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Practical aspects in the treatment of epilepsy
Author(s) -
Abild Kirsten,
Dam Mogens
Publication year - 1983
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1983.tb01533.x
Subject(s) - diazepam , medicine , epilepsy , phenobarbital , pregnancy , sedation , regimen , drug , pharmacokinetics , intensive care medicine , pediatrics , anesthesia , pharmacology , psychiatry , surgery , biology , genetics
The different forms of epilepsy require different treatment, and drug choice depends on certain pharmacological and pharmacokinetic principles. Optimal treatment is based on single drug therapy, if possible, and monitoring of plasma antiepileptic drug levels. Such treatment, together with clinical observations and the cooperation of a well‐informed patient, will achieve the best seizure control. Nevertheless, seizure recurrence or increased seizure frequency is a possibility. When withdrawal of treatment is indicated, it must be done according to certain principles. The possibility of pregnancy must be considered when choosing antiepileptic drugs for fertile women. Drug kinetics are different during pregnancy, and frequent monitoring and adjustment of the regimen are essential. Special care is necessary during delivery because of a higher risk of complications and apparently increased perinatal mortality. Plasma half‐life of antiepileptic drugs may be increased or decreased in newborns. Slow elimination of diazepam contributes a special risk. Breast feeding is safe in most cases, but phenobarbital and diazepam may cause sedation of the infant.