Abstrakt
Ideally, 80% epileptic seizures and syndromes could be well treatable by standard monotherapy with valproic acid or carbamazepine, remaining patients need combined therapy and novel drugs. The classic antiepileptic treatment strategy depends on interictal clinical and EEG data.
Due to this approach (ready-made therapy), more than one third of patients are uncorrectly treated. The modern (tailored) therapy should be based on the ictal semiology, evaluation of seizure pathophysiology and informations about mechanism of drug action.
The age of patients, side effects and economic aspects of selected drug should also be taken into consideration. Our experiences with video-EEG monitoring in 404 epileptic patients indicate, that seizure reclassification with consequent tailored therapy lead to improvement of quality of life, namely in patients with non-convulsive seizures and in patients suffering from Lennox-Gastaut syndrome.