![]() ![]() Routine monitoring of AED levels is not recommended unless clinically indicated. Monotherapy with all indicated AEDs should be attempted before initiating combination therapy. The use of AEDs should be considered only when the benefits of reducing the risk of a second seizure outweigh the risks of an adverse drug effect. Patients planning for pregnancy should know that antiepileptic drugs are possibly teratogenic.Įlectroencephalography should be used to confirm, but not to exclude, a diagnosis of epilepsy.Ĭhildren should not routinely be started on an AED to prevent recurrent seizures after a first unprovoked seizure. Patients who have had a recent seizure within the past three months or whose seizures are poorly controlled should refrain from driving and certain high-risk physical activities. For patients with seizures that are not controlled with these agents, alternative treatments include surgical resection of the seizure focus, ketogenic diets, vagus nerve stimulators, and implantable brain neurostimulators. When patients have been seizure free for two to five years, discontinuation of antiepileptic drugs may be considered. Routine monitoring of drug levels is not correlated with reduction in adverse effects or improvement in effectiveness and is not recommended. The appropriate choice of medication varies depending on seizure type. Delaying therapy until a second seizure does not affect one- to two-year remission rates. In the absence of risk factors, and because many patients do not experience recurrence of a seizure, physicians should consider delaying use of antiepileptic drugs until a second seizure occurs. The risk of adverse effects from antiepileptic drugs is considerable and includes potential cognitive and behavioral effects. ![]() In children, key risk factors are abnormal electroencephalography results, an epileptic syndrome associated with seizures, severe head trauma, and cerebral palsy. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on electroencephalography, abnormal brain imaging, nocturnal seizures, or an epileptic syndrome associated with seizures. Risk of recurrent seizures should guide their use. Goshen Sleep Disorders Center collaborates with other specialists to provide care for nocturnal seizure symptoms in Goshen, IN.The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Working together, our sleep specialists and neurologists can create a plan to improve your sleep and care for your complete well-being. Our experts understand that getting enough sleep is an important part of your health. Talk to your primary care provider about a referral to Goshen Sleep Disorders Center, where you can receive treatment from a board certified sleep specialist.
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