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Abstract: The patient reported that he always fainted without consciousness and did not remember what happened when he woke up. Through the patient’s symptoms and the EEG and other tests, it was determined that the seizures were epileptic. After the diagnosis was confirmed, the patient was treated with medication and given oral carbamazepine tablets. With the active cooperation of the patient and her family, after long-term drug treatment, the number of seizures decreased and the duration of convulsions shortened, and the treatment effect was better.
[Basic information] Female, 20 years old
Type of disease】Epilepsy
Hospital】Beijing Anzhen Hospital, Capital Medical University
Date of consultation】October 2021
Treatment plan】Medication (carbamazepine tablets)
Treatment Period】Long-term medication
Effectiveness】Significant reduction in the number of seizures
I. Initial consultation
Patient Xiao Li is a 20-year-old girl who came to our hospital accompanied by her family. She reported that she would always suddenly lose consciousness and then fall down, and her family told her that during the time of loss of consciousness, the patient would have convulsion-like manifestations, and the loss of consciousness would not last long, maybe only ten seconds or so, and then she would wake up on her own, but she did not remember what had happened. Due to the repeated occurrence of these symptoms, the patient often felt low self-esteem and came to our hospital to improve the situation. After listening to the patient and his family, the patient was initially diagnosed as having seizures, so he was asked to complete EEG and cranial CT examinations, and the EEG results showed abnormal discharges, while the cranial CT results were normal.
Second, the treatment process
Combining the patient’s seizure characteristics and the EEG findings, it was clear that the patient belonged to generalized seizure epilepsy, so the patient was given carbamazepine tablets for oral administration, and the patient and his family were instructed to start with a small dose of the medication and gradually increase it. If the effect of drug treatment is not satisfactory or serious adverse reactions occur, the patient should come to the hospital in time to adjust the drug or reduce the dose, and the patient and his family should come to the hospital for regular follow-up.
III. Treatment effect
After the patient took carbamazepine tablets, the number of seizures was significantly reduced, the interval between each seizure was shortened, the duration of body convulsions was also shortened, and the degree of convulsions became less severe. One year after taking the medication, the patient reported only occasional seizures. Because of the reduction in the number of seizures, the patient’s psychological condition of low self-esteem was also significantly improved, and he resumed normal social interaction with others, not being afraid to make friends because he had epilepsy, and his usual diet and sleep were good.
IV. Notes
We are glad that after a series of medication treatment, the patient’s epilepsy has been significantly controlled and the psychological inferiority complex has been further improved, but the patient still needs to pay attention to the following situations in daily life.
1, daily life should be on time, according to the amount, regular medication, do not privately reduce or stop the drug. If the number of seizures does not improve after taking medication, they should be promptly reviewed and the type of medication adjusted.
2, because when seizures occur, the patient will lose consciousness and fall, so the living environment should pay attention to avoid too sharp things on the ground to avoid being stabbed when seizures faint.
3, family members should pay attention to the fact that when the patient faints, they should promptly untie the patient and keep the patient breathing freely. When the patient is now convulsing, the patient’s body should not be forcibly suppressed so as not to cause injury to the patient.
V. Personal insight
Epilepsy is a treatable disease, and if patients undergo timely standardized treatment, such as following medical advice, more than half of the patients will never have seizures again for life, even if the seizures cannot be completely avoided by taking medication, the number of seizures can be reduced, just like the patient in this case, the seizures can be better controlled by taking medication.
In addition, patients with epilepsy do not need to feel a sense of shame, and family members should actively and patiently counsel patients to relieve their own sense of shame. Some patients may not come to the hospital because of the shame of having epilepsy, which may delay treatment.