Managing Epilepsy I: Medical Management

PVS Rana, MD, DM
Department of Internal Medicine ( Neurology)
Manipal Teaching Hospital
Manipal College of Medical Sciences
Pokhara, Nepal

Abstract

    Treatment of epilepsy has improved with advances in neurodiagnostic procedures, addition of newer antiepilepic drugs (AEDs), and proper selection of cases for early surgical treatment. Control of seizures with vagus nerve stimulator, approved by FDA, has provided a new tool for the treatment of difficult to control cases and there is a prospect for development of more effective devices in future. Monotherapy with appropriate AEDs for seizure types and epileptic syndrome, is the initial treatment of choice.  The concept of “ Rational Polytherapy” is a reality now and is advocated in those failing with monotherapy and substitution therapy. Refractory cases to medical therapy should be referred to neurosurgical centers for the better control of seizure.