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DRUGS FOR PARTIAL SEIZURES AND TONIC-CLONIC SEIZURES: SIDE EFFECTS OF CARBAMAZEPINE

admin — Wed, 11 May 2011 13:10:56 +0000

The side effect of carbamazepine that worries most parents (and physicians) is a decrease in the white blood cells, responsible for fighting infection. The normal white blood cell count is in the range of 5000-8000 cells. Children (or adults) who are taking carbamazepine often have lower white cell counts, perhaps 3000—5000. In one in ten such children, this lowering of the white count is temporary; it persists in only two percent. Usually this persistent low white cell count is of no consequence since the child is able to fight infections just as well as anyone else.
If your child has a low white count while on carbamazepine, don’t panic. Sometimes your child’s white count may be low from a viral infection. Your physician may want to repeat the count in five to seven days. If it has come back toward normal, the carbamazepine can be continued. If it has dropped further, the drug may need to be stopped temporarily. Stopping the drug suddenly may cause seizures to recur.
Aplastic anemia, in which the bone marrow stops producing blood cells, is a very rare but serious complication. We are aware of only a few reported cases in children. There appears to be no way to predict if a child will develop this condition. Frequent blood counts are expensive and painful and, besides, we have not found them useful.
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OTHER APPROACHES TO EPILEPSY THERAPY: THE KETOGENIC DIET – IS MY CHILD ELIGIBLE FOR THIS DIET? WILL MY CHILD HAVE TO REMAIN ON THIS DIET FOR LIFE?

admin — Mon, 07 Mar 2011 09:33:19 +0000

“Is my child eligible for this diet?”

The diet appears quite effective in children with myoclonic and atonic (drop) types of seizures, the types most resistant to current medications. However, it can be used in virtually all forms of epilepsy. The diet is not used during the first year of life, because the infant is not capable of maintaining the ketosis. There is no upper age limit to its use, but children over the age of four or five who have normal intelligence may have developed sufficient food preferences and sufficient independence that maintaining the diet can be difficult. We have used it successfully in pre-teens and adolescents when the individual and family are well-motivated.

“Will my child have to remain on this diet for life?”

No. Most children whose seizures are controlled on the diet remain on it for two years. After that time they can gradually be taken off the diet, and the seizures usually do not return, even without additional anticonvulsant drugs.

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OTHER APPROACHES TO EPILEPSY THERAPY: THE KETOGENIC DIET – IS MY CHILD ELIGIBLE FOR THIS DIET? WILL MY CHILD HAVE TO REMAIN ON THIS DIET FOR LIFE?”Is my child eligible for this diet?”The diet appears quite effective in children with myoclonic and atonic (drop) types of seizures, the types most resistant to current medications. However, it can be used in virtually all forms of epilepsy. The diet is not used during the first year of life, because the infant is not capable of maintaining the ketosis. There is no upper age limit to its use, but children over the age of four or five who have normal intelligence may have developed sufficient food preferences and sufficient independence that maintaining the diet can be difficult. We have used it successfully in pre-teens and adolescents when the individual and family are well-motivated.”Will my child have to remain on this diet for life?”No. Most children whose seizures are controlled on the diet remain on it for two years. After that time they can gradually be taken off the diet, and the seizures usually do not return, even without additional anticonvulsant drugs.*146\208\8*

PROBLEMS FOR WOMEN WITH EPILEPSY

admin — Tue, 28 Apr 2009 12:39:28 +0000

The effect of menstruation on seizure frequency. The interaction between anticonvulsant drugs and oral contraceptives. The effects of anticonvulsant drugs on the fetus.

Some mothers report that their seizures become more frequent, others less frequent during pregnancy, and others have seizures which remain more or less unchanged in pregnancy. There seems no way of predicting what is going to happen in the first pregnancy, except that those with very frequent seizures are unfortunately, likely to get worse. By and large, subsequent pregnancies in any one mother follow much the same pattern. An unexpected and totally unexplained finding has been that those pregnant with a male baby are rather more likely to have more frequent seizures. Although epilepsy may start for the first time during pregnancy, this usually seems to be coincidental, and there is no good evidence that pregnancy itself is a

particularly potent event in inducing seizures. One possible reason for an increase in frequency of seizures during pregnancy is that the body processes anticonvulsant drugs differently. The interactions between pregnancy and drug metabolism may be complex.

Some anti-epileptic drugs pass through the placenta into the fetus. Phenobarbitone is perhaps the best-known example. After delivery the baby’s serum phenobarbitone falls, and during the early days after birth the baby may be much more fractious and irritable than most new-born babies.

Many mothers on anti-epileptic drugs wonder whether they can breast-feed their babies. Careful studies have been made on this point, and only small quantities of the drugs are secreted into milk, so it is quite safe to breast-feed.

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