[Changes in drug therapy and in seizure frequency in an institution for epilepsy patients between 1971 and 1986]

Trends in treatment of epilepsy in an institution for handicapped patients with epilepsy were investigated in a retrospective longitudinal study. Medications and seizure frequencies in the period 1971 to 1986 were compared in 663 patients living in the institution at least since 1971. The results show that the majority of patients were on polytherapy, being treated on average with 2.95 (1971) to 2.60 (1986) anticonvulsants. The use of phenytoin, primidone and the succinimides clearly declined; the use of phenobarbitol declined slightly. The use of carbamazepine and valproic acid and their mean doses increased. The mean serum concentration of most of the anticonvulsants studied tended to move into the "therapeutic" range. The primidone and phenytoin concentrations remained rather low. The frequency of seizures, in particular of grand mal seizures, decreased between 1971 and 1981; from 1981 to 1986, no clear trend could be established. The results are compared with those of studies carried out in various other countries. It is discussed whether special antiepileptic therapy is required for the treatment of handicapped patients.