Management issues for patients with idiopathic generalized epilepsies

Idiopathic generalized epilepsies (IGEs) are eight epilepsies defined in the 1989 ILAE Classification usually starting in childhood or adolescence. Since IGEs treatment is dependent on syndromic characterization, the clinical features are still the cornerstone of accurate classification and selection of appropriate treatment. We reviewed evidence-based data on treatment with antiepileptic drugs, as well as prognostic factors in IGEs. Evidence-based data support the use of valproate and ethosuximide in monotherapy for treatment of childhood absence epilepsy; topiramate in monotherapy for primarily generalized tonic–clonic seizures (PGTCS); and, as adjunctive therapy, of lamotrigine, levetiracetam and topiramate for PGTCS and levetiracetam for myoclonic seizures.