Therapeutic monitoring in patients with epilepsy

The aim of treatment for epilepsies is to control seizures without causing adverse effects by reaching the best possible quality of life. A satisfactory suppression of seizures is possible in 60 - 70% of patients. In patients with incomplete seizure control it is of importance to achieve seizure reduction and to diminish severity of seizures. The choice of the optimal drug is not only determined by seizure control but also by potential adverse effects. A disposition and accompanying diseases are varying individually. The choice of the optimised drug, titration rate and dosage needs to be individualised to achieve optimal effectiveness. The number of time adjusted daily application and an optimised combination of antiepileptic drugs is important too. The combination of antiepileptic drugs bears a higher risk of side effects which might be influenced in part on the pharmacokinetic or pharmacodynamic properties of the drug.

In summary, by aid of the TISA technique a better computer supported seizure detection and cognitive emotional testing we have methods at our hands providing practical decision aids which we did not have formerly. (Example: application of Orfiril® injection solution in a patient with repetitive seizures.) In addition to seizure control cognitive changes can be perceived earlier and the individual dosage adjusted accordingly. This could be an important precondition for more easy to handle in- and outpatient treatment.

full article