Highlights of a satellite symposium held at the XI World Congress of Neurology, September 2013, Vienna, Austria.
Key points:
1. It is important to get the initial AED monotherapy correct in adults with newly diagnosed epilepsy, to improve patient outcomes. The treatment decision should consider the current level of available evidence; for example, the latest ILAE guidance. Furthermore, the initial treatment should look beyond seizure control, by considering patient factors and AED characteristics, to meet the needs of the individual
2. It is important to persist in trying alternative AEDs, since novel agents can still provide improvements in seizure frequency and/or severity in previously refractory patients; as with monotherapy, it is important to get the initial adjunctive therapy correct and this should be tailored to the individual patient’s needs
3. There is a high prevalence of neuropsychiatric comorbidities in patients with epilepsy. Depression in epilepsy may be atypical, underdiagnosed, undertreated and associated with significantly reduced quality of life
4. Management of epilepsy needs to include assessment of neuropsychiatric and other comorbidities and treat these with appropriate AED therapy and/or other treatment options
5. Now and in the future, epilepsy management should always focus on the needs of the individual patient, in order to optimise their overall health status, functioning and quality of life
