1, epilepsy medication during the precautions.
① Adhere to long-term medication in full and on time, generally requires complete control after 2-5 years, EEG restored to basic normal, 70% of cases can be cured to stop medication. However, some secondary epilepsy and intractable epilepsy require long-term drug treatment.
It is necessary to use the medication regularly under the guidance of the attending physician, and regularly follow up and evaluate the liver and kidney function, blood routine and EEG monitoring once every 3 months to 1 year.
③Talk to your doctor promptly when side effects and adverse reactions occur, and discontinue or adjust your medication.
④ Daily life “food and drink” should also be noted, spicy and stimulating hair products such as: beef, lamb and dog meat, rooster and carp, spring bamboo and seafood, tobacco, betel nut, strong tea and coffee and cola, etc. Avoid eating, quit drinking. Pediatric patients eat less sugar food.
⑤ appropriate exercise to enhance physical fitness, to avoid cold-induced exacerbation of the attack, can not engage in prolonged strenuous exercise.
⑥Rest on time to ensure adequate sleep, can not stay up for a long time playing cards and mahjong chess.
(7) Do not watch TV on the Internet for a long time, especially do not play online games.
⑧ Keep emotional stability and positive self-confidence, not too sad and excited.
⑨ Avoid working at height, by fire, by water, and driving operative work, and choose relatively easy occupation.
⑩Try to avoid all kinds of triggering factors, and squat to avoid falling when the seizure premonition aura.
What are the treatment methods for epilepsy?
Once epilepsy is diagnosed, it needs to be treated systematically and formally as early as possible, and the main methods include
The main methods include: (1) drug therapy: including anti-epileptic drugs and Chinese medicine, adjuvant drug therapy, should follow the principle of individualized treatment, western drug therapy requires the selection of drugs according to the type of seizure, Chinese medicine treatment for evidence-based treatment.
②Surgical treatment: for drug-resistant epilepsy and secondary partial epilepsy, a few can be treated surgically after systematic and strict evaluation and localization, with methods such as craniotomy, stereotactic surgery and vagus nerve stimulation.
(iii) Ketogenic diet therapy: some children with refractory epilepsy can be treated with this method.
(4) Other adjuvant treatments: acupuncture points buried and physiotherapy such as magnetic therapy and low frequency transcranial magnetic stimulation.
What are the common causes of epilepsy?
The causes of epilepsy are many and complex, and the causes of seizures may be different for different age groups. According to the causes, epilepsy can be divided into primary, cryptogenic and secondary. such as febrile convulsions, electrolyte disorders, diabetes mellitus, chronic alcoholism, hyperthyroidism, and genetic metabolic diseases). Cryptogenic refers to epilepsy whose etiology cannot be clearly identified by current examination instruments and technical methods for the time being. Therefore, there are some patients in the clinic who are currently unable to determine the cause.
4. How do women with epilepsy prepare for pregnancy and breastfeeding?
When women with epilepsy face the problem of childbirth after marriage, they are worried about whether epilepsy will be inherited to the next generation, and they are also worried about the adverse effects of drugs on the fetus, and even about the aggravation of seizures due to pregnancy. In order to relieve patients’ concerns, reduce the risk of pregnancy accidents, and help them to pass the pregnancy period smoothly and safely, the following requirements and precautions are introduced with my clinical experience.
① Pregnancy timing: It is best to plan pregnancy after the seizures have been completely controlled and stable for more than 3 years. This is because grand mal seizures may lead to unexpected events such as fetal hypoxic miscarriage, premature birth or congenital mental retardation. Even about 1/3 of pregnant women with epilepsy have an increased chance of having a seizure during pregnancy.
②Drug selection and dose adjustment: individualize the medication to control seizures, avoid polypharmacy as much as possible, and suggest that monotherapy is best if seizures can be controlled. According to relevant studies at home and abroad, it is believed that: try to avoid valproate and phenytoin sodium, which have effects on women’s menstruation and ovarian function, while lamotrigine and levetiracetam are relatively safe. At the same time, pregnant women with epilepsy should remember not to blindly reduce and discontinue their medication on their own, but to carefully change and reduce the dosage under the guidance of a specialist, and some patients even need to be monitored for changes in blood drug concentrations.
The risk of inheritance: In general, the chance of inheriting epilepsy from parents to the next generation is less than 5%, especially for those with secondary epilepsy. There is no reliable and accurate prenatal diagnosis to predict whether a fetus will inherit epilepsy because the genes and patterns of inheritance of epilepsy are complex.
④ Regarding drug side effects: Antiepileptic drugs have relatively certain potential side effects, including effects on cognitive function and teratogenic risk, but in general their chance is less than 5%, and the risk is also reduced by avoiding valproate, valium sedatives, and phenytoin sodium. Therefore, pregnant women planning to become pregnant should not worry too much about the side effects of drugs.
⑤ Precautions and preparations during pregnancy: the first trimester of pregnancy must be accompanied by taking folic acid, especially for pregnant women who take valproic acid requires 5mg of folic acid per day, while a proper multivitamin supplement and calcium tablets should be taken during pregnancy. In addition, regular 4D ultrasound examinations should be performed so that any malformations can be detected and dealt with as early as possible. Coagulation function should also be tested before delivery so that vitamin K can be supplemented in time to prevent intracranial hemorrhage in newborns.
(6) Daily life: maintain emotional stability, regular life and living, relaxation, appropriate physical activities, avoid spicy and stimulating food, ensure sufficient sleep, avoid fever and cold.
The latest international study concluded that it is safe and beneficial for women with epilepsy to breastfeed their children, and not to worry too much about the effects of breast milk drugs on the baby. The first three months of “breastfeeding” is especially recommended, after which you can transition to a combination of dairy products and other complementary foods.
What tests are often required for epilepsy treatment?
In order to identify the cause of epilepsy, the condition or locate the foci of epilepsy, the following tests are required.
(1) liver and kidney function, electrolytes, blood count, blood glucose, and drug concentration measurement;
② Electroencephalography: especially, video EEG monitoring needs to be checked for accurate and reliable results, and even to capture the seizure period.
③ Neuroimaging: CT/MRI of head, magnetoencephalography, PET/SPECT, etc.
④ Genetic metabolic disease examination.
6.Epilepsy and the effect of medication on fertility and heredity
A large amount of information confirms that epilepsy has little effect on male reproductive function, but female patients need to plan pregnancy under the guidance of a doctor, and should try to avoid oral contraceptives, avoid conflicts with epilepsy drugs, and avoid valproic acid for women during childbearing pregnancy. The chance of inheriting epilepsy to the next generation and the incidence of fetal malformations from antiepileptic drugs is generally less than 5%, but patients with epilepsy should try to avoid having children with spouses who have neuropsychiatric disorders. The fetal malformation can be ruled out in time with regular ultrasound examinations, so there is no need to worry too much.
7. Goals of epilepsy drug therapy
①The primary goal is to maximize seizure control, reduce the degree of seizures, and decrease the number of seizures.
②The least adverse reactions, regular follow-up review and timely communication with the doctor about drug reactions;
③Improve the patient’s quality of life: reduce the impact of drugs on cognitive functions such as memory learning, strengthen psychological guidance, and avoid epilepsy-related psychiatric problems.
8. Which epilepsy patients are suitable for surgery and how effective is it?
Epilepsy surgery is a complex and systematic project that requires multidisciplinary cooperation and strict preoperative evaluation and positioning. Its main indications are.
① Drug-refractory epilepsy.
② Symptomatic epilepsy with a clear origin of the epileptogenic discharge foci and not located in important functional areas. A few about 1/3 can be completely controlled, 1/3 are alleviated to reduce seizures, and 1/3 are ineffective or even aggravated. Therefore, surgical treatment needs to be chosen with caution and is recommended to be performed in large epilepsy specialty centers.
9. There are four misconceptions about epilepsy treatment
Many medical advertisements about epilepsy treatment describe epilepsy as “one of the ten most difficult diseases”, but clinical practice has confirmed that 70% of newly diagnosed children and adults with epilepsy can be cured by standardized use of antiepileptic drugs. After taking antiepileptic drugs for 2-5 years, about 70% of children and 60% of adults no longer need to take medication; the rest of patients may no longer have seizures or have fewer seizures and less seizures as long as they take their medication regularly. There is no “cure” in modern medicine. The effectiveness of epilepsy treatment is evaluated by whether the number of seizures is reduced or stopped.
It is important to point out that there are four misconceptions about epilepsy treatment in society.
The first one is the belief in “ancestral prescriptions”.
The first one is that the person who is in charge of the treatment of epilepsy is the one who is in charge of the treatment of epilepsy. In fact, all drugs have side effects.
Misconception 3: The more varieties of drugs, the better the efficacy.
Myth 4: Worry about the side effects of anti-epileptic drugs and do not adhere to treatment.