[Treatment of the epileptic patient in special situations]

It is known that epileptic seizures can present not only in neurological diseases but also in a number of different medical diseases, and are important in the prognosis and treatment of the primary disease. The purpose of this study is to review a series of patients with epilepsy whose therapy involves a series of peculiarities.

We reviewed the treatment of epilepsy in groups of patients with the following characteristics: mental disability, cardiovascular disease, respiratory disease, liver failure, hepatic porphyrias, liver transplant, kidney failure, haemodialysis, kidney transplant, infectious diseases, acquired immunodeficiency syndrome, diseases of the digestive tract, endocrine diseases, preventive antiepileptic therapy, and surgical diseases.

The increase in life expectancy, together with the ensuing growth in the number of medical diseases, surgical procedures and pharmacological treatments, means that we often have to deal with epileptic seizures in these groups of patients. Many of the epileptic seizures presented in these patients are generally of the acute symptomatic type; they therefore require no long-term antiepileptic treatment and have a good prognosis, once the situation or disease that triggers them is righted or treated. When it comes to choosing a possible antiepileptic drug for these patients, basically all the pharmacological treatments for these medical diseases must be considered. This is because of the possible interactions that may reciprocally alter the effectiveness of the two types of drugs and, similarly, their pharmacokinetics, pharmacodynamic behaviour and preferred choice of pathways.