[Therapy of epilepsy: current strategy and tactics]

The article addresses the current strategy and tactics of epilepsy treatment, which suggest instead of the thesis "to start pharmacotherapy as soon as possible" the antithesis--"do not treat, when it is not necessary". The thesis "to start treatment always from monotherapy" is substituted for some forms of the disease by the antithesis "polytherapy--from the beginning: from successive monotherapy to alternative poly(duo)therapy". Psychological peculiarities of an interaction between a patient and a physician, age, gender and body mass and their impact on the treatment results as well as the problems of teratogenic influence of antiepileptic drugs (AED) on the fetus and risk factors for polycystic ovarii are analyzed. The author suggests a hypothesis on potential negative influence of any AED on epileptic seizures and, in light of pseudo- and true drug resistant epilepsy, analyzes the own observations of 1957-2000 period, which indicate a significant role of novel AED (carbamasepine, depakin, lamotrigine) in reducing of true drug resistance.