1: Seizure Treatment

Question 1

What medication should be given to all women of childbearing age taking antiseizure medication?

Answer 1

Folate
1 mg for nonpregnant women
4 mg for pregnant women

Question 2

T/F There is very little difference between namebrand and generic anti-seizure medication.

Answer 2

False. There is a statistically significant difference in bioavailability between brand and generic. Patients may have breakthrough seizures if switched. It could possibly occur with a generic-to-generic switch as well.

Question 3

T/F Antiseizure medication is very specialized and reserved for people with seizures.

Answer 3

False. Many are used for medical purposes other than seizures.

Question 4

How much estrogen is recommended for women on antiseizure meds?

Answer 4

At least 50 µg. Backup method still recommended.

Question 5

When would you use antiseizure medication prophylactically?

Answer 5

In patients predisposed to seizures:
Brain tumors
Vascular malformations

Question 6

T/F Antiseizure meds affect birth control other than just oral.

Answer 6

True

Question 7

Which antiseizure medications interact the most with oral contraceptives (6)?

Answer 7

Phenytoin (Dilantin)
Phenobarbital
Carbamazepine (Tegretol)
Topiramate (Topamax)
Oxcarbazepine (Trileptal)
Lamotrigine (Lamictal)

Question 8

T/F Women on antiseizure medication should breast-feed.

Answer 8

True. Infants were already exposed in utero, so the amount in breast milk will have less effect.

Question 9

What is the most common surgery for epilepsy?

Answer 9

Temporal lobectomy

Question 10

T/F Some neurologists say those with simple partial seizures are okay to drive.

Answer 10

True

Question 11

What medication interaction is a concern for women who have seizures?

Answer 11

Many anti-seizure medications interact with oral contraceptives.

Question 12

Which antiseizure med is the most teratogenic?

Answer 12

Valproic acid

Question 13

When do you usually start seizure medication?

Answer 13

After the second unprovoked seizure.

Question 14

What are the two treatment options for epilepsy?

Answer 14

Antiseizure meds

Surgery

Question 15

All antiseizure medications have an FDA warning for what?

Answer 15

Suicide risk. Data suggests this is more from the condition than just a side effect of medication.

Question 16

A lesionectomy is used to remove what (3)?

Answer 16

Cortical dysplasia
Cavernous malformation
Tumors

Question 17

What are the two most common seizure medication related birth defects?

Answer 17

Cleft lip

Cleft palate

Question 18

T/F Women on antiseizure medication must be counseled on birth defects. If they become pregnant, they should discontinue the medication until after delivery.

Answer 18

False. They should be counseled, but the benefits outweigh the risks. A seizure could lead to hypoxia in the fetus.

Question 19

Name surgical treatment options for epilepsy (5).

Answer 19

Temporal lobectomy
Lesionectomy
Multiple subpial transection
Corpus callosotomy
Hemispherectomy