NEUROLOGY
www.specialistforum.co.za
recurrence; it only reduces the risk for the
duration of treatment.
“The First Seizure Trial Group
randomly selected 397 patients with an
unprovoked, generalised tonic-clonic
first seizure to either receive prophylaxis
with a conventional anticonvulsant (i.e.,
carbamazepine, phenytoin, valproic acid) or
to receive no treatment and reported that
about 18% of treated patients had seizure
recurrence within one year, compared with
39% of untreated patients,” Ko said.
Therefore, patients must be told that
anticonvulsants can reduce their risk
of having another seizure, but will not
eliminate that risk.
seizures, avoiding or minimising treatment
side effects, and maintaining or restoring
quality of life. The initial treatment of
epilepsy is with a single antiseizure drug.
With an ever-expanding list of available
antiseizure drugs, and no single antiseizure
drug that is clearly superior in terms of
efficacy or tolerability, clinicians must
individualise the choice of antiseizure drug
for each patient.
References:
David Y Ko, MD Associate Professor of Clinical
Neurology, Associate Director, USC Adult
Epilepsy Program, Keck School of Medicine of the
University of Southern California
Epilepsy South Africa Foundation: Epilepsy: facts and
statistics/Epilepsy medication
Steven Karceski, MD, Initial treatment of epilepsy in
adults. SF
p^=^áÇë=jÉÇáÅ~ä=ÅÜêçåáÅ~äKéÇÑ===N===MRLMRLOMNT===T
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Anticonvulsant therapy
The mainstay of seizure treatment is
anticonvulsant medication. The drug of
choice depends on an accurate diagnosis
of the epileptic syndrome, as response
to specific anticonvulsants varies among
different syndromes. The difference in
response probably reflects the different
pathophysiologic mechanisms in the
various types of seizure and the specific
epileptic syndromes. Some anticonvulsants
(e.g., lamotrigine, topiramate, valproic acid)
have multiple mechanisms of action, and
some (e.g., phenytoin, carbamazepine,
ethosuximide) have only one known
mechanism of action.
Standard treatment for epilepsy
The standard treatment for epilepsy is
the regular use of one or more chemical
substances called antiepileptic or anti-
convulsant drugs/medication. The
management of patients with epilepsy is
focused on three main goals: controlling
The Specialist Forum | Vol. 17 No. 4
13-15 June
2017
8th SA AIDS
CONFERENCE
ICC Durban
www.saaids.com
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The Long Walk to Prevention:
Every Voice Counts
Thirty two years into the HIV/AIDS epidemic and 23 years
into South Africa’s democracy SA still has 288000 new
HIV infections each year. Only 60% of people who are HIV
positive know their status. We have already been on a
long walk with many battles won, but we need to work
harder to stop this epidemic, we
need to walk together to ensure that
22 MAY 2017
our most important asset, young Closing date for
men and women are not being pre-conference
infected, that they and others take
registration
their treatment and that everyone is
treated with dignity. This, the 8th 12 JUNE 2017
South African AIDS conference
On-site
promises to be one that focuses on
registrations
new ideas and brings people
together to begin to end AIDS.
Tel: +27 12 816 9149
[email protected]
WWW.SAAIDS.COM
May 2017
35