INTRODUCTION: About 3% of people will be diagnosed with epilepsy during their 
lifetime, but about 70% of people with epilepsy eventually go into remission.
METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the 
following clinical questions: What are the effects of starting antiepileptic 
drug treatment following a single seizure? What are the effects of drug 
monotherapy in people with partial epilepsy? What are the effects of additional 
drug treatments in people with drug-resistant partial epilepsy? What is the risk 
of relapse in people in remission when withdrawing antiepileptic drugs? What are 
the effects of behavioural and psychological treatments for people with 
epilepsy? What are the effects of surgery in people with drug-resistant temporal 
lobe epilepsy? We searched: Medline, Embase, The Cochrane Library, and other 
important databases up to July 2009 (Clinical Evidence reviews are updated 
periodically; please check our website for the most up-to-date version of this 
review). We included harms alerts from relevant organisations such as the US 
Food and Drug Administration (FDA) and the UK Medicines and Healthcare products 
Regulatory Agency (MHRA).
RESULTS: We found 83 systematic reviews, RCTs, or observational studies that met 
our inclusion criteria. We performed a GRADE evaluation of the quality of 
evidence for interventions.
CONCLUSIONS: In this systematic review we present information relating to the 
effectiveness and safety of the following interventions: antiepileptic drugs 
after a single seizure; monotherapy for partial epilepsy using carbamazepine, 
gabapentin, lamotrigine, levetiracetam, phenobarbital, phenytoin, sodium 
valproate, or topiramate; addition of second-line drugs for drug-resistant 
partial epilepsy (allopurinol, eslicarbazepine, gabapentin, lacosamide, 
lamotrigine, levetiracetam, losigamone, oxcarbazepine, retigabine, tiagabine, 
topiramate, vigabatrin, or zonisamide); antiepileptic drug withdrawal for people 
with partial or generalised epilepsy who are in remission; behavioural and 
psychological treatments for partial or generalised epilepsy (biofeedback, 
cognitive behavioural therapy (CBT), educational programmes, family counselling, 
relaxation therapy (alone or plus behavioural modification therapy, yoga); and 
surgery for drug-resistant temporal lobe epilepsy ( lesionectomy, temporal 
lobectomy, vagus nerve stimulation as adjunctive therapy).