Indications of anticonvulsant plasma levels monitoring in medical and surgical treatment of epilepsy

The results of long term (19-21 mth) intensive anticonvulsant plasma levels monitoring in 2 patients with partial complex epilepsy resistant to therapy are reported. In the first case the qualitative and quantitative therapeutic adjustment based on the monitoring data caused the disappearance of the seizures. In the second case, in which a right mid-temporal calcification (abscess) was demonstrated by CT-scan, the attacks were not controlled by different drugs. The patient became seizure-free after a right temporal lobectomy. The importance of long term anticonvulsant plasma levels monitoring in partial complex epilepsies unresponsive to pharmacological therapy is discussed in detail in view of possible surgical treatment.