Monitoring Antiepileptic Drug Serum Levels
Facilities for monitoring serum levels are often not available in developing countries, but where they are, it is important that they not be overused. Even in the industrialized world, adjustments in AED regimens are primarily based on clinical grounds, irrespective of the serum levels. Dosage adjustments should always be made on an individual basis and dictated by the performance of a given AED regimen in terms of seizure control on the one hand and side effect profile on the other. Serum...
The Economic Impact Of Epilepsy
The direct costs associated with epilepsy include medical expenses associated with medications, hospitalization, and outpatient clinic fees. Costs not typically considered in studies of developed countries include medical services rendered for seizure-related injuries e.g., burns and the high cost of simply reaching a clinic equipped to deal with seizure disorders. Such expenses should be included when assessing the direct cost of epilepsy in developing regions. In Italy, the direct costs of...
Seizure Sequelae
Seizure sequelae can represent either neurologic deficits provoked by acute neuronal exhaustion and other neurochemical changes depressing neuronal function, or injuries sustained during the actual or previous seizures. Scars may offer evidence of previous seizure-related injuries. The presence of scars probably indicates the need to improve seizure control. Scar identification offers an opportunity to educate the patient and his or her relatives about measures to avoid further similar...
Triage Of Epileptic Conditions
Most people with epilepsy have seizures that are easy to treat, respond to relatively low doses of all appropriate AEDs, and can usually be managed by primary care physicians. The majority of patients with these types of epilepsy will experience no disability if treatment is initiated appropriately, and for some, seizures will eventually remit and medication will no longer be necessary. In reality, 40 of patients with epilepsy have epileptic seizures that are difficult to control, but for many...
Sensory Stimulation
Seizures may be precipitated by a variety of sensory stimuli, particularly in certain specific epilepsy syndromes. Most common are patients with primary idiopathic generalized epilepsies who display photosensitivity. Intermittent photic stimulation from video games, stroboscopic lights, or a variety of alternating dark light patterns may induce myoclonic jerks or generalized convulsions in these patients. Photosensitive-related seizures are at times self-induced by intellectually disabled...
Seizure and Injury Prevention
Although antiepileptic drugs AEDs comprise a critical component of epilepsy care, AEDs will not cure epilepsy. However, some lifestyle interventions can assist with seizure control and injury prevention. In addition to encouraging patient compliance with medications, healthcare providers caring for people with epilepsy should recom mend maintenance of a regular, adequate sleep schedule. People with epilepsy should also be cautioned against excessive intake of alcoholic beverages or stimulants,...