Antiepileptic Drug (AED)Also called anti-seizure medication (ASM). A drug used to prevent or reduce the frequency of seizures in epilepsy.BioavailabilityThe proportion of a drug that enters the circulation and is able to have an active effect. Levetiracetam has ~100% oral bioavailability.ESETTEstablished Status Epilepticus Treatment Trial. A landmark 2019 RCT showing levetiracetam, valproate, and fosphenytoin are equally effective in status epilepticus.False PharmacoresistanceA condition where epilepsy appears drug-resistant not due to true drug resistance, but because the patient was prescribed an inappropriate antiepileptic drug.Focal EpilepsyEpilepsy in which seizures originate from a specific area (focus) of the brain. Also called partial epilepsy.Generalised EpilepsyEpilepsy in which seizures involve both hemispheres of the brain from the outset, including absence, myoclonic, and tonic-clonic seizures.Hazard Ratio (HR)A measure of relative risk over time. An HR of 1.32 for levetiracetam vs lamotrigine means patients on LEV were 32% more likely to fail treatment at any given time point.HRECHuman Research Ethics Committee. The body that reviews and approves clinical research protocols involving human participants.IatrogenicCaused by medical treatment or a physician. From Greek: iatros (physician) + genic (caused by).Iatrogenic Refractory Epilepsy (IRE)A condition in which apparent pharmacoresistance is caused by prescribing an inappropriate first antiepileptic drug, rather than by intrinsic drug resistance of the epilepsy itself. IRE is preventable.ILAEInternational League Against Epilepsy. The leading international organisation for epilepsy research and clinical practice guidelines.Levetiracetam (LEV)An antiepileptic drug that binds to synaptic vesicle protein 2A (SV2A). Brand names include Keppra, Keppra XR, Elepsia XR, and Spritam.NICENational Institute for Health and Care Excellence (UK). Produces evidence-based clinical guidelines including CG137 on epilepsy.PharmacoresistanceFailure of two or more appropriate antiepileptic drugs (at adequate doses) to achieve sustained seizure freedom.Reflex PrescribingThe practice of prescribing a drug by habit or convenience — particularly in emergency settings — without adequately considering the patient's specific epilepsy type, comorbidities, psychiatric history, or drug interactions.SANAD IIStandard and New Antiepileptic Drugs II. A landmark 2021 UK RCT published in The Lancet showing lamotrigine is superior to levetiracetam for newly diagnosed focal epilepsy.Status EpilepticusA seizure lasting more than 5 minutes, or two or more seizures without full recovery between them. A medical emergency.SV2ASynaptic vesicle protein 2A. The binding site for levetiracetam in presynaptic nerve terminals. SV2A plays a role in vesicular priming and neurotransmitter release.