Abstract
The choice of an antiepileptic drug depends firstly on its efficacy in specific seizure
types and epilepsies. However, it is imperative to consider whether possible adverse
events will outweigh any benefits. The advantages and disadvantages of vigabatrin,
lamotrigine, gabapentin, topiramate, tiagabine and felbamate are considered in some
detail, and oxcarbazepine, stiripentol, remacemide, zonisamide and levetiracetam more
briefly. Vigabatrin is effective for partial seizures and infantile spasms, but visual
field defects are limiting its use. Lamotrigine has a wide spectrum, needs to be prescribed
with care. Gabapentin is unlikely to cause adverse effects, but has relatively poor
efficacy. Topiramate is widely effective, but can be poorly tolerated. Tiagabine is
relatively untried in childhood epilepsies. The use of felbamate is restricted to
severe refractory epilepsies. Stiripentol can be effective in severe myoclonic epilepsy
in infancy. Zonisamide has a special place in the progressive myoclonus epilepsies.
Levetiracetam, remacemide and oxcarbazepine have been used mainly for partial seizures:
further studies of their roles in other circumstances are required.
Keywords
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Article info
Publication history
Accepted:
May 10,
2001
Received in revised form:
May 10,
2001
Received:
March 15,
2001
Identification
Copyright
© 2001 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
