Decreasing the Types and Quantities of Oral Antiepileptic Drugs Administered Alongside Intravenous Midazolam

ABSTRACT It is reported that 0.4 to 0.8% of the world’s population suffers from epilepsy. About 30%of epileptic patients are intractable. Controlling their seizures is very important for societybecause many patients can participate in gainful employment. In this case study we reporthow we reduce and/or change the oral antiepileptic drugs (AEDs) taken (AED adjustment)by administering intravenous (IV) AED for an intractable epileptic patient. The patient wasintroduced to our hospital when she was 17 years old. She was born as a premature babyand had been suffering from partial seizures since she was 1 year old. We adjusted heroral AEDs in order to add newer AEDs, but the drugs did not work effectively. Thus, wehospitalized her in order to use continuous intravenous Midazolam (MDL) 0.1mg/kg/hrwhile we adjusted her AEDs. We were able to stop administering four out of five kinds ofAEDs that the patient was taking simultaneously, without exacerbating her seizures. Thiscase suggests that: 1) when intractable epileptic patients are taking a large number of oralAEDs, newer, additional AEDs cannot work effectively, and reducing the number of oralAEDs is crucial in adjusting their oral AEDs; and 2) IV AEDs enable a reduction in theCase Study