Brief communication of assessment of clinical practice regarding pharmacological treatment of epilepsy: a survey of neurologists in Republic of Macedonia.

A questionnaire of 15 items was developed in order to evaluate clinical practice regarding pharmacological treatment of epilepsy among adult neurologists in R. Macedonia. It was mailed to 30 practising neurologists, 24 answered (80%). Half of them administer AED after a first unprovoked seizure considering EEG and MRI, while others usually wait for a second one before introducing treatment. Discontinuation of treatment should be individualized. Carbamazepine and lamotrigine are the most frequently prescribed first-line drugs for partial seizures; second choices include a number of older and new generation AEDs. For generalized tonic-clonic seizures, absences, myoclonic, mixed or undetermined seizures, valproate is by far the most commonly used AED. The survey showed that prescription patterns are in accordance with current evidence about the spectrum of efficacy of individual AEDs in different types of seizures. Yet some results are a cause of concern and continuous education of the neurological community on AED treatment of epilepsy is needed.