Antiseizure Medications

Epilepsy and status epilepticus (SE) are both common neurologic disease states encountered in any neurocritical care unit and require aggressive treatment to halt seizure activity [1]. Epilepsy type, intensity, and etiology usually vary between one patient to another. Patients with unprovoked seizure episodes are commonly diagnosed with epilepsy, whereas when a seizure continues for at least 5 minutes, it is defined as SE and must be treated as a medical emergency [2, 3]. In many cases, the specific etiology and pathophysiology of seizures are unknown [4]. What is generally known is that seizures emerge from a sudden abnormal electrical activity in the brain which typically lead to excessive neuronal discharge and involuntary body movements [2, 3]. There are several possible causes of epilepsy and SE that include genetic mutations, infectious diseases, metabolic abnormalities, immunity-related diseases, and in some cases unknown causes [5]. Treatment strategies are generally determined based on patient-specific factors and the underlying seizure type. This chapter will discuss in detail different antiseizure medications (ASMs) that are commonly used to treat seizures and status epilepticus in neurocritical care patients.