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Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6
Online ISSN 1827-1898
Chong D. J.
Division of Epilepsy and Sleep, Department of Clinical Neurology, Columbia University Medical Center, New York, NY, USA
With many new medications on the market and new data about the various side-effects of antiepilepsy drugs (AEDs), the medical management of epilepsy can seem unnecessarily complicated for the non-specialist. The process can be thought of taking place in 7 steps: 1) assessing the need for medications; 2) defining the seizures and classifying the epilepsy syndrome; 3) knowing which medications are best used in which syndromes; 4) taking into account patient priorities when choosing a medication, such as cotreatment or avoidance of neurobehavioral issues and weight loss or gain; 5) considering other life issues, such as planning a pregnancy and breastfeeding; 6) choosing a maintenance dose and deciding when to consider a change to another medication or to use dual therapy; and 7) if seizure-free, which patients to consider AED reduction or withdrawal. The goal is simply, no seizures and no side-effects. Seizure freedom is an important goal to reduce injury, mortality and improve quality of life. Improving tolerability is equally as important, as both acute and chronic side-effects of AEDs can be as disabling as seizures themselves.