Most physicians agree that a single seizure shouldn’t be treated with medication. Instead, they usually wait until the child has experienced at least two seizures before prescribing medication. The physician’s choice of medication will depend on the type of seizure the child has, the age of the child, how well the drug works, and the possible side effects of the drug. Most doctors prefer to prescribe just one drug (monotherapy) to the child.
The goal of drug therapy is to control seizures with the fewest side-effects possible. Physicians usually begin with a low dose to limit the side effects and gradually increase the dose as necessary. Frequent adjustments in dosage are also needed as the child grows. Be sure to advise teachers and other caregivers of all changes in dosage or drug type when they are adjusted by the physician. You should also discuss the possible side effects of each drug the child is taking.
Anti-seizure information is usually not recorded the first time a child has a seizure because approximately 50 per cent of them will never have another. When a second seizure occurs the chances of having another seizure increases to 80 per cent. For this reason, it is important that the family and physician discuss using anti-seizure medication to prevent further seizures.
Striking a Balance
Families need to find a proper balance between the uncertainty of recurrent seizures and their associated risks, and the possibility of side effects from the medication. If a child is started on medication, it is usually continued for one or two years after seizures have stopped. About 20 per cent of children on medication never have another seizure. Another 20 per cent of children on medication never have difficulty in controlling the seizures that last throughout childhood. It is thought that, for the remaining 60 per cent of children, half will be seizure free after only a year or two. The remainder will have a tough time for several years before seizures stop or are under adequate control.
Since children grow rapidly, regular checkups are important. Children may outgrow their medication dosage. Thus, an increase may be needed. The dosage may need to be adjusted at the onset of puberty. For pre-adolescents and adolescents who are on long term anti-seizure medication, calcium supplements may be recommended. In addition, parents or guardians need to make sure that a medication is being taken as prescribed. If medication needs to be taken during school hours, talk to your child, physician, and the school about how to handle this.