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Epilepsy

Description

An in-depth report on the types, causes, diagnosis, and treatment of epilepsy.

Highlights

Drug Approvals

• Lamotrigine (Lamictal) approved as add-on therapy for primary generalized tonic-clonic (PGTC) seizures, (“grand mal” seizures), in children aged 2 years and older and adults.
• Levetiracetam (Keppra) approved as add-on therapy for treatment of myoclonic seizures in adults and adolescents 12 years of age and older with juvenile myoclonic epilepsy (JME). Levetiracetam was also approved in injectable form as add-on therapy for adult treatment of partial-onset seizures.
• Topiramate (Topamax) approved as generic drug.

Anti-Epileptic Drugs and Birth Defects

• Valproate (Depakene, Depakote) has a significantly higher risk of causing serious birth defects than other types of anti-epileptic drugs (AEDs), according to a 2006 study in Neurology . Researchers recommend that women of child-bearing age use a different type of AED if possible, or use the lowest effective dosage.
• Lamotrigine (Lamictal) use during the first trimester of pregnancy may increase the risk for cleft lip and palate, according to data from the North American Antiepileptic Drug Registry.

Surgery

• Surgery can help eliminate or reduce seizures in patients with severe and intractable surgery, according to a 2006 study in the Journal of Neurosurgery . In the study of 399 patients, 81% had no or few seizures 6 months following surgery. Ten years after surgery, 72% of the patients remained totally or nearly seizure-free.
• Epilepsy surgery may help improve depression and anxiety, suggests a 2005 study in Neurology .

Household Safety

The kitchen and bathroom are two of the most dangerous places in the home for children with epilepsy, according to a 2006 study in the Lancet . Parents should take precautions to prevent burning accidents in the kitchen. Children with epilepsy should never bathe alone. Although all children with epilepsy have an increased risk of accidents, children with severe epilepsy have the highest risk.

• Review Date: 11/15/2006
• Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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