7: Epilepsy

Epilepsy may be associated with major social and medical problems, and coun selling of patient and family is essential for good management. The workup of a person with a seizure includes history, physical examinatio n, and laboratory testing. An electroencephalogram is essential to help cla ssify the seizure and epilepsy type. Neuroimaging (preferably by magnetic r esonance imaging) helps to exclude a structural abnormality. Seizures can be controlled with a single drug (monotherapy) in 70% of patie nts. The incidence of drug side effects is increased if more than one drug is us ed. Pregnancy is associated with an increased risk of seizures in 30% of women with epilepsy. Frequent assessment throughout pregnancy is important. There is a slightly increased risk of congenital malformation associated with th e antiepileptic drugs. Folic acid supplementation is advisable.