Anti-epileptic drugs: a guide for the non-neurologist

Epilepsy is the most common serious chronic neurological disorder affecting between 0.5% and 1% of Western populations. Most patients take anti-epileptic drugs (AEDs) for years if not decades, and are commonly admitted to hospital with seizures. Many have symptomatic epilepsy, arising as a consequence of another disorder, for example a brain tumour. General practitioners, emergency physicians and most hospital teams (especially general medicine) commonly encounter difficulties surrounding AEDs yet often require assistance from neurology services. This can be difficult when neurology services are not on-site or easily available. This article gives a practical overview of difficulties relating to AEDs and their management, with the focus on problems commonly encountered by non-neurologists. These include the patient who is acutely unwell, pregnant or elderly; AED side effects and drug interactions; status epilepticus and AED blood levels.