(4) Laboratory findings. An electroencephalogram (EEG) is the most
important test in the study of epilepsy. Drugs, photic stimulation, sleep, and
hyperventilation may be of diagnostic value. Include skull x-rays, CSF studies, GTTs,
CT scan of the head, cerebral angiograms, and brain stems.
(5) Drug therapy principles. No single drug is effective for all types of
seizures. The person may require several drugs. Begin treatment with the smallest
effective dose and increase the dosage until the seizures are controlled or until the
person experiences side effects from the drugs. Monitor the person's blood level of
anticonvulsants. For some reason, children often need and tolerate much larger doses
of medication than their age and weight would indicate. Never withdraw anticonvulsant
drugs suddenly. Continue medications for at least five seizure-free years. Alcoholics
experiencing seizures are not helped by anticonvulsant drugs or are of little value.
Medications for specific types of seizures.
(a) Grand mal-focal--psychomotor seizures. The drug of choice for
control of frequent seizures is DilantinR (phenytoin sodium). Watch for side effects.
Possible side effects include gum hypertrophy, nervousness, rash, ataxia, drowsiness,
and nystagmus (involuntary rapid movements of the eyeball). When this medication is
given intravenously, monitor the person's blood pressure every five minutes. Another
drug which can be given is phenobarbital.
Status epilepticus. Give one of the following drugs slowly:
1 ValiumR (diazepam).
2 DilantinR (phenytoin sodium).
3 Phenobarbital sodium.
4 AmytalR (amobarbital sodium).
5 Intractable cases may require general anesthesia.
Remember, when you arrive on the scene of an individual having a seizure, your
quick thinking and management of the situation may very well make all the difference in
the recovery of the patient. Your report on the circumstances of the incident will aid the
doctor in his diagnosis and result in quicker treatment for the patient.