Epilepsy stroke patient

For nearly 80% of patients with epilepsy, the underlying etiology is unknown.8 The most common recognized causes of epilepsy are head trauma and stroke. Developmental and genetic defects are the cause of about 5% of cases of epilepsy. Central nervous system (CNS) tumors, central nervous system infections, and neurodegen-erative diseases are other common causes. Other important causes of epilepsy are human immunodeficiency virus infection or neuro-cysticercosis infection, primarily occurring in Latin America. 

If the phlegm is pushed by the rebellious Qi, moves upwards and disturbs the sensory orifices of the head, patients will have dizziness, vertigo, tinnitus, deafness, a heavy sensation in the head, possible loss of consciousness, wind-stroke or epilepsy. 

Epilepsy is a clinical diagnosis defined by recurrent seizures. Controversy surrounds the most appropriate time to initiate AED therapy. Many clinicians do not initiate treatment until a second unprovoked seizure has occurred. Some clinicians start AED treatment after the first seizure, whereas others may initiate prophylactic treatment following a CNS insult thought likely to cause epilepsy eventually (e.g. stroke or head trauma). Appropriate treatment decisions may vary depending on individual patient clinical characteristics and circumstances. 

FP is now facing a diagnosis of complex partial seizure disorder. The etiology of his newly acquired epilepsy is unknown, but he believes that it is related to the stroke he recently experienced. An animal lover, he is trying to acquire a seizure dog (a dog that can sense the onset of seizures and warn patients in time to seek care or safety) to take with him on his rural rounds. Regarding antiseizure therapy, FP has his opinions (of course) but is seeking you out to select an anticonvulsant for oral maintenance therapy. Consider the choices below, and advise this practitioner colleague. 

Varoglu AO. Na VPA-induced acute ischemic stroke in an epileptic patient with methylenetetrahydrofolate reductase gene polymorphism. Epilepsy Res 2009 86(2-3) 232-6. 

Hsieh CY, Lai EC, Yang YH, Lin SJ. Comparative stroke risk of antiepileptic drugs in patients with epilepsy. Epilepsia January... 

IgG leakage IgG leakage from serum into the nervous tissue can be used as a marker of altered vascular permeability Detection of IgG leakage can be used to determine BBB disruption in experimental models [17, 51, 52] as well as in humans [16-18,53] Model of HIV-1-associated nemocognitive disorder [25], stroke [33], epilepsy [30, 34, 35], infectious disease linked to herpes virus or HIV-1 [36], mucopolysaccharidoses [37], patients with mitochondrial DNA disease [38]... 

---