Maintenance therapy of seizures in palliative care

Maintenance therapy of seizures in palliative care depends on the cause and type of seizure, potential benefits and burdens of investigations and treatment, and the patient’s prognosis, preferences and goals of care—see Principles of symptom management in palliative care.

Ongoing antiepileptic therapy may be indicated for patients with palliative care needs who have had multiple seizures, or who have had one seizure and further seizures are likely because of electroencephalogram (EEG) or structural brain abnormalities. Antiepileptics (eg levetiracetam, sodium valproate) may be appropriate—seek specialist adviceLeon Ruiz, 2019. For general information on antiepileptic choice, see the Neurology guidelines; additional considerations are required for patients with palliative care needs (eg suitability for subcutaneous administration).

For patients at risk of subsequent seizures, plan the care of a potential event, see Planning seizure management in palliative care.