The management of epilepsy has improved considerably over the past two decades but, despite this, a number of problems remain. They have already been alluded to in this text, but it may be of use to summarise them.
Polypharmacy (more than one anticonvulsant). It is worth repeating that the majority of people with epilepsy can be well controlled on one drug only (monotherapy). Naturally there are people with severe or complicated seizures who will need more than one medication. However, it is desirable to be on as little medication as possible.
Blood level monitoring. This has been a very useful advance in the management of epilepsy. There is a risk that doing a blood level may become an end in itself. If you feel that you are having too many blood levels done, ask your doctor what is being achieved. Do not let blood level results become a substitute for conversation and asking questions.
Non-compliance. If you are not taking your medication, be honest and tell your doctor. In a condition like epilepsy there is always a reason for people not taking their medication. It may be that you cannot see the value of taking medication because you have very few fits or perhaps because you have not understood the importance of taking the drugs regularly. If you are honest and tell your doctor that you are not taking your medication and you get a hostile reception, it is probable that he or she does not understand how you see things. A change of doctor may be desirable.
Should all seizures be eradicated? It is the right of epileptics, provided they are not in an occupation where harm might come to others, to decide on the degree of seizure control which they find acceptable. It is not, in my view, the prerogative of the doctor to insist on complete seizure eradication. This is a matter of consensus between patient and doctor which should be reached intelligently. To achieve this takes time and communication with your doctor.
Education. There is an ongoing need for education about epilepsy amongst people with epilepsy, the medical profession and the general public. It is for this reason that Epilepsy Associations exist. By joining your Association you will be helping yourself and very importantly helping the epilepsy cause in general. If you don’t stand up and be counted, the epilepsy movement will remain static, the prejudice and stigma will persist and you will have contributed to this ongoing state of affairs.
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Epilepsy
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