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From an epidemiological point of view, worldwide epilepsy has a bimodal increase in incidence, both in children and in the elderly. The epilepsy that begins in people over 65 is estimated to be of the order of 80 to 150 per 100,000 people and should be considered a different age group. Epileptic seizures in the elderly represent a clinical challenge for differential diagnosis, as well as to determine the type of crisis. The etiology is mostly structural, predominantly vascular pathology, particularly ischemic, followed by craniocerebral trauma and hippocampal sclerosis. Monotherapy with antiepileptic drugs (AEDs) is the gold standard. Considering the comorbidities of the elderly, the pharmacokinetics of AEDs, interactions with other drugs and tolerance, there are only class II and III studies for lamotrigine and levetiracetam for the treatment of epileptic seizures in the elderly. [ABSTRACT FROM AUTHOR]

Cutaneous adverse drug reactions include maculopapular exanthema, Stevens-Johnson syndrome, and toxic epidermal necrolysis and are a global public health problem associated with the use of antiepileptic drugs (AEDs). Lamotrigine (LTG) stands out among AEDs because it does not cause sedation and does not affect cognition. Cutaneous adverse reactions (cADRs) to LTG occur in patients carrying certain allele variants of the human leukocyte antigen (HLA) system; although infrequent, they are alarming because they put the life at risk and force discontinuation of the treatment. The fear of neurologists to cADRs to LTG decreases its prescription despite its therapeutic advantages. Here, we review the allele variants of the HLA system that have been associated with cADRs to LTG in Mexican mestizos and other ethnic groups; identification of these variants would serve to select the patients that may be treated with LTG. [ABSTRACT FROM AUTHOR]

Epilepsy, a serious problem of public health in Mexico, is linked to psychiatric co-morbidity, whose sexual expression is wrongly interpreted in society, and not well attended. The neural response and the epileptic mechanisms of affectation are described, as well as the processes derived from the use of anti-epileptic drugs and other ethiopathogenic factors to be considered in this problem. The timely clinical identification of the incapacity that implies feminine sexual dysfunction, remains blocked by myths and prejudices, or is simply ignored. The double social moral and the wrong interpretation of feminine sexual behavior, even when it is healthy, causes direct/indirect damages in different ways" Psychopathologic (self-devaluation, infant-juvenile sexual abuse, etc.), socio-familiar, neuro-physiopathologic, and by effect of illegal/legal substances. The approaches to these problems are recommend, and the frequent sexual alterations described, in order to promote the accomplishment of a better semiologic-propedeutic methodology in which treatment f the primary upheaval and its co-morbidity are simultaneously built. The appropriate reference of the patient is an unsustainable clinical need that reinforces comprehensive treatment. It is necessary to improve emotional aspects of the patients within themselves, in first instance, to increase quality in their conjugal, familiar and communitarian life. The restriction of social opportunities and the limitation of access to formal and occupational educative experiences to his and nay other stigmatized population is inadmissible. It is the responsibility of the health personnel to work specifically in eliminating both stigmas: sexual and epileptic, when trying to consolidate the humanistic paradigm of our profession [ABSTRACT FROM AUTHOR]