Medical treatment of acute seizures and epilepsy

Abstract

Almost every active epilepsy requires medical treatment. The aim is to keep the patient free of seizures while at the same time ensuring good tolerability. A number of drugs are available for the long-Term treatment of focal epilepsies, whereas the choice is more limited for generalized epilepsies. The choice of an anti-seizure drug should be based on the patient's expectations and life situation, his co-morbidities and the side effect profile of the anti-seizure drug, in addition to the epilepsy syndrome. Newer anti-seizure drugs will therefore usually be preferred. The development of newer drugs increases the chance of an individually well-Tolerated and successful therapy. On the other hand, the therapy costs of most of the newer anti-seizure drugs are higher. Most epileptic seizures are self-limiting. However, a prolonged epileptic seizure must be treated with benzodiazepines quickly and in sufficiently high doses to avert a refractory course of status epilepticus and to improve the outcome of the patient.