Risk-Benefit Analysis

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We have an 8-year old who has had two tonic-clonic seizures in the last 18 months. All the tests done after the first seizure (within one day of episode, 18 months ago) were negative (EEG, MRI, etc). The doctor recently did an EEG and found that there were sharp waves in his right temporal area. As a result of this, he has prescribed Topomax. How do we decide if our son should be medicated? Maybe try to run some kind of risk-benefit analysis.

Analysis:

If he takes the medicine, he risks experiencing the side effects from the Topomax. On the otherhand, the probability of additional seizures is reduced. But his rate of seizure occurrence currently is not significant (I guess).

If he doesn't take the medicine, then he will not experience the side effects of Topomax (may be the most significant factor), slightly more susceptible to a significant bodily injury (falling, etc), possible change of brain function (possible reduction of hippocampus size and an increase in the chances of further seizures by modification of brain morphology) by additional seizures.

It appears in this analysis that since he is not experiencing many seizures, that the risk incurred by the Topomox exceeds the risk of not being medicated.

Any Ideas.

Comments

RE: Risk-Benefit Analysis

Submitted by Clunk1234567 on Sat, 2004-11-13 - 14:17

All my scans EEGs MRIs were normal for the first thirty years, i now have brain damage due to a couple of fractures of the skull. You do not decide if your son should be medicated, please tell me you're not holding out on the meds.

"If he takes the medicine, he risks experiencing the side effects from the Topomax. On the otherhand, the probability of additional seizures is reduced. But his rate of seizure occurrence currently is not significant (I guess)".

If untreated epilepy can be a killer, the risk of the big one is there. The "I guess" comment tells me you haven't even bothered to research your idiotic move, and suggests your stupid enough to be holding out on the medication as we speak. This could be the result.

Status Elepticus

You start getting one seizure on top of another with no end in sight.
After a while the bodies irratic breathing causes oxygen supply problems to the brain.
The brain slowly dies.

"If he doesn't take the medicine, then he will not experience the side effects of Topomax (may be the most significant factor), slightly more susceptible to a significant bodily injury (falling, etc), possible change of brain function (possible reduction of hippocampus size and an increase in the chances of further seizures by modification of brain morphology) by additional seizures"

My "slighty significant" falling injuries

Busted teath
Broken legs
Broken kneecaps
Dislocated elbow
Dislocated shoulder
Broken arm
Fractured skull
Another fractured skull
Brain damage
Broken nose
Dislocated jaw

Most "falling" injuries involve the head region, like broken nose, busted teath, and fractures of the skull. Fall on a hard surface and your talking intensive care with serious life threatening injuries Do it in the middle of the road or at the top of stairs and......................

People like you are his greatest danger at the moment, and it will be stupidity like yours that will kill him

All my scans EEGs MRIs were normal for the first thirty years, i now have brain damage due to a couple of fractures of the skull. You do not decide if your son should be medicated, please tell me you're not holding out on the meds. "If he takes the medicine, he risks experiencing the side effects from the Topomax. On the otherhand, the probability of additional seizures is reduced. But his rate of seizure occurrence currently is not significant (I guess)".If untreated epilepy can be a killer, the risk of the big one is there. The "I guess" comment tells me you haven't even bothered to research your idiotic move, and suggests your stupid enough to be holding out on the medication as we speak. This could be the result.Status Elepticus<ul><li>You start getting one seizure on top of another with no end in sight.</li><li>After a while the bodies irratic breathing causes oxygen supply problems to the brain.</li><li>The brain slowly dies.</li></ul> "If he doesn't  take the medicine, then he will not experience the side effects of Topomax (may be the most significant factor), slightly more susceptible to a significant bodily injury (falling, etc), possible change of brain function (possible reduction of hippocampus size and an increase in the chances of further seizures by modification of brain morphology) by additional seizures"My "slighty significant" falling injuries<ul><li>Busted teath</li><li>Broken legs</li><li>Broken kneecaps</li><li>Dislocated elbow</li><li>Dislocated shoulder</li><li>Broken arm</li><li>Fractured skull</li><li>Another fractured skull</li><li>Brain damage</li><li>Broken nose</li><li>Dislocated jaw</li></ul>Most "falling" injuries involve the head region, like broken nose, busted teath, and fractures of the skull. Fall on a hard surface and your talking intensive care with serious life threatening injuries Do it in the middle of the road or at the top of stairs and......................People like you are his greatest danger at the moment, and it will be stupidity like yours that will kill him

All my scans EEGs MRIs were normal for the first thirty years, i now have brain damage due to a couple of fractures of the skull. You do not decide if your son should be medicated, please tell me you're not holding out on the meds.

"If he takes the medicine, he risks experiencing the side effects from the Topomax. On the otherhand, the probability of additional seizures is reduced. But his rate of seizure occurrence currently is not significant (I guess)".

If untreated epilepy can be a killer, the risk of the big one is there. The "I guess" comment tells me you haven't even bothered to research your idiotic move, and suggests your stupid enough to be holding out on the medication as we speak. This could be the result.

Status Elepticus

You start getting one seizure on top of another with no end in sight.
After a while the bodies irratic breathing causes oxygen supply problems to the brain.
The brain slowly dies.

"If he doesn't take the medicine, then he will not experience the side effects of Topomax (may be the most significant factor), slightly more susceptible to a significant bodily injury (falling, etc), possible change of brain function (possible reduction of hippocampus size and an increase in the chances of further seizures by modification of brain morphology) by additional seizures"

My "slighty significant" falling injuries

Busted teath
Broken legs
Broken kneecaps
Dislocated elbow
Dislocated shoulder
Broken arm
Fractured skull
Another fractured skull
Brain damage
Broken nose
Dislocated jaw

Most "falling" injuries involve the head region, like broken nose, busted teath, and fractures of the skull. Fall on a hard surface and your talking intensive care with serious life threatening injuries Do it in the middle of the road or at the top of stairs and......................

People like you are his greatest danger at the moment, and it will be stupidity like yours that will kill him

RE: RE: Risk-Benefit Analysis

Submitted by beautimouslove on Sat, 2004-11-13 - 14:25

right on sister... i am a student rn and i cannot say it like that.... good job.!!!!!

RE: RE: RE: Risk-Benefit Analysis

Submitted by monalisa on Sun, 2004-11-14 - 12:10

Right behind you on this one.What Clunk says in their post summed up very well the gains and the risks that should be considered overall ...

#Can I add this to that post?

Go back and talk to your child's neuro what you are discussing here please ?for your child's sake,and also?

Can I ask that you read the articles on this site that cover all you will need to know about diagnosis to treatment before you do.Then make the decision based on fact not supposition....