neuro

Question 1

Valproate (Depakote)

Answer 1

Valproate is an antiepileptic drug (AED) that acts by blocking sodium channels. Valproate is recommended as the first-line treatment of choice for most patients with initial onset JME. It is a broad spectrum antiseizure medication that controls all three seizure types in JME, and has the best established efficacy in JME. Although commonly used, valproate has a number of side effects, including weight gain, hair loss, tremors, GI symptoms, and hepatotoxicity.

Therapeutic level: 50-100mcg/ml

Question 2

Juvenile myoclonic epilepsy (JME)

Answer 2

Juvenile myoclonic epilepsy (JME) is a common type of generalized epilepsy that typically begins in adolescence, characterized by myoclonic jerks, generalized tonic-clonic seizures, and sometimes absence seizures.

Question 3

keppra (levetiracetam)

Answer 3

Therapeutic levels of levetiracetam are 6-20 mg/L in the pediatric patient with a seizure disorder.

Question 4

ketogenic diet

Answer 4

The ketogenic diet is a valuable nonpharmacologic treatment option that should be considered for children with intractable epilepsy (particularly nonsurgical candidates), or as a first-line treatment for specific types of epilepsy (such as GLUT1 transporter deficiency). The diet is also considered when the side effects of anticonvulsant medications are intolerable, have failed, or when allergies preclude their administration.
ideal child is between 2 and 5 years old because the desired steady state of ketosis is easier to maintain. Side effects usually involve abdominal pain and diarrhea (or constipation), vitamin and mineral deficiency, fatigue, slowed growth, and renal stones. This diet continues to show a higher degree of effectiveness than many medications.