Treatment Outcome for Epilepsy
Epilepsy is a chronic non-communicable disease that affects millions of people globally. It is estimated that the disease affects more than 10.5 million children worldwide (Beyene et al. 2020). Patients with epilepsy experience recurrent seizures and episodes of involuntary movement, which may involve a part of the body or the entire body. In some cases, epilepsy is followed by loss of consciousness and control of the bladder. Seizures originate from excessive electrical discharges in a group of brain cells. Some people experience attacks once a year, while others experience them repeatedly. However, a single episode does not illustrate epilepsy. About a tenth of people have one seizure during their lifetime (Beyene et al. 2020). Therefore, one is classified to have epilepsy if they have two or more unprovoked seizures. Epilepsy has destabilized the health sector in developing countries. Lack of modern diagnostic technology, delay in seeking health care, and illiteracy are among the factors contributing to the high epilepsy rate in developing countries.
Epilepsy is considered non-contagious, although it is associated with many underlying diseases mechanism. The exact cause of epilepsy remains unknown in almost half of the reported cases. However, researchers have divided the assumed causes into several categories. The categories include structural, genetic, metabolic, immune, infectious, and unknown. Epilepsy may occur following a brain tumor, severe head injury, stroke, genetic syndromes, and congenital brain damage. In many cases, epilepsy affects both genders equally. A study conducted among children attending the University of Gondar teaching hospital revealed an equal proportion of female and male patients (Beyene et al. 2020).
Epilepsy can affect children of all races, gender, and backgrounds (Beyene et al. 2020). However, it might be confused with other conditions, especially young children. Health caregivers have to be very accurate to arrive at the right diagnosis. In some cases, children outgrow their seizures as they grow up, whereas the seizures might persist to adulthood. Children with seizures respond well to medication, and they enjoy a normal and active childhood. It is easier to recognize seizures in children when they first occur. However, parents may miss the chance due to a blurred understanding of seizures. Many parents believe that seizures must be convulsive, hence attracting attention. They forget that sometimes seizures may be subtle and very brief where a child undergoes a brief episode of loss of awareness. Several childhood events may be confused with seizures. They include fainting spells, migraine, mental health issues, and daydreaming. Therefore, children need caregivers who can differentiate between epilepsy episodes and other events.
Therapy and anti-epileptic drugs are mostly used to treat and manage seizures (Beyene et al., 2020). The main objective of treating patients with epileptic seizures is to achieve seizure-free life. Therapy, a form of treatment aimed at relieving distress and mental health problem, is recommended for patients with epilepsy. Trained professionals offer therapy, including social workers, psychologists, and counselors. The baseline is that the patient will collaborate with the therapist and identify improvement after a short while. A good example is a drug addict who attends a therapy session. The addict is expected to minimize their drug intake as they progress with the therapy. Therapy may be classified as dual or mono, where monotherapy uses a single type of treatment to treat a certain condition. Dual therapy applies more than one treatment modality. Many patients opt for monotherapy since it minimizes the adverse effects of drug interactions. Additionally, it is less expensive as compared to duo therapy. On the other hand, dual therapy has higher efficacy and meets the desirable response rate. Numerous treatment outcomes are expected with patients with epilepsy. In a study conducted in Ethiopia, about 8% of the participants reported poor adherence to the treatment regimen (Beyene et al., 2020). These patients were under dual therapy and were using anti-epileptic drugs. Despite being under treatment, the patients reported uncontrolled seizures, and more than 48% reported adverse effects from their AED therapy (Beyene et al., 2020).
The adverse effects are clinical symptoms or signs deemed undesirable to the physician or patient. Anti-epileptic drugs have the potential to cause several effects. Patients may experience fatigue, drowsiness, blurry vision, and incoordination (Kaushik et al., 2019). Patients should disclose information about dose-related effects to medical caregivers for further actions. Doctors can revert AED adverse effects through dose reduction or changing treatment modalities (Walker & Ray, 2020).
Several basic principles should be administered for optimal AED administration. Health caregivers should select the appropriate AED therapy for epilepsy syndrome. There is no proven formula for determining the best treatment for epilepsy. However, the treatment approach can be based on the type of epilepsy being treated and patients’ characteristics such as age, sex, and race. The treatment approach for a woman in the hormonal age cannot be the same as that of children. It is important to consider patients’ characteristics and co-morbidities when choosing a treatment modality (Myers et al., 2018). Professionals suggest that AED monotherapy should be applied at the lowest effective dosage to manage seizures easily. Patients depict different various clinical responses during the treatment period. Some respond quickly and positively to treatment, while others respond negatively. Therefore, caregivers should treat epileptic patients based on the clinical response instead of the AED level. Epileptic patients in developing countries fail to access quality care due to the associated costs. Therefore, clinicians should help patients choose the best affordable AED therapy.
In conclusion, successful treatment of epilepsy depends on patient adherence and appropriate AED therapy selection. Adherence is the commitment of a patient to following the guidelines provided by the caregiver. A significant number of patients have poor adherence. Poor adherence in children results from a lack of understanding of the importance of medication, low self-efficacy, and lack of parental guidance. Caregivers should ensure children embrace excellent adherence since it is more likely to result in successful treatment.
References
Beyene, A., Ayalew, A. F., Mulat, G., Simachew Kassa, A., & Birhan, T. (2020). The treatment outcomes of epilepsy and its root causes in children attending at the University of Gondar teaching hospital: A retrospective cohort study, 2018. PloS one, 15(3), e0230187.
Kaushik, S., Chopra, D., Sharma, S., & Aneja, S. (2019). Adverse drug reactions of anti-epileptic drugs in children with epilepsy: a cross-sectional study. Current Drug Safety, 14(3), 217-224.
Myers, L., Trobliger, R., Bortnik, K., & Lancman, M. (2018). Are there gender differences in those diagnosed with psychogenic nonepileptic seizures?. Epilepsy & Behavior, 78, 161-165.
Walker, C. P., & Ray, S. D. (2020). Anti-epileptic medications. In Side Effects of Drugs Annual (Vol. 42, pp. 91-114). Elsevier.
