[The epileptic patient in general practice. What the family physician must attend to]

Some 25% of patients with epilepsy are under the sole care of their family doctors. Treatment is applied in accordance with clear guidelines. The leading aim of therapy is always freedom from seizures. The gold standard is monotherapy, with combination treatment taking second place. In focal epilepsy, the drug of first choice is still carbamazepine, and in generalized epilepsy valproic acid. The use of the new antiepileptics should be given careful consideration, not least on account of their high price. Switch-over from a proprietary to a generic drug may be associated with the problem of differences in bioavailability. Routine monitoring of serum levels is not useful, but is always necessary when a seizure occurs unexpectedly. On account of their disease, many people with epilepsy are discriminated against. Questions regarding the advisability of having children or driving a car, should, however, not automatically elicit a negative response.