Patients with developmental disabilities (DD) and epilepsy are treated for their seizure type(s) and syndrome just like any other person with epilepsy. Individuals with developmental disabilities are started on an antiepileptic drug(s) as the first-line of treatment.
AEDs are a mixed blessing for patients with DDs as they may be unusually sensitive to the adverse effects of both seizures and medications. For example, the adverse-effect profiles of some older AEDs such as phenobarbital and phenytoin suggest that they should not be considered first-line therapies for adolescents and adults with DDs. The newer AEDs appear to be just as effective as the older ones, but better tolerated in patients with DDs.
Clusters of seizures, prolonged seizures, and status epilepticus are more common in patients with DDs. Therefore, it is important to take AEDs as prescribed every day so as to avoid missing doses of medication and increasing the likelihood of a prolonged seizure. For prolonged seizures the most commonly prescribed medication is rectal diazepam. Also, in some cases of prolonged absence of or partial seizures without significant motor activity, lorazepam under the tongue may be helpful to stop the seizure.