Epilepsy: Workup and Management in Adults

Abstract

When managing epilepsy, there is a temptation to focus care with respect to the last and the next seizure. However, epilepsy is a multifaceted chronic condition and should be treated as such. Epilepsy comes with many physical risks, psychological effects, and socioeconomic ramifications, demanding a long-term commitment from the treating physician. Patients with epilepsy, compared to other chronically ill patient populations, have a worse quality of life, family function, and less social support. The majority of patients are well controlled on antiseizure drugs. However, approximately one-third will continue to have seizures despite optimized medical management. The primary aim of this article is to explore the long-term management of chronic epilepsy, and to address some of the particular needs of patients with chronic epilepsy.

Pharmacological treatment for older adults with epilepsy and comorbid neurodegenerative disorders

“…However, by employing the current knowledge of pathophysiology and selecting newer ASMs with more selective targets, in addition to careful clinical treatment strategies, much can be accomplished. Often lower dosing than that in younger adults is effective and starting titration schedules in the evening is advantageous with regard to avoiding initial unwanted adverse effects [41,42].…”