Current treatments of epilepsy

Abstract

Medical therapy is the mainstay for epilepsy, with most patients well controlled on a single antiepileptic drug (AED). In this non-refractory group, many patients have medication side effects and occasional seizures. Approximately 30% of patients with partial epilepsy and 25% of patients with generalized epilepsy are not well controlled on medications. These patients are often receiving multiple AEDs, with disabling seizures and side effects. Although second-generation AEDs are safer and better tolerated than the older AEDs, there are scant data to support significant advantages in efficacy. In VA studies with older AEDS, therapy with two AEDs improved seizure control in 40% of patients but seizure freedom was achieved in only 9%. A meta-analysis of the second-generation AEDs used as adjunctive therapies shows that 12% to 29% of patients had a 50% or greater reduction in seizure frequency. Surgery and the vagus nerve stimulator provide important therapeutic options in patients whose seizures are not controlled by AEDs. Special considerations about epilepsy care must be made in pediatric populations, those with developmental delays, women, and the elderly.

Biochemical and Histopathological Toxicity by Multiple Drug Administration

“…Although cerebrovascular reasons are more widespread in the old age, the reason is yet to be explored in 25% to 40% of patients who are 65 years of age or older (French and Pedley, 2008). Majority of the patients are well controlled on a single antiepileptic drug (Nadkarni et al, 2005). Since the early 1990s, a number of latest antiepileptic drugs have arrived in the market that proposed considerable benefits in terms of their favorable pharmacokinetics, enhanced tolerability and decrease probability for drug-drug interactions (Bialer and White, 2010).…”

Synthesis, Anticonvulsant Activity and Cytotoxicity of Novel Valproic Acid Derivatives

“…Epilepsy is a complex neurological disorder affecting about 50 million people of all ages, races, and social classes [1][2][3]. The life long consumption of antiepileptic drugs and their divers side predisposes the risk of drug-drug interaction [4,5].…”

Cell and Gene Therapies for Refractory Epilepsy

“…Conventional pharmacotherapy of epilepsy has largely been postsynaptic focusing on ion channels involved in neurotransmission and the modulation of neurotransmitter systems (Table 1). However, despite optimal treatment with currently available antiepileptic drugs (AEDs), the development of tolerance [99] and pronounced side effects remain significant problems and seizures persist in about 35 percent of patients with complex partial epilepsy [115]. For these intractable cases, surgical resection offers a final option, but only if a discrete focus of seizure genesis can be identified and only if the surgical intervention does not interfere with essential brain functions.…”