Which antiepileptic drugs are most appropriate for focal versus generalized onset seizures
The choice of antiepileptic drugs (AED) is dictated by the types of seizures that the patient has experienced. Generalized-onset seizures are typically treated with broad-spectrum medications, and focal-onset seizures may be treated with either narrow- or broad-spectrum medications.
One exception is absence epilepsy, which has generalized-onset seizures, but it is best treated with a narrow-spectrum medication (typically ethosuximide).
If possible, monotherapy should be used.
Broad versus Narrow Spectrum Antiepileptic Drugs (AEDs)
| Broad Spectrum AEDs | Narrow Spectrum AEDs |
|---|---|
| Treats focal- or generalized-onset seizures : Benzodiazepines Felbamate Lamotrigine Levetiracetam Phenobarbital ∗ Tiagabine ∗ Topiramate Valproic acid Vigabatrin ∗ Zonisamide | Treats focal-onset seizures : Carbamazepine Eslicarbazepine Ezogabine Gabapentin Lacosamide Oxcarbazepine Perampanel Phenytoin Pregabalin Rufinamide Treats absence seizures : Ethosuximide |
∗ May aggravate absence seizures.
