Management strategies for refractory localization-related seizures.
Localization-related epilepsy, the most common type of seizure disorder, often provides major management problems. Five new antiepileptic drugs (AEDs) with different mechanisms of action have been licensed in the United Kingdom in the 1990s for adjunctive use in the management of poorly controlled partial seizures. These were, in chronologic order, vigabatrin, lamotrigine, gabapentin, topiramate, and tiagabine. Their practical deployment is explored here. Mention also is made of clobazam and acetazolamide. Combination therapy with two or even three AEDs having complementary pharmacologic effects can provide an essential contribution to the management of partial seizures. This article discusses some of the pharmacologic strategies used in treating patients with refractory localization-related epilepsy.
Brodie
M J
MJ
Epilepsy Unit, University Department of Medicine and Therapeutics, Western Infirmary, Glasgow, G11 6NT, Scotland. martin.j.brodie@clinmed.gla.ac.uk
D000085:Acetates / Q000008:administration & dosage / Q000627:therapeutic use; D000588:Amines; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004828:Epilepsies, Partial / Q000188:drug therapy*; D005632:Fructose / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D000077213:Lamotrigine; D009557:Nipecotic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D000078308:Tiagabine; D000077236:Topiramate; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage / Q000627:therapeutic use; D020888:Vigabatrin / Q000008:administration & dosage / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D009557:Nipecotic Acids; D014227:Triazines; D000077236:Topiramate; D005632:Fructose; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D020888:Vigabatrin; D000077213:Lamotrigine; D000078308:Tiagabine