Schachter Steven C
Department of Neurology, Harvard Medical School, MA, USA.
Med Clin North Am. 2009 Mar;93(2):343-51, viii. doi: 10.1016/j.mcna.2008.10.001.
The diagnosis and management of patients with epilepsy is often undertaken by pediatricians, internists, and geriatricians (primary care physicians [PCPs]). Although referral to a neurologist may be necessary if the diagnosis of epilepsy is unclear or if the patient does not respond to initial therapy with antiepileptic drugs, PCPs may subsequently follow-up with patients to implement the recommendations of the neurologist. To maximize the likelihood of treatment success, PCPs should supplement antiepileptic drug therapy with patient education and referrals for psychosocial and vocational support when needed. Special considerations are warranted for women of childbearing potential and elderly patients.
癫痫患者的诊断和管理通常由儿科医生、内科医生和老年病医生(初级保健医生[PCP])进行。虽然如果癫痫诊断不明确或患者对抗癫痫药物初始治疗无反应,可能需要转诊至神经科医生处,但初级保健医生随后可对患者进行随访,以落实神经科医生的建议。为了使治疗成功的可能性最大化,初级保健医生应在抗癫痫药物治疗的基础上,对患者进行教育,并在需要时转介患者接受心理社会和职业支持。对于有生育潜力的女性和老年患者,需要特别考虑。