Every anticonvulsant drug, both old and new, has its problems, and clinical trials are fraught with potential hazards (e.g. liver fatalities with valproate, leukopenia with carbamazepine, erythe multiforme and lymphoma with phenytoin, and learning disorders with barbiturates). Hopefully, the Vigabatrin-induced CNS vacuoles in animals will prove to be a species specific effect but close monitoring in man is required. CAUSES OF ANTIEPILEPTIC TREATMENT FAILURE The Veterans Administration Epilepsy

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... ooperative Study Group (Regional Epilepsy Center, VA Med Cntr, 4500 S Lancaster Rd, Dallas, TX) have evaluated monotherapy with carbamazepine, phenobarbital, phenytoin, and primidone in a total of 622 patients with previously untreated partial seizures, with particular attention to seizure frequency, neurotoxicity, and systemic toxicity. These 3 factors contributed equally to failure in the first 6 months but systemic toxicity, primarily skin rash, played a relatively minor role in drug failure after that time interval, with the same