Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Sita Jayalakshmi
Scientific Tracks Abstracts: J Pediatr Therapeut
Majority of epilepsies start in childhood. Appropriate diagnosis and management is essential to improve quality of life in these children. Syndromic approach to epilepsies is useful in the management of epilepsies in children. The anti-epileptic drug (AED) of choice is based on its effectiveness in controlling seizures, adverse effect profile, pharmacokinetics, drug interactions and cost. Phenobarbitone is the drug of choice for neonatal seizures. Intermittent clobazam is useful for prophylaxis in the management of febrile convulsions while continuous use of phenobarbitone and valproate is recommended in complex febrile convulsions. ACTH is the drugs of first choice in all cases of west syndrome except in tuberous sclerosis while Vigabatrin is preferred in Tuberous Sclerosis. Treatment with AED is not required in children with benign rolandic epilepsy when seizures are infrequent. Sodium valproate is the most effective drug in most cases of idiopathic generalized epilepsies - childhood absence, Juvenile absence and Juvenile myoclonic epilepsies, but it may cause weight gain, hair loss, and menstrual irregularities and has a higher incidence of fetal teratogenicity. Therefore, lamotrigine may be preferable in adolescent girls. In partial seizures oxcarbazepine, carbamazepine, phenytoin or phenobarbitone may be used and in uncontrolled epilepsies add on therapy of Lamotrigine, Levetiracetam and Topiramate helps in achieving seizure control. Early surgery is recommended in carefully selected patients with refractory partial epilepsy while simple and rational combinations of two or three AEDs may be given in children with refractory epilepsy who are not suitable candidates for surgery.
Sita Jayalakshmi is at present working as senior consultant neurologist at Krishna Institute of Medical Sciences, in Hyderabad, India. She worked as Additional professor of Neurology at NIMS, Hyderabad till April 2010. Has special interest in epilepsy and co-ordinates a comprehensive epilepsy surgery care programme at KIMS. Their group has performed more than 400 epilepsy surgeries with a favorable outcome. Academic and research interests: Sita Jayalakshmi always has maintained a keen academic & research interest in Epilepsy and Neurophysiology and has publications in national and international journals like Seizure, Acta Neurologica Scandinavica, Neurology India also contributed chapters to textbooks in Neurosciences.