title: Epilepsy in adults.
abstract: BACKGROUND
  Epilepsy is a common disorder and most adult patients will be managed primarily by general practitioners. Despite new developments in the classification and treatment of epilepsy, basic principles of diagnosis and treatment remain valid, such as the importance of an accurate, detailed history and adjusting antiepileptic drug (AED) doses on the basis of seizure control and adverse effects rather than blood test results.
  
  
  OBJECTIVE
  This article addresses current issues in the diagnosis and management of epilepsy, including initial evaluation and use of AEDs.
  
  
  CONCLUSIONS
  Older AEDs are still prescribed commonly; newer AEDs have similar efficacy and improved tolerability. Human leukocyte-associated antigen (HLA) testing is recommended before commencing Asian patients on carbamazepine to minimise the risk of Stevens-Johnson syndrome (SJS). Referral to an epilepsy specialist is recommended if seizures are not controlled after trialling two AEDs. Important issues pertaining to reproductive and bone health are complex and poorly understood.
authors.affiliation: MBBS, BSc, FRACP, Neurologist, Department of Neurology, Royal Melbourne Hospital; Department of Medicine, The University of Melbourne, VIC.
authors.forename: Meng
authors.initials: M
authors.lastname: Tan
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000209:etiology; D000328:Adult; D000483:Alleles; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D044466:Asian People / Q000235:genetics; D001334:Automobile Driving; D015519:Bone Density / Q000187:drug effects; D003937:Diagnosis, Differential; D016903:Drug Monitoring; D004827:Epilepsy / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D013262:Stevens-Johnson Syndrome / Q000208:ethnology / Q000209:etiology; D017211:Treatment Failure
chemical_list: D000927:Anticonvulsants; D006680:HLA Antigens