| 항발작약물의 발작 외 신경계 질환 사용 |
| 김경민1, 김병수2, 김희진3, 김승우1, 백경원4, 석진명5, 선우준상6, 송인욱7, 우호걸8, 이익성9, 정진만10, 최교민11, 최윤호7, 양광익12, 대한신경과학회 진료지침위원회 |
1연세대학교 의과대학 신경과학교실
2이화여자대학교 의과대학 이대목동병원 신경과
3한양대학교 의과대학 신경과학교실
4고려대학교 안암병원 신경과
5이화여자대학교 의과대학 이대서울병원 신경과
6강북삼성병원 신경과
7가톨릭대학교 의과대학 인천성모병원 신경과
8경희대학교 의과대학 경희대학교병원 신경과
9중앙병원 신경과
10고려대학교 의과대학 고려대학교안산병원 신경과
11건국대학교병원 신경과
12순천향대학교 의과대학 순천향대학교천안병원 신경과 |
| Use of Antiseizure Medications in Neurological Disorders Beyond Epilepsy |
| Kyung Min Kim MD1, Byung-Su Kim MD, PhD2, Hee-Jin Hee-Jin MD, PhD3, Seung Woo Kim MD, PhD1, Kyoungwon Baik MD, PhD4, Jin Myoung Seok MD, PhD5, Jun-Sang Sunwoo MD, PhD6, In-Uk Song MD, PhD7, Ho Geol Woo MD, PhD8, Eek-Sung Lee MD, PhD9, Jin-Man Jung MD, PhD10, Kyomin Choi MD, PhD11, Yun Ho Choi MD, PhD7, Kwang Ik Yang MD, PhD12, on behalf of the Clinical Practice Guideline Committee of Korean Neurological Association |
1Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
2Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans Univerrsity College of Medicine, Seoul, Korea
3Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
4Department of Neurology, Korea University Anam Hospital, Seoul, Korea
5Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans Univerrsity College of Medicine, Seoul, Korea
6Department of Neurology, Kangbuk Samsung Hospital, Seoul, Korea
7Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University, Seoul, Korea
8Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Koreaq
9Department of Neurology, Jungang Hospital, Jeju, Korea
10Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
11Department of Neurology, Konkuk University Medical Center, Seoul, Korea
12Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea |
Corresponding Author:
Kwang Ik Yang ,Tel: +82-41-570-3823, Fax: +82-41-579-9021, Email: neurofan@schmc.ac.kr
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Received: September 11, 2025 Revised: September 28, 2025 Accepted: September 29, 2025 Published online: November 1, 2025 |
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| Abstract |
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Antiseizure medications (ASMs), originally developed for epilepsy, are increasingly used across non-epileptic neurological disorders. They modulate excitatory -inhibitory balance, nociceptive sensitization, neuroplasticity, trigeminal activation, and sleep-wake regulation through actions on voltage-gated ion channels, GABAergic and glutamatergic transmission, and synaptic vesicle proteins. These mechanisms underlie their broader therapeutic potential. In migraine, topiramate and valproate reduce attack frequency and chronification risk, and remain first- or second-line preventive options in current guidelines. In neuropathic pain, gabapentin and pregabalin alleviate peripheral and central sensitization and are effective in diabetic neuropathy, postherpetic neuralgia, and trigeminal neuralgia, improving pain and sleep though requiring cautious use in older or opioid-treated patients. ASMs enhance slow-wave sleep and are now preferred first-line therapy for restless legs syndrome, offering lower augmentation risk than dopamine agonists. In movement disorders, primidone and topiramate reduce tremor severity in essential tremor, while carbamazepine and oxcarbazepine effectively prevent attacks in paroxysmal kinesigenic dyskinesia. Lamotrigine, valproate, and carbamazepine are established mood stabilizers in bipolar disorder, while gabapentinoids may be cautiously used as adjuncts in anxiety disorders or post-traumatic stress disorder. While ASMs provide valuable alternatives for refractory or intolerant patients, safety concerns, including cognitive impairment, respiratory depression, and severe skin reactions, necessitate individualized selection, monitoring, and informed consent. Future research should clarify their long-term safety and enable biomarker-guided, personalized use beyond epilepsy. |
| Key Words:
Antiseizure medications | Migraine disorders | Neuralgia | Restless legs syndrome | Bipolar disorder |
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