Show Summary Details
Page of

The Medical Treatment of Chronic Active Epilepsy 

The Medical Treatment of Chronic Active Epilepsy
The Medical Treatment of Chronic Active Epilepsy

Simon Shorvon

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2021. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 07 December 2021

Chronic epilepsy can be defined as epilepsy in which seizures are still occurring five or more years after the initiation of therapy. Therapy in this situation is more difficult and less successful than treatment in newly diagnosed epilepsy. In this chapter, the choice of antiepileptic drug and the strategies for medical therapy are outlined. The choice of antiepileptic drug depends on seizure type, tailoring the drug to individual patient profiles, side effects, and pharmacokinetics. The lack of any difference in efficacy and the limitations of the concept of drug resistance are discussed. A protocol for medical treatment is given. This should be based on a thorough assessment in which: diagnosis is reviewed and aetiology established, seizures classified, and a review made of previous drug history, compliance, seizure precipitants and non-pharmacological factors. The treatment plan should consist of a sequence of n=1 drug ‘trials’. The plan should document the proposed sequence of antiepileptics to trial, the duration of the trial and which background medication to continue and to withdraw. Non-pharmacological measures, lifestyle measures and surgical therapy should be considered. The chapter ends with an outline of prognosis and the patterns of relapse and remission of seizures in chronic epilepsy.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.