Epilepsy

EPILEPSY

OUTLINE

I . Introduction 3

II . Etiology 3

A . Idiopathic or Constitutional Epilepsy 3

1 . Congenital abnormalities and perinatal injuries 3

2 . Metabolic diss 3

3 . Trauma 3

III . Poor compliance of drugs leads to recurrence 4

IV . Clinical and EEG data 6

V . Monitoring plasma drug levels 6

VI . Dose reduction and recurrence 6

VII . Conclusion 7

I . Introduction

The term epilepsy denotes any dis characterized by recurrent seizures . A seizure is a transient disturbance of cerebral function due to an abnormal paroxysmal

neuronal discharge in the brain . Epilepsy is common , affecting approximately 0 .5 of the population in the USA . This argues that treatment of epilepsy today is highly successful with those developing epilepsy becoming seizure-free and only a small percentage still retaining it with a difficult treatment on those cases (Tierney , 1993 . This argues that there is no one fixed drug or treatment for this condition and that a lot depends on the monitoring done by family , doctors and healthcare practitioners

II . Etiology

Epilepsy has several causes . Its most likely cause in individual patients relates to the age at onset

A . Idiopathic or Constitutional Epilepsy : Seizures usually begin between 5 and 20 years of age but may start later in life . No specific cause can be identified , and there is no other neurologic abnormality

B . Symptomatic Epilepsy : There are many causes for recurrent seizures

1 . Congenital abnormalities and perinatal injuries may result in seizures presenting in infancy or childhood

2 . Metabolic diss such as hypocalcemia , hypoglycemia , pyridoxine deficiency and phenylketonuria are major treatable causes of seizures and other metabolic diss such as renal failure and diabetes may also be responsible

3 . Trauma is an important cause of seizures at any age , but especially in young adults . Posttraumatic epilepsy is more likely to develop if the dura mater was penetrated and generally becomes manifest within 2 years following the injury . However , seizures developing in the first week after head injury do not necessarily imply that future attacks will occur . There is suggestive evidence that prophylactic anti-convulsant drug treatment reduces the incidence of posttraumatic epilepsy (Tierney , 1993

There are other causes for epilepsy but these are the three major ones What is important is that most of those who develop seizures , eighty percent are best treated with a single drug (Duncan , 1991 ,

. 159 However , most experts have not decided on the rate with which antiepileptic drugs must be tapered or discontinued in patients with active epilepsy

III . Poor compliance of drugs leads to recurrence

It has been revealed that poor compliance , drug interactions and long-term toxicity can result if more than one drug is prescribed . There is no other goal in therapy except to have a complete seizure control with a single drug taken once or twice a day , without side-effects . If patients are not taken cared of well , there is a possibility that this will occur for a long time . Thus , precise classification of the types of seizure and of the kind of epilepsy is...