Neurológia pre prax 6/2009

Mistakes and errors in treating epilepsy

The number of antiepileptic drugs has been increasing. An increased number of drugs brings with it certain pitfalls as well as the possibility of an ill-judged indication, mistakes and errors. The most common errors include: 1. failure to administer the maximum tolerated dose in uncontrolled epilepsy, 2. addition of another drug before the previous one failed to have an effect, 3. delayed patient referral to a higher specialized centre, 4. mistaking frontal lobe seizures for nonepileptic psychogenic seizures, 5. errors in diagnosing epileptic syndromes, 6. suboptimal use of new generation antiepileptics, 7. unnecessarily high dosage of antiepileptics, 8. erroneous selection of an optimal drug for a certain type of epileptic seizure, 9. premature discontinuation of an anticonvulsant in seizure-free patients, 10. failure to follow therapeutic goals, 11. prescribing antiepileptics in improper situations, 12. inappropriately rapid dose escalation.

Keywords: epilepsy, epileptic syndrome, compliance, monotherapy, epilepsy surgery, nonepileptic seizures, psychogenic seizures.