A pragmatic algorithm to select appropriate antiseizure medications in patients with epilepsy.

Epilepsia
Ali A Asadi-PooyaEmilio Perucca

Abstract

Antiseizure medications (ASMs) are the first-line treatment for epilepsy. Many ASMs are available; this offers the opportunity to improve therapy by tailoring it to individual characteristics, but also increases the possibility of healthcare professionals making inappropriate treatment choices. To assist healthcare professionals, we developed a pragmatic algorithm aimed at facilitating medication selection for individuals whose epilepsy begins at age 10 years and older. Utilizing available evidence and a Delphi panel-based consensus process, a group of epilepsy experts developed an algorithm for selection of ASMs, depending on the seizure type(s) and the presence of relevant clinical variables (age, gender, comorbidities, and comedications). The algorithm was implemented into a web-based application that was tested and improved in an iterative process. The algorithm categorizes ASMs deemed to be appropriate for each seizure type or combination of seizure types into three groups, with group 1 ASMs considered preferred, group 2 considered second line, and group 3 considered third line. Depending on the presence of relevant clinical variables, the ranking of individual ASMs is adjusted in the prioritization scheme to tailor recomm...Continue Reading

References

Dec 13, 2006·Seizure : the Journal of the British Epilepsy Association·Alla B GuekhtEugeny I Gusev
Feb 5, 2013·Seizure : the Journal of the British Epilepsy Association·Ali A Asadi-PooyaAbbas Rahimi-Jaberi
Mar 13, 2014·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·A VerrottiG Coppola
Apr 30, 2014·Seizure : the Journal of the British Epilepsy Association·Victor PattersonAnupam Bhandari
Sep 28, 2014·Lancet·Solomon L MoshéTorbjörn Tomson
Dec 10, 2014·Expert Review of Clinical Pharmacology·Sherifa Ahmed Hamed
Dec 18, 2014·Epileptic Disorders : International Epilepsy Journal with Videotape·Gaetano Zaccara, Emilio Perucca
May 3, 2015·Pharmacological Reports : PR·Barbara BłaszczykStanisław Jerzy Czuczwar
May 23, 2015·Acta Neurologica Scandinavica·H A Gefroh-Grimes, B E Gidal
Jun 17, 2015·Epilepsy Research and Treatment·Taoufik AlsaadiFatema Al Hammadi
Jul 29, 2015·Seizure : the Journal of the British Epilepsy Association·Victor PattersonSreenivas Vishnubhatla
Feb 6, 2016·Continuum : Lifelong Learning in Neurology·Dileep R Nair
Apr 5, 2016·Epilepsia·Ali A Asadi-Pooya
Apr 14, 2016·Epilepsy Research and Treatment·Ekaterina Viteva
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Jul 12, 2017·Expert Review of Clinical Pharmacology·Sherifa Ahmed Hamed
Sep 22, 2017·Epilepsy & Behavior : E&B·Baibing ChenKamil Detyniecki
Nov 4, 2017·Pediatric Neurology·Jorge VidaurreShannon Yarosz
Jan 2, 2018·Seizure : the Journal of the British Epilepsy Association·Victor PattersonYogesh Jain
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Mar 19, 2019·Current Treatment Options in Neurology·Simy K Parikh, Stephen D Silberstein
Apr 8, 2020·Acta Neurologica Scandinavica·Gaetano ZaccaraEmilio Russo

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