Several Problems Worthy Of Attention In The Prevention And Treatment Of Epilepsy

Epilepsy is one of the most common chronic brain diseases and brings great harmfulness to the patients. The course of Epilepsy often lasts many years, with or without treatment, so the management of it needs long-term care. Exploring the problems in the prevention and treatment of epilepsy will improve the prognosis of the disease.Epilepsy is a treatable disease and approximately 70% of it can be made under control by antiepileptic drugs(AEDs).However, there are still about 30% of seizures are refractory to AEDs, which is defined as drug-resistant epilepsy.Therefore, an alternative method for the prevention and treatment of epilepsy is urgently needed. Currently, non-pharmacological epilepsy treatments offer alternative treatment options, of which music therapy has received increasing attention. Studies suggest that music therapy can be effective at reducing epileptiform discharges and/or controlling seizures, providing a new option for clinicians in the treatment of epilepsy. Although the underlying mechanism of music therapy is unknown, it may be related to the theory of resonance, mirror neurons, dopamine pathways and parasympathetic activation. At present, the application of music therapy in the treatment of refractory epilepsy, refractory status epilepticus, Lennox-Gastaut syndrome and other types of epilepsy has been reported in the literature. To summarize the experience in the process of music therapy in epilepsy, it will be beneficial for clinicians to conduct this useful therapy.Currently, the antiepileptic drugs(AEDs) can control approximately 70% of the seizures, but the side effects induced by AEDs may make matters worse for the patients, especially the fatal side effects that may even cause disasters to the patients with epilepsy. Therefore, it is extremely crucial for clinicians to understand the common side effects and to take reasonable measures to avoid the occurrence of the disasters. In this essay, we review the incidence of fatal arrhythmia caused by antiepileptic drugs in recent years and the common AEDs with the potential of leading to sudden cardiac death, including carbamazepine, levetiracetam, lamotrigine, phenobarbitone, et al. The underlying mechanism of this phenomenon is unknown,but it may be related to the change of autonomic nerve excitability, ventricular late potential, myocardial ischemia and hypoxia, et al. The prevention and treatment measures include the evaluation of cardiac function, creatinine clearance rate and plasma concentration of drugs, a reasonable choice of AEDs, and rational treatment methods for the intoxication of AEDs.Febrile seizure (FS) is not any type of epilepsy, but it is easy to develop into epilepsy, especially complex febrile seizure, which is one of the risk factors of epilepsy in children. Therefore, some scholars hold the opinion that drugs may be used to reduce the recurrence of FS and the risk of developing into epilepsy. However, this view is controversial. In this thesis, qualitative and quantitative analysis methods are applicated to evaluate four meta-analyses on the prophylactic use of medications on the recurrence of FS. The results suggest that it should not be routinely recommended the use of antiepileptic drugs or antipyretic drugs to prevent the recurrence of FS.