[Efficacy of Epileptological Consultation After Initially Unsuccessful Antiepileptic Medication]

At least 25 % of patients with epilepsy do not achieve seizure freedom with their first antiepileptic medication. The aim of this study is to make a contribution to discussions on the efficacy of further antiepileptic medications in achieving seizure freedom for at least one year or reduction of seizure frequency of more than 50 % for more than one year.

All patients who presented between January 1, 2009 and July 1, 2013 to the epileptological outpatient consulting service of the University of Rostock with at least one seizure in the previous year despite taking at least one antiepileptic medication were evaluated. Outcome was assessed according to the data available on July 1, 2014.

70 patients (35 f/35 m) aged 43.6 years on average (SD 16.7) with active epilepsy, who had taken 3.7 antiepileptic drugs on average (SD 2.8) before the first presentation to our service, were counseled on further antiepileptic treatment options. On average, 1.96 (SD 1.8) antiepileptic drugs were introduced in the therapy. At the last visit to our service, 15.7 % of the patients were seizure free for more than one year and 45,6 % of the patients had a reduction of seizure frequency of at least more than 50 %.

With specialized epileptological counseling, substantial improvement in seizure frequency can be achieved in about 60 % of patients with epilepsy after failure of the initial antiepileptic drug.