Golden Tips To Treat Epilepsy!
Epilepsy is a medical disorder involving episodes of abnormal electrical discharge in the brain and characterized by periodic sudden loss or impairment of consciousness, often accompanied by convulsions.
Status epileptics refer to a continuous succession of fits occurring without any period of recovery. It may be fatal if not rapidly controlled. It is commoner in buy valium online no script childhood and in patients who have intracranial lesions but it may occur in all types of epilepsy if medication is irregular or is suddenly withdrawn.
• Treatment should be prompt and energetic since status epileptics constitutes a grave emergency. Adequate respiration must be maintained and the fits suppressed.
• Intravenous diazepam is probably the most useful drug for the control of status epileptics. Initially 20 mg should he injected intravenously and this should be repeated at five minute intervals until the fits are controlled; thereafter the drug is given.
• It is better to use one drug, rather than a combination; only if a single drug does not control fits should a further anticonvulsant be added.
• Phenytoin may be combined with phenobarbitone or carbamazepine, though, because of induced hepatic enzymes the serum level of phenytom may be reduced when it is given concurrently with carbamazepine. Primidone and phenobarbitone should not be given together, since primidone is partially converted into phenobarbitone. None of the above drugs is useful in the treatment of petit mal.
• Other drugs, such as diazepam, nitrazcpam and clonazepam can also be used in the treatment of epilepsy.
• All of these drugs may cause drowsiness; they may also cause osteomalacia and folate deficiency resulting in megaloblastic anemia. All have some teratogenic effect, which is probably most marked with Phenytoin. Phenytoin also gives rise to gingival hyperplasia in children and coarsening of features in adults. Rarer toxic effects of phenytoin include lymphadenopathy and a syndrome mimicking systemic lupus erythematosus.
• Ethosuximide is probably the most useful drug in this condition in a dose between 750 and 1500 mg daily. Effective treatment should be guided by serum levels of the drug when possible. Ethosuximide occasionally causes nausea, drowsiness and rarely, leucopenia.
• Sodium valproate is useful in the treatment of grand mal epilepsy, and is particularly effective in petit mal attacks but is of little value in focal epilepsy. It does occasionally cause potentially fatal liver necrosis and accordingly it would seem wise to restrict the use of sodium valproate to those patients who have mixed grand mal and petit mal attacks, and to those patients with petit mal who have not responded to ethosuximide.
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