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Background <p>Epilepsy is one of the most common chronic neurological disorders worldwide, with an incidence of 0.5–1%. It is frequently associated with comorbidities, complications and a&#xa0;reduced quality of life in affected individuals. Once epilepsy is diagnosed treatment with antiseizure medication (ASM) is recommended, which reduces the risk of the occurrence of further seizures by 50%.</p> Objective <p>This article provides a case-based review via examples of guideline-compliant and individualized pharmacological treatment of adult patients with epilepsy. Examples of both established and newer ASMs are presented with respect to the indications, efficacy and tolerability.</p> Results <p>The current German guidelines recommend lamotrigine, levetiracetam and lacosamide as first-line treatment options for focal seizures. Valproate is recommended as the first line treatment of generalized and unclassifiable epilepsy, although its teratogenic potential represents a substantial limitation to its use. Individual pharmacotherapy case-based options are presented.</p> Discussion <p>The selection of an appropriate ASM should follow the current guideline recommendations but must also be individualized, taking patient-specific factors, such as age, sex, occupational requirements and comorbidities into account.</p>

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Vom Anfall zur Therapieentscheidung: anfallssuppressive Medikamente in der klinischen Praxis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月30日

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  • Martyna Janusz,
  • Leona Möller

摘要

Background

Epilepsy is one of the most common chronic neurological disorders worldwide, with an incidence of 0.5–1%. It is frequently associated with comorbidities, complications and a reduced quality of life in affected individuals. Once epilepsy is diagnosed treatment with antiseizure medication (ASM) is recommended, which reduces the risk of the occurrence of further seizures by 50%.

Objective

This article provides a case-based review via examples of guideline-compliant and individualized pharmacological treatment of adult patients with epilepsy. Examples of both established and newer ASMs are presented with respect to the indications, efficacy and tolerability.

Results

The current German guidelines recommend lamotrigine, levetiracetam and lacosamide as first-line treatment options for focal seizures. Valproate is recommended as the first line treatment of generalized and unclassifiable epilepsy, although its teratogenic potential represents a substantial limitation to its use. Individual pharmacotherapy case-based options are presented.

Discussion

The selection of an appropriate ASM should follow the current guideline recommendations but must also be individualized, taking patient-specific factors, such as age, sex, occupational requirements and comorbidities into account.