Mental health articles

Medical treatment of seizures in people with intellectual disabilities is the
same as for people without intellectual disabilities. However, it might be
more difficult to achieve control over the seizures. The seizures may also be
more severe and more frequent.
Often a person with intellectual disabilities and epilepsy has physical
disabilities and mental health problems. The stigma associated with disability
can cause the person to have low self-esteem and bring about psychological
problems.
A comprehensive assessment of social (e.g. culture, interests and lifestyle),
environmental (e.g. stress) and medical aspects of the person’s life
(e.g. past and present medical history, sensory problems, special medical
conditions) is necessary to determine an appropriate intervention plan.
Recording of seizures and ongoing events is also very important in
order to determine the nature of the epilepsy and its causes (e.g. when the
seizures started, how long they lasted for, how frequent theywere etc.) and
to monitor the effectiveness of any interventions made.
Biological interventions
There are many different types of medication available now to help
manage epilepsy, and the carefully planned use of these is very important
for controlling the seizures. The doctor will try to find the most suitable
medication and dose to prescribe.
Different types of anti-epileptic medication (also known as anticonvulsants)
treat different types of epilepsy. The basic principles of treatment
are the same as for people without intellectual disabilities.
Medication is started at a low dose and slowly increased to a dose
which controls the epilepsy. However, if it is severe epilepsy then more
than one type of medication might be needed. Withdrawal of medication
should be done gradually, as stopping the medication suddenly can cause
uncontrolled seizures.

It is important that you keep a record of seizures and that you bring this
to the clinic. It may be that seizures tend to occur at a particular time. Medication
can be altered to overcome this. Some women experience increased
seizures around periods and may need extra medication at this time.
The combination of anti-epileptic medication with antipsychotics or
antidepressants (see Chapter 4 on therapeutic interventions) can increase
seizures. However, it may be necessary in order to treat a mental health
problem or help control behaviour. In such cases the doctor will consider
prescribing a higher dose of anticonvulsants.
Some medicines that you can buy over the counter such as cold cures,
and medicines to treat hay fever, interact with anti-epileptic drugs. You
should therefore always check with the chemist or the doctor before
buying non-prescription medicines.

BLOOD TESTS
Monitoring with blood tests (to check the level of medication in the blood)
may be useful in controlling seizures and controlling side effects. Some
types of medication can only work if they are at certain concentration
levels in the blood stream (e.g. phenytoin) and blood tests can help to
decide the dose of medication to be taken. Some types of medication have
side effects when the level of medication in the blood is too high (e.g.
carbamazepine). With stable epilepsy, some doctors advise an annual
check of blood levels but this is not necessary with all types of
anti-epileptic medication.
Saliva testing may be possible as an alternative to blood testing for
some people.

Tags: seizures