ZURICH CONSENSUS CONFERENCE ON NEW ANTIEPILEPTIC DRUGS AND ANNUAL-MEETING OF THE SWISS-CHAPTER OF THE INTERNATIONAL-LEAGUE-AGAINST-EPILEPSY- PROCEEDINGS OF A CONFERENCE HELD IN ZURICH, APRIL 19-20, 1993 - INTRODUCTION - GOALS

Epilepsy is characterized by recurrent seizures. Many epilepsies with focal seizures as well as convulsive generalized seizures respond sati sfactorily to antiepileptic drugs (AEDs) that reduce repetitive firing (e.g., phenytoin, carbamazepine, and valproate) or that augment GABA( A)-mediated inhibition (e.g., phenobarbital and benzodiazepines). A nu mber of drugs presently under development, such as NMDA receptor antag onists, loreclezole, losigamone, methysticine, and dextromethorphan, a re promising in acute animal models of otherwise drug-resistant convul sant activity. As a result of recent studies in both experimental mode ls and surgically resected human epileptic brain, the prospects for de velopment of AEDs have significantly improved. Several new AEDs recent ly have reached the commercial market or are in experimental or clinic al trials. A comparative presentation of the standing of the new AEDs with respect to their efficacy and side effects is necessary, but stil l very difficult. Because initial experience with new AEDs is restrict ed to populations with severe drug-resistant epilepsy, the crucial que stion whether potential new AEDs can alter prognosis is not yet defini tively answered. There is a clear need to compare the effects of stand ard AEDs and new AEDs in naive patients and over longer follow-up peri ods. Moreover, because of the strong desire to develop antiepileptic t herapy that directly treats the primary etiology of a given epileptic syndrome, or modifies the neurobiological processes that cause recurre nt seizures, better experimental epilepsy models for chronic epilepsy and further clinical studies are necessary to increase the knowledge o n the pathophysiology of distinct epileptic syndromes. In this respect , studies on the differences between responders and nonresponders to a given AED treatment are extremely valuable.