Navarro Vincent
AP-HP, hôpital de la Pitié-Salpêtrière, unité d'épilepsie et fédération de neurophysiologie clinique, 75651 Paris cedex 13, France.
Presse Med. 2011 Mar;40(3):271-8. doi: 10.1016/j.lpm.2011.01.001. Epub 2011 Feb 5.
Currently available antiepileptic drugs aim to avoid recurrence of the epileptic seizures. They act by different mechanisms, at the level of the synaptic transmission and the membrane excitability. There is a large choice of antiepileptic drugs. The prescription of an antiepileptic drug relies on strict rules: it is first necessary to determine the epileptic syndrome, because some molecules may be inefficient or may worsen an epileptic syndrome, whereas they can be highly efficient in another epileptic syndrome. Among the antiepileptic drugs, known to be efficient in a specific epileptic syndrome, the choice of one molecule is done according to the suspected tolerance and therefore mainly depends on the characteristics of the patient. Rules for the initiation and adaptation of antiepileptic drugs are presented. Additional molecules, with new targets, must be developed in the future to take care of 25% of the patients with an epilepsy resistant to adapted and well-conducted treatments.
