• Meng Tan.
• MBBS, BSc, FRACP, Neurologist, Department of Neurology, Royal Melbourne Hospital; Department of Medicine, The University of Melbourne, VIC.
• Aust Fam Physician. 2014 Mar 1; 43 (3): 100-4.

BackgroundEpilepsy is a common disorder and most adult patients will be managed primarily by general practitioners. Despite new developments in the classification and treatment of epilepsy, basic principles of diagnosis and treatment remain valid, such as the importance of an accurate, detailed history and adjusting antiepileptic drug (AED) doses on the basis of seizure control and adverse effects rather than blood test results.ObjectiveThis article addresses current issues in the diagnosis and management of epilepsy, including initial evaluation and use of AEDs.DiscussionOlder AEDs are still prescribed commonly; newer AEDs have similar efficacy and improved tolerability. Human leukocyte-associated antigen (HLA) testing is recommended before commencing Asian patients on carbamazepine to minimise the risk of Stevens-Johnson syndrome (SJS). Referral to an epilepsy specialist is recommended if seizures are not controlled after trialling two AEDs. Important issues pertaining to reproductive and bone health are complex and poorly understood.

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