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Medical management of refractory epilepsy—Practical treatment with novel antiepileptic drugs
Author(s) -
BenMenachem Elinor
Publication year - 2014
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12494
Subject(s) - lacosamide , perampanel , vigabatrin , epilepsy , medicine , lamotrigine , intensive care medicine , antiepileptic drug , epilepsy syndromes , refractory (planetary science) , levetiracetam , anticonvulsant , psychiatry , physics , astrobiology
Summary The ultimate treatment goal in epilepsy therapy is always freedom from seizures with as few treatment adverse effects as possible. If seizures persist with the first monotherapy, alternative monotherapy with another antiepileptic drug ( AED ) should be considered. Continuing seizures should lead to a reevaluation of differential diagnosis and adherence. Epilepsy surgery as an alternative therapy may be suitable in selected cases. If the diagnosis of epilepsy is established and epilepsy surgery is not appropriate, AED treatment should be optimized. Evidence for how to proceed is lacking. Concepts such as rational polytherapy have been advocated but remain speculative concerning better efficacy based on the use of AED s with differing modes of action. A variety of new AED s including rufinamide, lacosamide, vigabatrin, perampanel, and retigabine have been recently introduced in the United States . They are briefly characterized in this update review.