Advances in the pharmacological treatment of epilepsy with Japan-specific issues

The benefits of modern treatments for epilepsy have long been excluded from Japan. However, after a long drug approval period, the following 4 new antiepileptic drugs (AEDs) have recently become available in Japan: gabapentin in 2006, topiramate in 2007, lamotrigine in 2008, and levetiracetam in 2010. Some newer AEDs have similar efficacy and improved tolerance compared to older AEDs. However, not all epilepsy patients can receive the direct benefits of the newer AEDs, because the care of patients with both newly-diagnosed and intractable epilepsy is not only the responsibility of neurologists with expertise in epilepsy, but also of general neurologists, pediatricians, psychiatrists, and neurosurgeons in Japan. This article addresses the current issues in the diagnosis and management of epilepsy, and emphasizes the importance of newer AEDs, especially for general neurosurgeons in Japan.