Epilepsy Treatment of focal seizures

Epilepsy Treatment of focal seizures in children, young people and adults.

  • First line treatment: carbamazepine, lamotrigine
  • Alternative first line treatment: levetiracetam, oxcarbazepine, sodium valproate
  • Cautions: be aware of potential effect of sodium valproate in pregnancy
  • Adjunctive treatment (if first line treatment is not effective or not tolerated): carbamazepine, clobazam, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, sodium valproate, topiramate
  • Cautions: be aware of potential effect of sodium valproate in pregnancy
  • Action if adjunctive treatment is not effective or tolerated: consider referral to tertiary epilepsy services (where other AEDs may be tried)

Epilepsy Treatment of generalised tonic clonic seizures

Treatment of generalised tonic clonic seizures in children, young people and adults.

  • First line treatment: sodium valproate, lamotrigine (if sodium valproate is not suitable)
  • Cautions: be aware of potential effect of sodium valproate in pregnancy. If the person has myoclonic seizures or may have juvenile myoclonic epilepsy lamotrigine may worsen myoclonic seizures
  • Alternative first line: treatment carbamazepine, oxcarbazepine
  • Cautions: be aware that these drugs may worsen myoclonic or absence seizures
  • Adjunctive treatment (if first line treatment is not effective or not tolerated): clobazam, lamotrigine, levetiracetam, sodium valproate, topiramate
  • Cautions: be aware of potential effect of sodium valproate in pregnancy. If the person also has absences or myoclonic seizures, or may have juvenile myoclonic epilepsy do not offer carbamazepine, gabapentin, oxcarbazepine, phenytoin, pregabalin, tiagabine or vigabatrin.

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