What are the principles of drug treatment for epilepsy?

  1, try to treat early; 2, has been diagnosed as epilepsy, and has had many seizures, should immediately begin treatment to avoid convulsive brain injury; 3, no obvious organic brain disease occurred, and the cause of the onset of the disease can not be found for a while, if the first seizure is not serious, you can temporarily do not take medication, but must be closely observed; 4, and then have recurrent seizures, then should start taking medication. In the case of children with benign epilepsy, observation is also the main focus after the first seizure, and later on, depending on the development of the disease, the corresponding treatment will be done.  5, according to the type of seizure selection of drugs: seizure types are more, according to different seizure types should be selected different drugs.  (1) Sodium valproate extended-release tablets (trade name: Depakene extended-release tablets), which is a broad-spectrum antiepileptic drug, has the best pharmacological effect on epileptic akathisia seizures, and can also be applied in myoclonic seizures, tonic clonic seizures, atonic seizures or mixed seizures.  The following are the general rules for drug selection for epilepsy treatment, with those listed first being the drugs of choice. It should be emphasized that the final determination of which drug to use is based on the child’s physical condition, previous treatment with medication, drug source, family economic situation and other factors, and is decided by the physician after comprehensive consideration.  a. Tonic clonic seizures: phenobarbital, sodium valproate, carbamazepine, phenytoin sodium, paroxetine.  b. Aneurysmal petit mal seizures: sodium valproate, clonazepam.  c. Myoclonic and atonic seizures: sodium valproate, clonazepam, paroxetine, diazepam.  d. Limited motor seizures: carbamazepine, topiramate, paroxetine, sodium valproate.  e. Psychomotor seizures: carbamazepine, topiramate, sodium phenytoin, paroxetone, phenobarbital.  f. Infantile spasms: ACTH corticotropin or prednisone, nitroprusside, clonazepam, sodium valproate.  For general treatment, start with one drug first, and for intractable seizures that are difficult to control, two or more drugs are available.  6. Start with small doses and adjust the dosage in time: Doctors will pay attention to the individual differences and age characteristics of the children and start with small doses and gradually increase the dosage if necessary until the seizures are completely controlled. After the seizure is controlled, the dosage should be adjusted according to the change in weight of the child and the blood concentration of the drug. Take medication simply and regularly To ensure that the concentration of drugs in the blood is as stable as possible, take medication regularly. “If you take your medication intermittently for three days, you will not be able to achieve effective drug concentrations in the blood, and you will not be able to achieve the antiepileptic effect. The method of taking medication is to be as simple as possible to ensure a normal life. The process of stopping the medication should be slow. 7. Epilepsy is a chronic disease that requires long-term medication, and it is generally advocated to continue taking medication for 2 to 4 years after the seizures have stopped, and then after 6 months to a year of medication reduction, and finally stopping the medication.  8.Regular review, pay attention to the toxic side effects of drugs; 9.Regular review, pay attention to the use of antiepileptic drugs for toxic side effects, timely adjustment of dosage or replacement of drugs. In addition to general physical examination, blood routine, liver and kidney function should be checked at the time of follow-up, and drug blood concentration and electroencephalogram should be monitored regularly if available.