From diagnosis to wise treatment
A practical epilepsy framework built around accurate classification, deliberate drug choice and the patient's real-world treatment burden.
The four organising questions
1. Is the event an epileptic seizure?
2. If yes, what seizure/epilepsy type?
3. What is the best first drug for this person?
4. If needed, what is the best next drug or escalation?
Reflex prescribing
Keep prescribing connected to the diagnosis, the person and a review plan. Clear explanations and evidence for treatment conversations.
OpenClinical approach
Four questions: Is it a seizure? What type? Best first drug? Best next step?
OpenSeizure & epilepsy classification
2025 ILAE seizure classes, epilepsy types, syndromes and why classification matters.
OpenDifferentials & provoked seizures
Syncope, functional seizures, migraine, sleep and movement disorders, metabolic and acute symptomatic causes.
OpenInvestigations
Use history first, then answer targeted questions with EEG, MRI, laboratory, genetic and other testing.
OpenAntiseizure medicine guide
Mechanism, half-life, adverse effects, indications and place in therapy — classic and modern agents.
OpenSeizure first aid & counselling
Practical first aid, rescue plans, safety counselling and emergency thresholds.
OpenTreatment philosophy
Maximise seizure control while minimising treatment burden and avoid unnecessary lifestyle restriction.
OpenSUDEP & risk counselling
Discuss seizure-related risk proportionately and focus on modifiable risk, especially convulsive seizure control.
OpenDrug-resistant epilepsy
After two appropriate drug failures, reassess diagnosis and consider surgery, neurostimulation and dietary therapy.
OpenSpecial situations
Pregnancy, reproductive safety, older adults, renal/hepatic disease, mood, cognition and interactions.
OpenSpecialist escalation
Reassess diagnosis and refer appropriately for drug resistance, surgery, pregnancy complexity and difficult syndromes.
OpenProminent prescribing feature
LevWise
LevWise retains its full depth as EpilepsyWise's flagship case study in rational prescribing: levetiracetam's benefits, behavioural risks, evidence base, alternatives, SANAD II context and Iatrogenic Refractory Epilepsy.
Enter LevWiseThe prescribing principle
Divide before drugs. Don't have favourites. Medicine selection should follow seizure biology, comorbidity, pharmacokinetics, reproductive considerations, interaction burden and the patient's goals — not prescribing habit.
Open the comprehensive drug table