Clinical guideline: antiepileptic drugs of choice for focal and generalized seizures in adult patients with epilepsy

Abstract

The mainstay of treatment in patients with epilepsy is antiepileptic drugs (AEDs). Currently, there are a significant number of AEDs in Mexico. For the pharmacological management of the patient with epilepsy, it is important to know the pharmacoki-netics, dosage, mechanism of action, and formulations of the AED. 70-80% of patients with either focal or generalized seizures are completely seizure free on AED monotherapy. When, despite the use of AED in monotherapy, seizure freedom is not achieved, a second AED should be used; AEDs with different mechanisms of action are empirically combined for this purpose. If a patient persists in having seizures with the use of an adequate AED, at appropriate doses and with therapeutic adherence, a correct diagnosis of the seizure type and a differential diagnosis should be reconsidered, using a new clinical evaluation and auxiliary diagnostic tests.