Epilepsy and epileptic syndrome

12 rules of treatment with anticonvulsants

1. The patient is monitored after the first epileptic seizure (including EEG monitoring), and anticonvulsants are recommended after the 2nd or 3rd seizures.

2. The patient is selected a single anticonvulsant that is effective for the identified epileptic seizures, and treatment begins with the same drug, that is, the principle of monotherapy is followed.

3. The selected anticonvulsant is initially given in small doses and its dose is gradually increased until the attacks are over, ie until the therapeutic dose is reached.

4. The choice of drug is approached individually, taking into account the circumstances and side effects that prevent its recommendation. Once the attacks have stopped, the increase in the dose of the drug is also stopped, and in this way the therapeutic dose is selected.

5. The patient and his relatives are warned about the continuous use of the drug and its side effects. If you experience any side effects, you should seek medical advice immediately.

6. Clinical and laboratory tests are performed to determine the side effects of the drug. If they are observed or toxic effects begin to occur, the dose of the drug is reduced and replaced with another drug.

7. Even if the dose of the selected drug is increased, if the epileptic seizures do not stop, gradually reduce the dose and switch to another drug in parallel.

8. If monotherapy does not help, switch to polytherapy,2 anticonvulsants are recommended together. Here, the interactions of the selected drugs are taken into account, i.e., drugs that have the same effect, inactivate each other, or enhance their toxic effects are not prescribed together. In very rare cases, a third anticonvulsant is chosen.

9. In the initial stage of treatment, an EEG is performed every 3 months and epileptic activity is studied. Laboratory tests, including liver function tests, are performed

If focal neurological symptoms occur, CT or MRI may be performed.

10. Treatment with anticonvulsants should be continued for at least 2-3 years and gradually discontinued. Sometimes these medications have to be taken for years.

11. The patient and his relatives are warned that epileptic seizures may recur. The possibility of using surgical methods of treatment is taken into account and the patient's relatives are informed about it.

12. The patient is taught a healthy lifestyle. It is said that a healthy lifestyle is an important factor in preventing recurrence of epileptic seizures and faster recovery of the patient.

Note. Table 2.33 shows the different drugs used in epilepsy

Here's a few basic facts about a stomp pad. When choosing these drugs, it is necessary to follow the rules generally accepted by epileptologists. The required anticonvulsant is selected by the neuropathologist, not GPD.

2.33-table

Prescription for using anticonvulsants