[Therapy of brain-related minor seizures]

The pharmacotherapy of minor seizures depends on the type of epileptic manifestation. Generalized minor seizures (petit-mal) must be differentiated from focal (partial) seizures. The former are further divided into the typical absence attacks of childhood and benign myoclonic seizures. The drug of choice for both forms of generalized minor seizures is valproate, which also has the advantage of being reliably effective against the frequently associated grand-mal seizures. The focal seizures' epileptic activity is either in the neocortex (simple partial seizures) or in the limbic system (complex partial seizures). Neocortical focal seizures are characterized by motor jerks in one limb (Jacksonian type), head turning (adversive attack), or localized sensory manifestations, and limbic or psychomotor attacks by brief impairment of consciousness and often by motor automatisms. Focal seizures, which are sometimes difficult to control, are best treated with carbamazepine or phenytoin.