Question

An 8-year-old child experienced foot numbness and whole-body cramps during sleep at night. This symptom has recurred six times. The doctor diagnosed it as epilepsy. The parents are confused by this diagnosis, as there is no history of this condition in the family, and they are seeking professional advice.

Answer

For the treatment of pediatric epilepsy, the following principles should be followed:

  1. Provide accurate knowledge to parents, schools, and patients, emphasizing the importance of long-term regular treatment and maintaining regular follow-up.
  2. Arrange reasonable study and living schedules to avoid factors that may trigger epilepsy attacks.
  3. Conduct etiological treatment.
  4. Use antiepileptic drugs or surgical treatment. Principles for the use of antiepileptic drugs:
  5. After a clear diagnosis, antiepileptic drugs should be used as soon as possible in conjunction with etiological treatment.
  6. Select medications based on the type of epilepsy attack .
  7. Mainly use single-drug treatment to avoid the simultaneous use of multiple drugs.
  8. Understand the metabolic characteristics, dosage range, and toxic side effects of major antiepileptic drugs.
  9. Start medication with 1/2 to 2/3 of the dose and gradually increase the dosage.
  10. Continue medication for 2 to 4 years after the last seizure.
  11. Avoid self-adjusting dosages, sudden discontinuation of medication, etc.
  12. If there are adverse reactions or signs of poisoning during treatment, monitor blood drug concentrations and adjust medications under medical guidance. Treatment for status epilepticus:
  13. Conduct etiological treatment.
  14. Maintain airway patency.
  15. Protect brain function by providing hypertonic glucose to reduce brain edema after convulsions.
  16. Stop convulsions: lorazepam is the first choice.