Patient: EEG results:Epilepsy. The EEG has been uploaded to you. Today’s EEG was done during a seizure. It proves that your judgment is accurate. What are the oral antiepileptic drugs? What is the treatment? I look forward to hearing from you. Thank you very much! Patient: I’ve been taking carbamazepine for 3 days now, and I haven’t had a seizure. I take 1 capsule 3 times a day, and I peed my pants 4 times this afternoon, is that a side effect of the drug? Patient: Director Shi you looked at the EEG, do you think epilepsy is very serious? Is the current dosage OK? Do you still need to increase the dosage? How long should I stop taking the medicine? Can this kind of epilepsy be cured? Is it necessary to stop taking the medication and gradually reduce the dosage? Thank you from the bottom of my heart on behalf of my family! Patient：Dr. Shi said:{Generally, the duration of the medication is 3 to 5 years for complete control of epilepsy, and then gradually reduce the medication. Elderly people may have to take medication for life for the most part.} Does 3~5 mean 3 days to 5 days? My mother started taking Carbamazepine on the 20th, and today her symptoms are under complete control, she hasn’t had a single seizure, but her speech is less than before, her diet is normal, she takes 1 capsule 3 times a day, can she reduce the dosage now? Patient: Director Shi’s noble medical ethics and exquisite medical skills are really admirable! Patient：My mother has a rash since yesterday. Mainly on the chest and back. Patient: OK, go to the hospital tomorrow to clarify whether it is a side effect of the drug, thank you our savior! Patient: The doctor determined that the rash was caused by the medication, and my mother is now off the medication. I would also like to ask Director Shi, do you have any good treatments for episodic sleep disorder? My son has been suffering from episodic somnolence for 7 years and was diagnosed in Beijing. The treatment is oral Ritalin. Patient: It would be nice to know the name of the medication. Does this new medication have a therapeutic effect? Ritalin has no therapeutic effect on sleepiness, and it would be nice to know if this new drug has a therapeutic effect. Thank you, Mr. Shi. Patient: Mr. Shi, is the new drug you mentioned for treating episodic somnambulism Modafinil? Shi Haisan, Neurology Department, Guangzhou Brain Hospital: Hello, your mother is in the advanced stage of dementia should be clear, the symptoms you described, I did not see myself, there is no corresponding examination, can only guess. The symptoms you describe may be epilepsy? Psychiatric symptoms (subluxation)? Or something else? Suggest to do an EEG to see, if there are epileptic waves, you can take oral anti-epileptic drugs to treat. If there is no epileptic wave, try to treat with low dose antipsychotics or tranquilizers. It is better to do MRI. Shi Haisan, Neurology, Guangzhou Brain Hospital: Oral antiepileptic drugs: Carbamazepine, Valproate, Lamotrigine, Topiramate, Zolpidem, Valium, etc. The first choice is sodium valproate or carbamazepine, and the second choice is valproate. Sodium valproate or carbamazepine is preferred, starting from a small dose and increasing the dose in 3~5 days until the epileptic symptoms disappear. Review the EEG regularly. Pay attention to the side effects of drugs. Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: Sorry, we have not received the patient’s EEG. Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: Common side effects of carbamazepine: rash, nystagmus, excessive sedation, liver and kidney damage. The patient is a person with advanced dementia, and enuresis is also common. Of course, carbamazepine may cause urinary loss due to excessive sedation. This phenomenon can be observed and not treated urgently. Blood concentration should be checked regularly. Shi Haisan, Department of Neurology, Guangzhou Brain Hospital: The efficacy of epilepsy mainly depends on whether the clinical manifestations are under control, has your mother’s symptom improved and relieved? If the symptoms have been controlled, then observe. If the symptoms are not under control, then we should increase the medication until they are completely under control. The EEG should be checked regularly to see if it is normal. Generally, the medication should be taken for 3 to 5 years for complete control of epilepsy, and then gradually reduced. Most of the elderly may need to take medication for life. Neurology Department of Guangzhou Brain Hospital Shi Haisan: I’m sorry, it’s 3~5 years. The neurology department of Guangzhou Brain Clinic is not able to reduce the dosage now. The neurology department of Guangzhou Brain Clinic is also a good source of information about the neurology department of Guangzhou Brain Clinic! Guangzhou Brain Hospital Neurology Shi Haisan: antiepileptic drugs do have the side effect of rash, if it is clear that the drug is caused by the first stopping the drug, and then according to the anti-allergy treatment, such as intramuscular injection of calcium, or Benadryl. Oral anti-allergy medication and topical glycerite lotion. Wait for the rash to subside before trying another anti-seizure medication. Start with a smaller dose. Shi Haisan, Neurology Department, Guangzhou Brain Hospital: If you think it is caused by medication, stop the medication immediately. Give anti-allergy treatment. Wait for the skin diagnosis to subside, and then choose another antiepileptic drug. Shi Haisan, Neurology Department, Guangzhou Brain Hospital: Hi, seizure sleep disorder is not common, I don’t have much experience with it, but I did use Ritalin in the past. But recently I know that there is a new drug specifically for treating seizure sleep disorder, but it is still in clinical research and not fully marketed. I forget what the drug is called. Shi Haisan, Neurology Department, Guangzhou Brain Hospital: It seems to be. I am not sure. Because we don’t have it in our hospital. Patient: description of the condition (main symptoms, onset time) patient is my mother, Alzheimer’s disease for nearly 10 years, the current symptoms; can walk, slow to reflect, urinary and fecal can not govern, at present the more serious is every afternoon or evening clenched fists, close the mouth, with trembling, do not eat or drink do not speak, do not sleep, this symptom sometimes lasts for 10-20 hours, to relieve, lasts for a long time more and more! The symptoms sometimes last for 10-20 hours before they subside and continue for longer and longer periods of time, looking horrible, and only after they subside can they talk and eat. The family is helpless and anxious. If it doesn’t subside in three or four days, it’s life-threatening, it’s horrible. On April 7, 2009, my mother went to Xuanwu and was seen by Director Huiqing, who said it was advanced Alzheimer’s disease, and she was treated with Oracetam injections for 10 days and two boxes of Megaman, but there was no significant effect. I would like to ask the doctor what is the cause of my mother’s severe daily symptoms, how to alleviate these symptoms as soon as possible, and what kind of treatment should be taken? I look forward to your reply. Thank you!!!