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Diazepam ( Valium ) :

All types especially status epilepticus.

0.3 /kg IV & 0.5 mg/kg rectal per dose.

General rules of use of antiepileptic drugs:

A single drug should be used at first → if seizures not controlled → increase

the dose gradually until:

-Control is achieved or

-The maximum dose reached or

-Side effects appeared.

• If the maximum dose has been reached with no control → check for

compliance:

If non compliance: reassure and educate.

If compliance: do serum level:

•If it is below the therapeutic range → allow to increase the dose till the
serum therapeutic level is reached.

•If after reaching serum therapeutic levels with significant improvement

but not total control → add a second antiepileptic drug.

•If after reaching serum therapeutic levels with minimum improvement

→ withdraw the drug gradually and replace with another antiepileptic.

• If side effects appear, gradually withdraw and replace with another

antiepileptic.

Treatment continues for 2-3 years after the last epileptic attack with weaning

over 3-6 months → never stop anti epileptic drug suddenly → fatal Status

Epilepticus may occur.

Lifelong antiepileptics are given for

Organic epilepsy (cerebral palsy )

Difficult control