[When to begin antiepileptic treatment?]

The decision to begin an antiepileptic treatment is not always an easy one, as this treatment will be long lasting with possible side-effects. However, if the patient has had several seizures or if, after a first seizure, there are certain features predicting that other seizures will follow, then in all but very rare cases this decision must be made and applied as soon as possible. Patients who will have chronic epilepsy are recognized within the first two years, and among the factors preventing a therapeutic failure, early treatment is of the utmost importance. After a first, strictly isolated seizure, and for lack of convincing figures as to the risk of recurrence, many data must be examined, the most important being the patient's wish. All this shows that there is room for various decisions.