Patient: female, 6 weeks old, 21 kg, first episode in August 2006, rapid eyelid vibrations within twenty minutes of falling asleep, upturning, rapid twitching at the corners of the mouth, both sides, slight stiffness in the neck, softness in the rest of the body. It lasts for 30 or 40 seconds, or less than 10 seconds in milder cases, and then turns over and goes back to sleep. Last night’s attack ended up with straight arms and half-open eyes for 10 seconds or so, and then I couldn’t wake up and turned over and went back to sleep. When I had an attack, my stomach hurt for a few days and I snored in my sleep. Laboratory tests, 24-hour EEG after the first seizure in August 2006: more medium-high potential spike waves and spike-slow integrated waves were seen in the right frontal pole, frontal, anterior temporal, central seat, two middle temporal, and two occipital regions of right posterior temporal during wakefulness and natural sleep. In May 2007, the last check of EEG during sleep: right central-parietal-occipital, right middle-posterior temporal saw 9.0-3.2hz spike-slow, spike-slow complex waves, with right central-parietal as the most prominent. The CT liver function is normal to the North University of Women’s Hospital to see, began to eat De Bajin, four months relapse plus the amount can not be controlled to change the lamotrigine, a single drug with the amount of 75 mg in the morning and 75 mg in the evening, nearly a year and eight months without relapse, this relapse on July 29, the first three light, only a few seconds eye twitch, August 11 piano performance, nervousness, photography, etc. the night of the attack is heavier, ate two pills An Gong pill these days nothing, the night before last night each heavy The last morning Ramo has risen to two tablets in the morning and two tablets in the evening (one 50 mg). It is inconvenient to see a doctor, and I have made an appointment for a 24-hour EEG, which will be done on September 7. What should I do? How much more Lamo should I take? Previously, it was said to be benign pediatric epilepsy, what do you think? Is it okay to go to Jilin University Hospital No. 1 without going to Beijing this time? It will take more than 10 days before I can go to Changchun to see it, how can I spend these days? It seems that he is going to have seizures every night. Can I use some temporary preventive medication, such as Valium or something else? Otherwise, the child will suffer too much from this daily. Please tell me! I work in a hospital and I can observe and administer medication. I still have Valium at home. Can I use them? I hope you will write back soon! Thank you. Parent Statement: Last night I wanted to push Valium intravenously, just push 0.1 mg on the blood vessel pain crying, so I used 0.5 mg reserved enema, ten minutes after going to bed, all right for the night, today on the first day of first grade, the first day of school, said the stomach pain, the teacher called me, hold back did not answer back, did not say pain at night. Last night lamotrigine has been added to 2.5 tablets (2 tablets in the morning), is it resistant to the drug and then add it does not work, last time I took De Bajin relapse like that, what should I do tonight? I want to use Valium enema again, and then go to Periwinkle in 5 days to control the attack first. But can I use it every night? Can you please show up soon? Zhu Highest Answer: In view of your child’s condition, consider adding levetiracetam, which has a different site of action than lamotrigine, etc., and has the effect of blocking abnormal brain discharge generalization, and can be the first choice for additional therapeutic use, and has a synergistic effect with other drugs. It has been reported to have a rapid onset of action, mild side effects, and no effect on cognition or function in children. This drug is already available in China under the trade name – Kaipulan. Patient: I don’t dare to add it myself, but I have to wait to go to Changchun to see the doctor there who suggested this drug, to prevent seizures in the next few days, and then to use Valium enemas. The first thing you need to do is to make sure that you have the right amount of money to spend. Do you think she still has benign epilepsy? Is it a refractory type of epilepsy? The last seizure was soft and not tense, with the corners of the mouth pumping to the left. Zhu Haixuan replied: Valium enema is not a permanent solution, pay attention not to overuse, to avoid respiratory depression. The patient: I know, every night I instill four or five milligrams each time okay, just want to survive these five or six days, or you have a better way? Zhu Highest Answer: The previous view of epilepsy treatment was to treat it as monotherapy as possible. The new view is that if monotherapy does not work, the probability of switching to another monotherapy is very low, so the combination of two drugs sometimes has better efficacy, and sometimes the side effects are lower when used properly. Patient: Professor Zhu, my daughter has been suffering from frontal lobe epilepsy for four years, and when she had frequent seizures nearly two years ago, she sought your advice in an emergency, and later confirmed that the medication we saw from Professor Jiang of Peking University was exactly the same as your medication principles at that time. The lamotrigine is 50 in the morning and 75 in the evening, and the keplan is 500 mg in the morning and 500 mg in the evening (Professor Jiang’s formula from Peking University, and it seems that other children with more than 100 pounds do not have such a large amount of it) was added directly to this amount, and then the amount was not increased again, and it seems that it is not completely controlled. Question 1: It’s been almost a year since I changed to Keplar, and my height has grown by 6 or 7 cm and is now 133 cm, but my weight has dropped by one kilogram, and my skin and bones are now only 23 kg, and I am eating well, with adequate nutrition and digestion. Question 2: My child often yawns and stops breathing for 10 seconds during sleep (he had his adenoids removed a year ago), but I didn’t pay attention to this symptom when I talked to the doctor. I look forward to hearing from you, thank you. Answer: The 8-week-old girl is in the middle to upper 75th percentile for height (close to the 75th percentile) and 23 kg for weight (slightly below the 50th percentile). Certain antiepileptic drugs may affect appetite and may cause gastrointestinal upset after administration. Your child is great as long as your child has a good appetite, eats well, and has adequate nutrition. Yawning and apnea during sleep may be a normal sleep behavior, but it does not exclude the result of abnormal EEG discharge in epilepsy, which can be identified by dynamic or video EEG. You can ask Professor Jiang Yuwu for further advice.