Management of Adult Onset Seizures.
Epilepsy is a common yet heterogeneous disease. As a result, management often requires complex decision making. The ultimate goal of seizure management is for the patient to have no seizures and no considerable adverse effects from the treatment. Antiepileptic drugs are the mainstay of therapy, with more than 20 medications currently approved in the United States. Antiepileptic drug selection requires an understanding of the patient's epilepsy, along with consideration of comorbidities and potential for adverse events. After a patient has failed at least 2 appropriate antiepileptic drugs, they are determined to be medically refractory. At this time, additional therapy, including dietary, device, or surgical treatments, need to be considered, typically at a certified epilepsy center. All these treatments require consideration of the potential for seizure freedom, balanced against potential adverse effects, and can have a positive effect on seizure control and quality of life. This review article discussed the treatment options available for adults with epilepsy, including medical, surgical, dietary, and device therapies.
Department of Neurology, Mayo Clinic, Phoenix, AZ. Electronic address: Crepeau.amy@Mayo.edu.
Amy Z
AZ
Crepeau
Department of Neurology, Mayo Clinic, Phoenix, AZ.
Joseph I
JI
Sirven
D000328:Adult; D017677:Age Distribution; D038481:Anterior Temporal Lobectomy / Q000379:methods / Q000592:standards*; D000927:Anticonvulsants / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D055423:Diet, Ketogenic / Q000379:methods / Q000592:standards*; D004599:Electric Stimulation Therapy / Q000379:methods / Q000592:standards*; D004827:Epilepsy / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*
D000927:Anticonvulsants