Treatment of Seizure Disorders of different types
It is truth that to eliminate the causes of seizure disorders whenever possible is an effective treatment to the disease. However, to correctly identify seizure disorders can be often too difficult. Therefore, appropriate treatment is essential to get seizure disorders under control. Treatments of some common types of seizure disorders are as follow:
Most seizures are not very cruel and they will not last for a very long time, so emergency drug treatment is not needed in terms of this type. Acute seizures and status epileptics are two types of seizure disorders which will last for over five minutes before they begin to calm down. Therefore, drugs are required to make the seizures come to an end as soon as possible. Besides, the patient’s breathing condition should simultaneously be under closed observation so as to guarantee that the patient is exposed to enough oxygen. During the process of taking drugs, IV access and lorazepam are given at a certain rate. Some patients may need to take a larger doses of this drugs, but it should be strictly followed the doctors’ advice because different doses of drugs can sometimes perform in opposite effects. If the dose of lorazepam is up to 8 mg, then another drug, fosphenytoin should be added.
There are different drugs to use to treat different types of seizure disorders. Phenobarbital and phenytoin are effective in treating not only generalized seizures but also simple partial seizures, such as status epilepticus. The average doses of this medicine are 3 to 5 mg per day depending on the constitutions of each patient. And the averaged dose of phenytoin is 4 to 7 mg per day. Both of the medicines can cause a group of signs and symptoms that together which are characteristic or indicative of seizure disorders, such as sedation and ataxia.
Valproic acid is more widely used than the above mentioned two and apart from generalized and partial seizure disorders, it is also an ideal drug treats some myoclonic epilepsies or some mixed seizure disorders. In terms of absence epilepsy, ethosuximide is regarded as one of the perfect choice for the treatment.
Epilepsy surgery is a final choice of treatment for patients who still suffer seizure disorders with any drugs treatment. Before the surgery is done, enough preparation is needed to make it a success. First of all, patients are tested professionally at specialized epilepsy centers. This is an important step because test report can become guidance for the doctor to tell whether surgery can help to control seizure disorders or not. The surgery is performed to help to remove the defect in the brain which is identified as the cause of seizure disorders. The surgery can eliminate seizures or at least relieve the activity of seizures and make them under control. Many people have to take anticonvulsants after the surgery but they can usually take lower doses than they took before. Sometimes, stimulation of the vague nerve serves as one of the treatment of seizure disorders, too
Considerations for treatments of seizure disorders
One of the most important things to take into consideration is the principle of long-term treatment. Different patients need different drugs. Whatever drugs are used, the doses and kinds should be strictly following the doctors’ advice. Otherwise, it will become dangerous to take the drugs because the same drugs can sometimes cause or cure seizure disorders depending on the doses.
Some drugs, such as phenytoin and valproate, can reach the appropriate range very rapidly. Others, such as lamotrigine and topiramate, must begin with a relavely low dose and increase gradually over several weeks before finally reaching to the standard therapeutic dose. As tolerance of the drug varies from individual to individual, the dose of the same drug is not actually the same in different people. If seizures continue, the daily dose has to go up by small increments because too much drugs-taken means more side effects will be created. People’s constitutions differ so some patients may develop toxicity during their drug taking treatment. Reducing the dose is always needed whenever toxicity happens and another drug should be added to operate with the previous drug to fight seizure disorders. Usually, patients who need two drugs treatment must be under close observation. Two-drugs-taken treatment is all in all, much more complicated than single-drug-taken treatment, which can neglect the interaction of the drugs. If two drugs interact too strongly, it can result in metabolic derangement, making the initial, ineffective drug tapered and withdrawn. Therefore, multiple drugs treatment is seldom used to treat due to its high incidence of side effects, poor adherence, and drug interactions.
It is inappropriate to stop taking drugs once seizures are controlled because of the risk of relapse. And patients should continue taking drugs for at least 2 years until they finally become seizure-free. In general, childhood seizure and more than one drug treatment can increase the likelihood for a relapse. In that case, patients need to go to the doctors for further treatment.
When it comes to drugs, no one can deny the fact that adverse drug effects can have negative impact on patients’ health. The most common side effects is an allergic scarlatiniform or morbilliform rash. And neither of them is totally safe during pregnancy. There are some points that patients should keep in mind in order to reduce the adverse drug effects in the lowest rate. For example, patients taking valproate should have regular liver function tests while patients taking carbamazepine should have CBC monitored regularly for the first year of therapy.
With regard to surgery treatment dealing with the stubborn seizures, extensive testing and monitoring are in great need. And anticonvulsants-taken is needed by some patients depending on their constitutions. Some people need to take this drug to be seizures-free while some people can automatically become seizures-free without taking anticonvulsant. And patients should make it clear which problems they should extremely pay much attention to by asking their doctors. Vagus nerve stimulation, an adjunct to drug therapy, can lead to deepening of the voice, cough, and hoarseness.
Treatment of Seizure Disorders in the Elderly
Appropriate and prompt treatment to seizure disorder plays a crucial role in reducing the pain and trouble it has brought about to the elderly. It is said that treatment can delete 1/3 of patients with epileptic seizures and 1/2 of the frequency of seizures. Although it is often difficult to cure seizure disorders completely, the dream of well-controlled seizures can actually come true by drugs.
General speaking, there are four effective types of treatment of seizure disorders for the elderly. First of all, elimination from the source is proof to be the most effective ways to prevent seizures from attacking the body. Therefore, it is highly recommended that the elderly should learn more about the cause of seizure disorders and the tips to prevent this disease. Secondly, precautions should also be considered if there are patients in a family. Loss of consciousness, strange movement and so on are the typical symptoms of seizure disorders and can be life threatening if they are not dealt with in a right way. The former two are the basic rules of treatment. When seizure disorders do occur, doctors are sure to be the most important people to help. They will prescribe some helpful medicine to the elderly to take regularly in order to get seizures under control. However, if more than two drugs-taken do no difference to the series condition, then surgery will become the final way to treat seizure disorders. But surgery is not the best way to treat seizure disorders in the elderly because the function in the old body is not very well and surgery can increase the risk of death in the elderly.
During the treatment period, the old patients should be taken good care of and never be exposed to injury. Their brains and necks should be under good protection, too. This is because brain is where the seizure disorders are active in. With respect to this, patients can lie on their beds with a pillow under their heads. As some patients cannot stop smacking their tongues when seizures occur, other people can help them by rolling the patients onto the left side to reduce aspiration.
Recently, discussions about the most appropriate time to initiate AED (automated external defibrillator) therapy fail to reach a universal agreement. Different people tend to hold a different view. Some clinicians think that only after a second unprovoked seizure has arisen does the initiate treatment perform its duty while other regard the most appropriate time to initiate AED therapy is after the onset of a first seizure.
In general, the treatment for epilepsy is aim at getting seizures and the side effects out of the patients and returning a high quality life to the patients. Usually, age-related pharmacokinetic and pharmacodynamic changes must be regarded when AEDs are utilized to treat epilepsy in seniors. With lower concentration of circulating plasma proteins of the old, it is likely that the free fraction of circulating AEDs will increase and the benefits to measure free AED levels will be more than those to measure routine total AED levels in seniors.