Abstract:
:Medical therapy is the mainstay for epilepsy, with most patients well controlled on a single antiepileptic drug (AED). In this non-refractory group, many patients have medication side effects and occasional seizures. Approximately 30% of patients with partial epilepsy and 25% of patients with generalized epilepsy are not well controlled on medications. These patients are often receiving multiple AEDs, with disabling seizures and side effects. Although second-generation AEDs are safer and better tolerated than the older AEDs, there are scant data to support significant advantages in efficacy. In VA studies with older AEDS, therapy with two AEDs improved seizure control in 40% of patients but seizure freedom was achieved in only 9%. A meta-analysis of the second-generation AEDs used as adjunctive therapies shows that 12% to 29% of patients had a 50% or greater reduction in seizure frequency. Surgery and the vagus nerve stimulator provide important therapeutic options in patients whose seizures are not controlled by AEDs. Special considerations about epilepsy care must be made in pediatric populations, those with developmental delays, women, and the elderly.
journal_name
Neurologyjournal_title
Neurologyauthors
Nadkarni S,LaJoie J,Devinsky Odoi
10.1212/wnl.64.12_suppl_3.s2subject
Has Abstractpub_date
2005-06-28 00:00:00pages
S2-11issue
12 Suppl 3eissn
0028-3878issn
1526-632Xpii
64/12_suppl_3/S2journal_volume
64pub_type
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