Epilepsy
Classifying the epilepsy, choosing and monitoring antiseizure medication, drug interactions, drug resistance and surgery, pregnancy, older people, withdrawal and SUDEP.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Epilepsy is an enduring tendency to unprovoked seizures. The operational definition, recurrence risks and first-seizure work-up are in Approach to seizures and first seizure.
- Classify on three levels: seizure type, epilepsy type (focal, generalised, combined, unknown) and, where possible, epilepsy syndrome. The type drives drug choice.
- About two-thirds become seizure-free on medication. Those who fail two appropriate drugs have drug-resistant epilepsy and should be assessed for surgery, not given a fourth and fifth drug for years.
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Sources
- Therapeutic Guidelines: Neurology (epilepsy)AU/NZTherapeutic Guidelines Limited
- Assessing Fitness to Drive (AP-G56), Seizures and epilepsyAU/NZAustroads and National Transport Commission, 2022
- Men warned of sodium valproate risk ahead of fatherhood (TGA paternal exposure warnings)AU/NZAustralian Pharmacist (Pharmaceutical Society of Australia), 2024
- Updated classification of epileptic seizures: position paper of the International League Against EpilepsyILAE (Epilepsia), 2025
- Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic StrategiesILAE (Epilepsia), 2010
- Epilepsies in children, young people and adults (NG217)NICE, 2022, updated 2025
- SANAD II trial, focal epilepsy (levetiracetam, zonisamide or lamotrigine)The Lancet, 2021
- SANAD II trial, generalised and unclassifiable epilepsy (valproate versus levetiracetam)The Lancet, 2021
- New-onset geriatric epilepsy: a randomized study of gabapentin, lamotrigine, and carbamazepine (VA Cooperative Study 428)Neurology, 2005
- Valproate use in men: as a precaution, men and their partners should use effective contraceptionMHRA Drug Safety Update, 2024
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback