Management

Genetic Epilepsy with Febrile Seizures Plus (GEFS+)
•    Many children do not require daily or long-term antiseizure medication. Families should receive a rescue medicine plan for long febrile seizures and guidance on fever care. Some children need a daily antiseizure medicine if they also have seizures without fever. Physicians may change medications if a medication seems to make seizures worse.

Dravet Syndrome (DS)
•    Common medicines include valproate, clobazam, stiripentol, cannabidiol, fenfluramine, the ketogenic diet, and vagal nerve stimulation. Some antiseizure medications (sodium channel blockers like carbamazepine or lamotrigine) usually make seizures worse in DS and are avoided. Families should receive a seizure action plan with rescue steps including a rescue medication plan for long seizures, how to manage fevers (often NSAIDs are preferred) and how to reduce risks for seizures, seizure-related injuries, and SUDEP, including monitoring.

Familial Hemiplegic Migraine, Type 3 (FHM3)
•    During attacks, pain and nausea medications are used, and many physicians avoid certain migraine medications that tighten blood vessels. To prevent attacks, medications like verapamil, acetazolamide, or lamotrigine may be tried. People learn how to avoid head injuries and when to go to the emergency room if an attack seems different or lasts longer than usual.

Developmental and Epileptic Encephalopathy 6B (DEE6B)
•    Care is intensive and team-based: antiseizure medications, dietary therapy, feeding and breathing support, and physical/occupational therapy. Families receive medical and seizure rescue plans and supportive services. Because some SCN1A changes in DEE6B make the channel over-active, certain medicines that are avoided in DS (called sodium-channel blockers) may help in carefully selected patients.