Treatment Protocol

The AES guideline panel suggests treatment with levetiracetam rather than no levetiracetam.

Considering an alternative antiseizure medication rather than levetiracetam might be reasonable.

The AES guideline panel suggests against the use of valproate.

Initiation of valproate might be reasonable if appropriate or if alternatives are not available.

The AES guideline panel suggests treatment with oxcarbazepine rather than levetiracetam.

Oxcarbazepine is contraindicated.

The AES guideline panel suggests the use of levetiracetam rather than phenobarbital.

The AES guideline panel suggests treatment with either topiramate or carbamazepine.

Topiramate is preferred.

Carbamazepine is preferred.

Carbamazepine is contraindicated.

The AES guideline panel suggests the use of lacosamide rather than no lacosamide.

The AES guideline panel suggests treatment with valproate rather than no valproate.

Serum levels of valproate, 25-hydroxyvitamin D, and carnitine should be monitored and supplemented accordingly due to increased risk of carnitine and vitamin D deficiency.

The AES guideline panel suggests treatment with topiramate rather than no topiramate.

Topiramate should be used with caution due to the increased risk of metabolic acidosis and kidney stones.

The AES guideline panel suggests treatment with lamotrigine rather than no lamotrigine.

Use caution in patients with hypersensitivity reactions (Stevens-Johnson syndrome). Risk increases with co-administration with valproate.

Lamotrigine is contraindicated.

The AES guideline panel suggests the use of rufinamide rather than no rufinamide.

The AES guideline panel suggests treatment with stiripentol rather than no stiripentol.

The AES guideline panel suggests the use of brivaracetam rather than no brivaracetam.

The AES guideline panel suggests a ketogenic diet rather than no ketogenic diet.

Classic ketogenic diet is recommended due to higher efficacy rates and the need for more exact calculations to account for rapid growth during this time period.

Dietary therapy may be considered as a first-line treatment.

The AES guideline panel suggests against the use of a modified Atkins diet.

The AES guideline panel suggests a ketogenic diet rather than a modified Atkins diet.

The AES guideline panel suggests either the modified Atkins diet or low glycemic index treatment.

Phenytoin is contraindicated or should be used with caution due to risk of hypersensitivity and worsening of seizures.

Phenytoin is contraindicated.