Epilepsy is a common complex neurological disorder responsible for significant morbidity and mortality. 1 The word epilepsy is derived the word “epilambánein" which means “to take hold of”. 2 An Ayurveda literature in Charaka Samhita describes epilepsy as "apasmara" which means "loss of consciousness". The Charaka Samhita has shown abundant references to all aspects of symptomatology aetiology, diagnosis and treatment of various types of epilepsy. 3
The word seizure is derived from the Latin word sacire, which means "to take possession of. It is a convulsive event due to hyper synchronous, excessive, abnormal discharges from central nervous system (CNS) neurons that results in seizure activity. 4
A seizure is a convulsive, time limited change in behaviour and/or motor activity from abnormal electrical activity in the brain. 5 Thus
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The current International League against Epilepsy (ILAE) guidelines classify patients with epilepsy as refractory epilepsies if they have failed to achieve a sustained seizure free status despite treatment with two appropriate and well tolerated AED regimes either as mono or polytherapy. 11, 21
Since last 15 years, numerous new AEDs have been approved and launched in the market, because of their better safety, tolerability and control of seizures than old AEDs. These newer AED development epitomises hope for people affected with refractory epilepsy. The new generation AEDs are widely used as add on treatment in patients already treated with other AEDs. 22
About 30% of patients with epilepsy either become refractory to current treatments or experience significant adverse events. 23-25 Most currently used newer AEDs offer novel mechanisms of action and additional favourable safety profiles than the first generation antiepileptic drugs (AEDs).