A series of conceptual reconsiderations and therapeutic advances in recent years has resulted in meaningful changes in the classification, diagnosis, and treatment of @entity302 . The first step in evaluation of the @entity1 with @entity302 is determining whether the @entity410 are partial or generalized in onset; this determination will guide further evaluation and is mandatory in choosing an antiepileptic drug (AED). With 12 new AEDs and 1 device approved for use in @entity302 by the US Food and Drug Administration since 1993, the choice of AED has become more complex and it is impossible to predict whether a @entity1 will respond favorably to a drug based on clinical features or clinical laboratory results. AEDs have many different mechanisms of action, but there does not seem to be a strong base of evidence to demonstrate that AED choice should be based on mechanism of action. Yet, a new secondary analysis of data from clinical trials of the new AED @entity13876 suggests that combining this AED with another AED that has minimal or no activity at the @entity1372 channel may lead to better tolerability and efficacy. The new AEDs have been tested in randomized controlled trials and compared with placebo; however, there are few head-to-head trials assessing the efficacy of various AEDs, and none of them provide evidence of a clear first choice drug or first add-on drug. Adverse effect profiles of the new generation of AEDs generally show better overall tolerability, but the choice of AED must be individualized (often based on comorbidities) because the adverse effect profiles of the newer AEDs differ widely. One area where the new AEDs consistently outperform the older AEDs is pharmacokinetic profile. Three new AEDs have no hepatic metabolism or protein binding, and others have minimal drug-drug interactions. Ultimately, selection of an appropriate agent involves matching a @entity1 to a medication, or combination of medications, with the best record of efficacy while avoiding issues of tolerability and unwanted drug interactions (specifically tied to the needs of a given @entity1 ). Despite major advances in AED development, approximately one-third of @entity1 with @entity302 will have incomplete control of @entity410 no matter which AED is used alone or in combination, emphasizing the need for more effective AEDs. @entity1 with medication-resistant @entity302 may be candidates for @entity302 surgery, a highly effective treatment that is underutilized in this population.

Current challenges in the management of XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patient', 'person', 'people'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizures'] @entity1372 :: ('MESH:D012964', 'Chemical') :: ['sodium'] @entity13876 :: ('MESH:C403507', 'Chemical') :: ['lacosamide'] @entity302 :: ('MESH:D004827', 'Disease') :: ['epilepsy']
@entity302 :: (MESH:D004827,Disease) :: ['epilepsy']
