Pages Below:

Epilepsy

Affects 0.5% of population
Two or more episodes of altered consciousness, behaviours, emotion, sensation or movements, resulting from cerebral neuronal discharge with no obvious stimulus before the attack (c.f. other causes of seizures)
Characterized by paroxysmal discharge of cerebral neurones associated with either
- A clinical event apparent to the observer e.g. a tonic clonic seizure
- Or as an abnormal sensation perceived by the patient e.g. distortion of consciousness in temporal lobe epilepsy

generalised
partial seizures
- simple - fully conscious throughout
- complex - loss of consciousness

Education / support of family
Inform school
Advice about lifestyle
At least 2 years, do not stop suddenly
The following questions should be addressed
- Are the fits truly epileptic – e.g. not syncope, cardiac arrhythmia?
- Is the epilepsy caused by a condition that requires treatment in its own right – e.g. brain tumour, alcohol withdrawal?
- Are there remediable or reversible factors that aggravate the epilepsy or ppt. individual attacks?
- Is there a clinically important risk if the patient is left untreated?
- What type of epilepsy is present?
Ideally the drug should
- Suppress all clinical and EEG signs of patient’s epilepsy
- Produce no immediate or delayed side effects
Choice of Anticonvulsants
- Use a single drug based on the type of epilepsy
- Generally increase the dose every 2 weeks until either the seizures cease or signs of toxicity appear and / or the plasma drug conc. is in the toxic range
- If unsatisfactory substitute another drug
- <10% of epileptic patients benefit from 2 or more concurrent anticonvulsants

[ Home ] [ Up ]