Roy G Beran
Introduction: Current attitude to epilepsy management avoids use of blood level determination, a position which may be appropriate in stable situations. Despite this, use of blood levels may have a definite role in managing cluster
seizures.
Background: Cluster seizures are a medical emergency treated with short acting benzodiazepines (BDZ) and longer acting anti-epileptic medications (AEM). Blood levels of the longer acting AEM may assist management
decisions.
Discussion: In an age of individualized patient care, it seems counterintuitive to treat cluster seizures, a medical emergency, with standard dosages and no laboratory evaluation. AEM blood levels allow confirmation of adequate dosage and repeated treatment if the levels are sub-therapeutic. It affords the patient and clinician added insight to improve patient care.