Epilepsy, commonly known as “sheep epilepsy”, appears to be an acute seizure with sudden loss of consciousness, falling to the ground, twitching of limbs, salivation or screaming at the mouth, etc. After the seizure, the person is as usual. In fact, epilepsy, like hypertension and diabetes, is a chronic disease. In addition to the treatment of the cause of the disease, the core of epilepsy treatment is currently drug therapy. The treatment of epilepsy is often delayed because many patients are not aware of the disease and the problems they may face during the drug treatment process. In this article, we will give examples of common medication errors in the clinical management of epilepsy, which patients can take note of.
1. Stopping the use of drugs
Epilepsy is not an acute disease, so if you take a few days of medication, you can stop when your symptoms get better. The damage to the brain during a grand mal seizure is mostly irreversible. Therefore, patients with epilepsy must adhere to long-term, standardized use of antiepileptic drugs under the guidance of doctors in order to achieve good treatment results. This is a very important thing that patients with epilepsy and their families must be aware of. The first thing you need to do is to take your medication again to avoid serious consequences.
2, unauthorized medication
The actual fact is that the actual person is not a person, but a person who is not a person. For example, phenytoin sodium is suitable for generalized tonic clonic seizures, while sodium propionate is suitable for atonic petit mal seizures, so it is very dangerous to use medication without doctor’s guidance. The use of antiepileptic drugs is not without side effects, and they need to be identified when used.
3.Multiple drugs “combination”
The simultaneous application of two or more antiepileptic drugs may interact with each other at various stages of pharmacokinetics and pharmacodynamics. For example, phenytoin sodium can inhibit the blood concentration of sodium valproate, and luminal can reduce the blood concentration of phenytoin sodium. Therefore, usually a single drug is the main, if necessary, only two drugs in combination, three or more drugs together often can not achieve the desired effect, but to increase the side effects.
4, believe in the “magic pill”
In fact, to date, there is no “magic bullet” to cure epilepsy. The process of correcting abnormal neuronal firing requires the induction of normal firing, which takes at least two years, and no one can change the biological mechanism without permission.
5. Fear of affecting intelligence
The most effective way to prevent epilepsy from affecting intellectual development is to control seizures early. This is because each seizure can lead to neuronal damage in the brain, directly affecting intelligence. The longer the course of the disease, the more seizures, the greater the degree of damage to the brain. The early, regular and reasonable drug treatment can avoid intellectual damage.
6. Worry about the side effects of drugs
Currently, the side effects of commonly used antiepileptic drugs are fatigue, drowsiness, and memory loss, but as long as the dose is properly controlled under the guidance of a doctor, the side effects can be reduced or avoided. It is recommended that patients pay attention to the side effects of drugs during the use of medication, once the discomfort and timely adjustment of drugs to achieve better therapeutic results, and at the same time, to reduce the adverse effects of drugs.
7. Adjust the dose at will
Usually, during the treatment of epilepsy, doctors will adjust the dose of medication according to the fluctuation of the patient’s condition in order to achieve the ideal treatment status. It seems that the adjustment of medication is simple, but it is not. It requires a combination of symptoms, EEG, and blood levels. Therefore, it is best for patients to have their medication doses adjusted by an experienced doctor in the same hospital for a long time.
8. Suddenly stop taking medication
When seizures are still frequent after continuous application of antiepileptic drug therapy, doctors will remove the drugs that are ineffective or have the greatest side effects, but it is not advocated to stop taking the drugs suddenly. Usually… The doctor will then adjust the effective drug to the effective dose range and decide whether to add other drugs according to the symptoms.
9. Discontinuation process is too short
When the patient’s seizures are completely controlled for 2 to 5 years and the EEG is normal, the medication can be considered to be discontinued gradually. However, the patient’s status should be closely observed during the discontinuation process, and the EEG should be rechecked regularly. If there is no clinical seizure and the EEG is normal, the dosage can be gradually reduced until it is completely discontinued. If seizures occur again during or after the dose reduction, antiepileptic treatment should be restarted.
In conclusion, epilepsy is a chronic disease, but it is by no means uncontrollable. Many of the world’s great men and women with extraordinary achievements, such as Nobel, Napoleon, and Lincoln, were epileptic, and their talents and achievements were not ruined by their illness. The majority of patients with epilepsy can be cured clinically and no longer have seizures after withdrawal of medication. 20% of patients with intractable epilepsy that is not well controlled by medication can also be treated surgically. With the development of imaging and neurophysiological techniques, the localization of epileptic lesions is becoming more precise and the efficacy of surgery is gradually improving.