Current Treatment Options in Neurology

, Volume 14, Issue 4, pp 356–368

Antiepileptic Drug Selection for Partial-Onset Seizures

Authors

  • Bassel F. Shneker
    • Ohio State University
    • Comprehensive Epilepsy Program, Department of NeurologyUniversity of Virginia
EPILEPSY (E WATERHOUSE, SECTION EDITOR)

DOI: 10.1007/s11940-012-0186-5

Cite this article as:
Shneker, B.F. & Fountain, N.B. Curr Treat Options Neurol (2012) 14: 356. doi:10.1007/s11940-012-0186-5
  • 318 Views

Opinion statement

Effective treatment of seizures resulting from epilepsy relies on several basic principles, regardless of which drug or treatment is selected. Treatment starts with a confident diagnosis that the symptoms are, indeed, seizure. The seizure type should be classified as focal in onset or primary generalized, and there should be a relentless search for the etiology. Many antiepileptic drugs (AEDs) are available to treat partial-onset seizures. Given that the efficacy of AEDs is comparable, selection of the appropriate drug is mostly determined by whether any comorbidities are present, such as migraine, obesity, depression, or chronic pain. In the absence of comorbidities, it depends on the side effect profile, cost, and convenience. Most AEDs, with a few exceptions, must be increased to a maximum tolerated dose before a second drug should be added. Most patients can become seizure free or adequately controlled if continued interventions are considered at each encounter until patients are seizure free.

Keywords

Antiepileptic drugsAEDsSeizuresSelectionPartial onsetPharmacologicEpilepsySeizure disorderFocal seizuresTreatmentDietSurgeryVagus nerve stimulationDeep brain stimulationResponsive neurostimulation

Copyright information

© Springer Science+Business Media, LLC 2012