This protocol is for patients with focal seizures who have not achieved adequate seizure control despite sequential monotherapy attempts. When second-line antiseizure monotherapy has been tried and proved unsuccessful, a defined next step exists within evidence-based guidelines.
For focal seizures where second-line monotherapy options have not succeeded, a specific antiseizure medication is recommended as third-line monotherapy. Which agent, and the clinical considerations guiding its selection, are detailed in the full structured protocol.
If second-line monotherapies tried are unsuccessful in people with focal seizures, consider lacosamide as third-line monotherapy.