Simplification of antiepileptic pharmacotherapy: from the viewpoint of rational management for epilepsy

Rational management for epilepsy was investigated mainly from the viewpoint of antiepileptic pharmacotherapy. At first, diagnoses were reviewed by the ILAE classification for epilepsies and epileptic syndromes in 603 patients who visited a newly-established outpatient clinic for epilepsy and problems concerning the diagnosis of epilepsy were pointed out. Then, habitual pharmacotherapy in the past was assessed critically in cases where details of treatment before hospital attendance could be known. Further, the results of prospectively conducted simplification of pharmacotherapy where the appropriate choice of drugs and dosage were taken into account were reported. Furthermore, questions about the conventional criteria for drug effect evaluation were described and new criteria through which the influence on the daily life was also evaluated were presented. Finally, from the standpoint of comprehensive treatment, the system of rational management was discussed.