ITEMS IN AFP WITH KEYWORD:
In children with drug-resistant epilepsy, a ketogenic diet decreases the risk of seizures by 50% after three to four months.
Children who have a simple febrile seizure and are well-appearing usually do not require routine diagnostic testing. For children with complex seizures, the neurologic examination should guide further evaluation. given the benign nature of febrile seizures, the routine use of antiepileptics is not indicated because of adverse effects of these medications. Antipyretics do not decrease the risk of febrile seizures. Management consists of parent reassurance and education regarding home management of seizures.
In patients with partial-onset (focal) seizures, levetiracetam (Keppra), lamotrigine (Lamictal), and carbamazepine (Tegretol) were associated with the longest time to treatment withdrawal (i.e., the recommended patient-oriented outcome measure that balances tolerability with effectiveness).
Routinely initiating treatment with an antiepileptic after a first seizure is not recommended in part because of the potential for adverse effects. Identifying when patients will benefit from pharmacotherapy or other adjunctive options requires ongoing careful assessment of risk factors.
Feb 1, 2017 Issue
Antiepileptic Drugs After First Unprovoked Seizure [Medicine by the Numbers]
The decision to start an antiepileptic drug after a first unprovoked seizure has long been a clinically challenging one.
Jun 1, 2016 Issue
When to Discontinue Antiepileptic Drug Therapy for Patients in Remission [Cochrane for Clinicians]
Children with epilepsy should be seizure-free for at least two years before stopping antiepileptic drug therapy, especially those who have partial seizures or a history of abnormal electroencephalography (EEG) results.
This guideline from the Academy of Neurology (AAN) provides information on prognosis and management options for unprovoked first seizures in adults.
What are the effects of treatments for typical absence seizures in children?
Nonfebrile seizures may indicate underlying disease or epilepsy. The patient history can often distinguish epileptic seizures from nonepileptic disorders by identifying the events directly preceding the convulsion, associated conditions, and details of the seizure, including triggers, length, and ty...
Febrile seizures are common in the first five years of life, and many factors that increase seizure risk have been identified. Initial evaluation should determine whether features of a complex seizure are present and identify the source of fever. Routine blood tests, neuroimaging, and electroencepha...