Treatment of Epilepsy with Myoclonic Atonic Seizures During the Stormy Phase with Generalised Tonic-Clonic Seizures
Clinical Scenario
About a third of patients with this epilepsy syndrome experience a so-called stormy phase — a period marked by numerous seizures and multiple seizure types occurring in rapid succession. This phase is clinically demanding and frequently involves generalised tonic-clonic seizures alongside myoclonic seizures, and can culminate in non-convulsive status epilepticus.
Stormy phase
Generalised tonic-clonic seizures
Myoclonic seizures
Non-convulsive status epilepticus
Treatment Approach (Partial Overview)
The recommended approach for the stormy phase involves antiseizure pharmacotherapy combined with dietary intervention — with the possibility of an additional anti-inflammatory agent where warranted.
The complete regimen, combination strategy, sequencing, and full clinical guidance are available in the structured protocol.
References
- About a third of patients experience a so-called stormy phase, characterised by numerous seizures and seizure types, often generalised tonic-clonic and myoclonic seizures, culminating in non-convulsive status epilepticus.
- The Delphi consensus recommended valproate and benzodiazepines (either alone or in combination) and the ketogenic diet for treatment during the stormy phase; steroids can also be considered.
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