 months of listening 
to Mozart K.448. The remaining three (27.3%) showed minimal or no effect 
(effectiveness <50%; unmodified or worsened seizure frequency). The average 
seizure reduction was 53.6 ± 62.0%. There were no significant differences in 
seizure reduction with IQ, etiology, or gender. We conclude that Mozart K.448 
should be further studied as a potential add-on therapy in the treatment of 
children with refractory epilepsy.