General Approach to Treatment

Once it is concluded that the patient has seizures, the type of seizure and epilepsy syndrome, if any, must be determined. Proper identification and classification of the seizure type is essential in selecting appropriate pharmacotherapy. Without an accurate classification of the seizure type, it is possible to select a medication that is ineffective or even harmful to the patient.

^^ Additionally, the risk of a subsequent seizure must be determined before starting pharmacotherapy. If there is an underlying treatable cause, such as hyponatremia or a CNS infection, the risks of another seizure and the development of epilepsy are very small. In these cases, the only pharmacotherapy that is necessary is to correct the underlying problem and possibly short-term use of an AED. Risk factors for repeated seizures in patients without an underlying disorder include

• Structural CNS lesion

• Partial seizure type

• Positive family history

• Postictal motor paralysis

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