Topics to Discuss with Your Doctor If You Have Epilepsy
- How confident are we about the diagnosis? Could it be something else?
- What etiologies are suspected and how are they being further clarified?
Precipitants and Precautions:
- What precautions should I take to reduce the chances of a seizure?
- What should I do if a dose of medication is missed?
- What is the role of stress?
- Can I drink alcohol?
- Can the patient take herbs or other alternative medicine treatments?
- What tests are indicated?
- What are the different types of EEG testing and which one is indicated? (e.g. sleep-deprived routine EEG, inpatient video-EEG, ambulatory EEG)
- Is lumbar puncture or pictures of the brain indicated?
- Is a medication necessarily needed?
- Why was this specific treatment selected? What other choices were considered and what are their advantages and disadvantages?
- What can I reasonably expect to achieve by taking this drug?
- What specific side effects should the patient be on alert for? When should the physician be notified? What precautions can be taken to reduce the chances of side effects?
- How does the current antiepileptic drug affect my mood? Are there any alternative medications that may help my mood?
- How long will it take to know that the drug is working?
- Blood levels: When, why and how medication levels should be checked? Discuss schedule and reasoning behind checking blood counts and chemistries.
- Is an extended-release form of the drug indicated?
- What should be done if a medication dose is missed?
- What will be done if the antiepileptic drug doesn't work?
- Drug interactions
- Benefits and deficits of generic vs. brand formulation
- Cost considerations
- How long will the patient be on this antiepileptic drug? Can the drug be discontinued?
- Are there any investigational trials that should be considered?
- Is the patient compliant with medications?
Surgery for Epilepsy:
- Surgical options (e.g., resective surgery, corpus callosotomy, vagal nerve stimulation)
- Am I a candidate for surgical treatment?
- What does an evaluation for epilepsy surgery entail?
- What can be expected from epilepsy surgery?
- What are the risks?
- What is the vagal nerve stimulator?
- Ketogenic diet?
- Do herbal treatments work?
- Acupuncture and relaxation therapy?
- Will epilepsy be a life-long condition? Will medications be needed for the patient?s entire life?
- Risks of subsequent epilepsy in children with febrile seizures.
- What are the chances of recurrence after a single seizure?
- Is the seizure harmful?
- If the patient has been recently seizure-free, what are the chances of remaining seizure free? Can medication be reduced or eliminated?
First-aid (download list of safety tips from seizureli.com) :
- What should the patient or others do if a seizure occurs?
- Does a seizure recurrence necessarily warrant going to the emergency room?
- Should the patient inform the physician about every seizure?
Impact of Epilepsy on Lifestyle:
- What activities should be restricted?
- Can I drive? How long do I need to be seizure-free until driving is permitted?
- Do I need to report information to the state department of motor vehicles? Does the doctor need to do this?
Questions about the psychological impact of epilepsy and its treatments would include:
- What should I do if I feel depressed or anxious? Should I be seen by a specialist for this?
- Is there a risk of lowering of the seizure threshold with a medication that my psychiatrist has prescribed?
- Could mood or behavioral problems be related to an antiepileptic therapy? Is a change in treatment indicated because of this?
- Discuss areas of possible sexual difficulties such as fear of intimacy, lack of sexual drive, difficulty attaining erection or orgasm.
- What do we know about the risk of birth defects with current or future recommended antiepileptic agents?
- What is the nature of the potential birth defects?
- What can be done to lower these risks?
- Can I breast-feed?
- What additional resources are available to help the patient learn more about epilepsy?
- What societies or foundations can help the patient by advocating for legal rights, obtaining insurance, and benefits?