Exploring the evaluation of antiepileptic drug change in people with intellectual disabilities and high-frequency epileptic seizures: seizure control and sustained responsiveness to the environment.
OBJECTIVE
Optimum antiepilepsy medication should be successful in reducing seizures with minimal adverse effects on the patient's ability to concentrate or general level of awareness. The purpose was to investigate the potential of a method of measuring responsiveness to environmental events as a means of reflecting awareness levels among people with intellectual disabilities undergoing review of medication for high-frequency epileptic seizures.


METHODS
Observations of 22 participants referred to a specialist clinic were conducted three times a month over a 5-month period following the initial baseline measures and clinical intervention. Behavioral responsiveness was measured by calculating the likelihood of appropriate activity occurring given the occurrence of staff interaction. This likelihood was represented by the statistic Yule's Q. Seizure frequency was also evaluated.


RESULTS
Participant responsiveness after drug review was similar to baseline indicating an absence of long-term adverse effects. Participants experienced a significant decrease in seizure frequency.


CONCLUSIONS
It was concluded that drug review led to seizure reduction while behavioral measurement confirmed no loss of responsiveness.
Smith
Clare
C
Welsh Centre for Learning Disabilities Applied Research Unit, University of Wales College of Medicine, Cardiff, Wales, UK.
Kerr
Mike
M
Felce
David
D
Baxter
Helen
H
Lowe
Kathy
K
Meek
Andrea
A
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001288:Attention / Q000187:drug effects; D004185:Disability Evaluation; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D004777:Environment; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy / Q000503:physiopathology; D007361:Intelligence Tests; D008875:Middle Aged; D011446:Prospective Studies; D012107:Research Design; D012919:Social Behavior; D013997:Time Factors; D014705:Verbal Behavior / Q000187:drug effects
D000927:Anticonvulsants