A 28 year old woman sees her general practitioner after experiencing what sounds like a convulsion without any apparent provoking factor. Over the past month she has also had “blank spells” during which her husband noticed her to be unresponsive. Her general practitioner suspects she may have developed focal epilepsy and refers her to an epilepsy specialist. The specialist elicits from the patient and her husband additional features in the history that are highly compatible with seizures arising from the temporal lobe (lip smacking, ipsilateral motor automatism, and contralateral dystonia) and confirms the diagnosis by finding focal epileptiform discharges on electroencephalography and cortical dysplasia in the left temporal lobe on brain imaging. To prevent further seizures the specialist advises treatment with antiepileptic drugs (AEDs). The patient is reluctant to start treatment because she has read that AEDs have many adverse effects, could interact with her oral contraception, and are harmful for babies. She wonders if there are newer AEDs that for her might be better than the traditional ones
