ABSTRACT

Aggravation of seizures by antiepileptic drugs (AED) is a rare phenomenon. Observation of a dramatic increase in seizure frequency after the introduction of an AED and a clear-cut decrease in its frequency to the baseline level may lead to a diagnosis of paradoxical seizure aggravation. It may be associated with one of the following four conditions: inappropriate selection of AEDs for a particular seizure type, AED-induced encephalopathy, AED intoxication, and unanticipated seizure aggravation that can not be accounted for by any known cause. In this review, AED-related seizure aggravation and its underlying mechanisms are revisited to point out the necessity to keep this rare phenomenon in mind.