Medical therapy for intractable complex partial seizures1

Abstract

Treatment of intractable complex partial seizures should reduce the frequency or severity of the attacks and reduce or eliminiate side effects from the medication. Most important, a correct diagnosis of seizure type should be attained. Frequently, an evaluation and subsequent treatment changes can best be carried out if the patient is hospitalized. The advantages of high-dose monotherapy with phenytoin, carbamazepine, or primidone are discussed. The effectiveness and methodology of the secondary anticonvulsants (benzodiazepines, valproic acid, methosuximide, acetazolamide, and progestational agents) are reviewed. Many patients can be treated with one nonsedating anticonvulsant.