Treating epilepsy

Multidrug therapy

If one kind of medication does not work, a second is added. If the patient's attacks stop, the first medicine is reduced, since most people can be treated with just one type (monotherapy). If the epilepsy is difficult to treat, it might be necessary to try other medicines. However, if additional medicines prove ineffective, the chance of controlling the attacks is reduced.

How does the doctor determine the dosage?

The level of medicine in the blood is often measured to determine its effect on the fits. It is important to remember that therapeutic levels (and their side effects) for epileptic patients are only guidelines and that every patient should be treated individually.

How often should the medicine be taken?

Most medicines given to treat epilepsy are taken in one or two doses a day. No matter how the patient feels, it is important to take the medicine on a regular basis to achieve satisfying results. Forgetting to take it might trigger an attack.

What kind of medicine should be used?

Various medicines are available for different types of epilepsy. Some types are fairly specific, only having an effect on certain kinds of epilepsy, while, in other cases, they have no effect, or might even raise the risk of attacks. In complicated cases of epilepsy, it is often a difficult task for the doctor to find the right treatment.

How to keep a diary of attacks

It is vitally important for patients to make a note of the date and intensity of their attacks. The frequency and severity of fits are the only guidelines to how well a treatment is working. Without this information, it is difficult or even impossible to know whether it is effective or not.

Treatment during pregnancy

Counselling before conception is essential, since, for various reasons, it is important to plan the pregnancy in advance. Mothers suffering from epilepsy run a higher risk (5 per cent compared to about 1 per cent) of giving birth to babies with congenital deformities.

A supplement of folic acid may also reduce the risk, but this has to be given before conception and then every day until birth. In addition, the need for medication generally increases during pregnancy and the dose has to be raised.

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