Choosing an appropriate antiepileptic drug is the key to successful medical management of epilepsy in children. The choice of antiepileptic drug depends on several factors, of which the most important is accurate seizure classification. The other factors used to choose an appropriate antiepileptic drug include the side effect profile of the drug, The available age- and patient-appropriate preparations of the drug, Whether therapeutic levels are needed quickly or not (depending on the frequency and severity of the patient’s seizures), and the patient’s comorbidities.
Epilepsy is a serious global problem that affects approximately 1% of people worldwide (1). Epilepsy is a chronic condition of the central nervous system (CNS) characterized by epileptic seizures, which can affect physical and mental functions (2). Epileptic seizures are unprovoked reoccurring episodes of abnormal, excessive, or hypersynchronis neuronal activity in the CNS (2). The treatment options of epilepsy include medications called antiepileptic drugs (AED) and surgeries based on individuals’ specific diagnosis and background (1). The AED Keppra®, S-enantiomer of α-ethyl-2-oxo-1-pyrrolidine acetamide, or Levetiracetam (LEV) is Food and Drug Administration (FDA)-approved for the treatment and prevention of epileptic
However, medication therapy has been proven to be successful for almost three quarters of patients with generalized seizures. Unfortunately only fifty percent of epileptics with partial seizures are able to control seizure activity with medication. In the developing world nearly eighty percent of cases are inappropriately or not treated at all (centre, 2015). Depending on the age of the patient, the patient is nearly two to four times more at risk for early death during a seizure episode. The primary treatment for epilepsy is phenobarbital which is the least expensive anticonvulsant used to control generalized and partial seizures. Unfortunately due to its abuse potential it is often a controlled substance in countries and therefore not recommended as a first line of treatment. The lack of the ability to treat the majority of cases has led to severe social stigmas of epileptics and in many cases denial of the privileges such as being able to marry or drive a vehicle. Even with proper treatment nearly three out of ten epileptics continue to have seizures despite anticonvulsant therapy. A further estimated twenty percent can control their seizure activity if a second or third anticonvulsant is added to their regimen. Other than anticonvulsant medications minimizing or eliminating seizure triggers is the priority of therapy. Understanding the patients sensitivities are useful in indicating when a seizure will occur. Avoiding
Epilepsy is one of the most common of all the neurological disorders. Epilepsy effects about Sixty-Five million people worldwide and three million in the USA alone(CureEpilepsy). Epilepsy is when a person has a seizure for no actual reasons, unlike people who have them because of low blood sugar or withdrawals. A person can be diagnosed with this disorder is they have one or more seizures that aren’t caused by a known condition. Rarely do they perform surgery for epilepsy, Medication is commonly used to control seizures.
Mainly, there are 2 types of seizures: Focal (partial) seizure and generalized seizure. Focal seizure starts in and affects a large part of one hemisphere or just a small area in one of the lobes. Focal seizure is sub-divided into Simple Focal Seizures
Seizure disorder affects 65 million people worldwide. The prevalence of active cases of epilepsy vary between high-income and low-income countries likely due to differences in risk factors. High-income countries have a prevalence of 5-8 per 1000 in a population, while low-income countries have a prevalence of 10 per 1000. The risk factors that cause this discrepancy are assumed to be infections and inadequate care during and after pregnancy. There is also a vast difference in epilepsy mortality rates between high-income and low-income countries. High-income countries’ mortality rate are only 2-5 times higher than the general population as compared to the low-income countries’ rate of 37 times higher (Fazel et al, 2013).
VPA, carbamazepine and phenobarbitone were the most commonly used traditional AEDs in our study. Previous studies showed a significant decrease in the serum level of fT4 and increase in the serum level of TSH in patients treated with VPA; and these changes persisted throughout study period[8,11,26,27,28]. In a study conducted on adolescent girls with epilepsy, the group received VPA showed higher serum levels of TSH and lower serum levels of fT4 than did the untreated group, although still within the normal range. Other studies found that TSH levels increased in patients using VPA while fT4 levels were found to be unchanged[12,26,29,30].3,4,9,11 On the other side, some studies found that both fT4 and TSH concentrations were unaffected in patients treated with VPA[10,30]
Epilepsy is a central nervous system disorder(CNS) causing recurrent seizures and can only be defined when there is at least one epileptic seizure. John Hughlings Jackson, a notable British neurologist proposed that epilepsy is "an occasional, an excessive and a disorderly discharge of nervous tissue". About 65 million people(1% of the human population) in the world have epilepsy and the cases account for 80% in developing countries.  In this essay, the normal physiology of nerve transmission in cerebral cortex and pathophysiology of epilepsy will be discussed. The mechanism of action of valproate is also studied and how it leads to the treatment of epilepsy.
Epilepsy is the name for several neurological disorders in which people have epileptic seizures. It affects an estimated 65 million people around the world (cureepilepilepsy.org) and varies greatly from case to case. There are several treatment options for patients as well as research for developing better ways to diagnose and treat epilepsy.
Epilepsy is a chronic brain disorder, characterized by recurrent seizures, which are unprovoked. Around five percent of all people have one epileptically seizure in their lives. However, this does not meant that the person has epilepsy. Neurologists only talk about “actual” epilepsy, which is defined as a person having at least two seizures in one year. Around sixty million people in
Muralidhar’s study was compared to a similar study complete by Musicco et al. In Musicco et al’s, which study the treatment of seizures, study the median age for a seizure was around 24.8 years, in Muralidhar’s the age was 33.4 years. The abnormal CT scans were compared to a study conducted by Wallace JC, which studied brain scanning of late-onset seizures, Wallace found that out of one hundred thirty-two patients, fifty-one had abnormal CT scans. Muralidhar’s study concluded that out of fifty cases, seventeen were abnormal. Four cases showed abnormities on the EEG test, which is eight percent. Another study done by Donselaar et al., he studied seizures in adult patients that were not treated with medicine, he found that twenty nine percent were abnormal. The patients that were not treated with medication, anti-seizure, had a reoccurrence of seizures within six months, there was a percentage of twenty-four reoccurrences. In a similar study conducted by Scotoni et al., he studies the risk of seizures reoccurring, he found an eighteen percent occurrence
Our study carried out on fifty (50) children divided into two groups, the patient group included 30 epileptic children presenting with benign childhood epilepsy with centrotemporal spikes with normal physical and mental development and the control group included 20 age and sex matched healthy children.
Individuals who suffer from epilepsy drastically differ in many characteristics, such as the frequency and severity of the seizures, age, comorbidity, medical history, and overall health, so the antiepileptic drug strategy should be tailored to each patient’s seizure type (Rugg-Gunn and Sanders, 2012). Some examples of medication include Carbamazepine and Valium. While taking AEDs, it is important to monitor blood levels, occurrence of side effects, and seizure frequency in order to manage drug treatment and decide whether to continue, discontinue, or change drugs/dosage. Other non-epilepsy drugs may also lower the seizure threshold, including antidepressants and antipsychotics (Rugg-Gunn and Sanders,
Levetiracetam is probably a major breakthrough in the treatment of epilepsies. It is a highly effective, broad-spectrum, one of second generation AED with a unique mechanism of action.