Angelman syndrome refers to the category of those pathologies, the search for effective treatment of which medicine is engaged to this day. The etiological treatment of the disease is in the development stage of various methods and means, many of which have not yet been tested in humans. So for the time being, doctors have to limit themselves to symptomatic therapy, which helps at least somehow alleviate the unenviable situation of children and adults with a puppet syndrome suffering from epileptic seizures, salivation, hypotension and sleep disorders.
So reduce the frequency and strength of epileptic seizures can be with a properly selected anticonvulsant drug. But the whole difficulty is that seizures in patients with AS differ from the usual epileptic seizures in that they are characterized by several types of convulsions, which means that it will be possible to ease the condition by the administration of several drugs at once.
The most popular anticonvulsants used to treat Anghelman syndrome are: valproic acid, topiramate, lamotrigine, levetiracetam, clonazepam and preparations based on them. Less commonly used drugs based on karmazepina, phenytoin, phenobarbital, ethosuximide, as some of them can provoke a paradoxical effect, which is to increase and increase the frequency of epileptic seizures. This happens if the drug is used as part of monotherapy.
For the treatment of salivation, two methods are usually used: medicinal (preparations suppressing the formation of saliva) and operational, consisting in reimplantation of the salivary ducts. But in the case of CA, these methods are considered ineffective, and the question remains open. Parents and those who care for such patients, we have to pay special attention to this moment, since the patients themselves usually do not control salivation, and some simply can not take care of themselves.
Another problem is the short duration of sleep. Often children with Angelman's syndrome sleep no more than 5 hours, which negatively affects the work of the whole organism. Excitable, active children, loving games and communication (even if they try to confine themselves to non-verbal ways), are noticeably tired for the day. To have a good rest, the body needs a sound full sleep, but that's just the trouble with it.
It would seem that to improve sleep in excitable patients should be sufficient drugs with sedative effect (phenothiazines and atypical antipsychotics), calming the nervous system. But in the case of CA, the use of such drugs is fraught with the appearance of negative effects. Therefore, doctors prefer nevertheless to light hypnotic drugs, such as "Melatonin" (a natural hormone drug based on the sleep hormone), which give patients an hour before going to bed in the amount of 1 tablet, and "Diphenhydramine." the frequency of administration and dosage of which is set by the doctor, depending on the condition and age of the patient.
Sometimes patients with angelman syndrome have problems with digestion and stool. To adjust a chair it is possible by means of laxative preparations (it is better than a phytogenesis).
And you can approach the problem differently, as the American doctors did, based on some methods of treating autism, because many of the symptoms characteristic of CA are also characteristic of autism (impulsivity, involuntary movements, repetitive actions, violation of attention, communication problems, etc. .). It was noted that the administration of the hormone secretin, normalizing digestion and stools, positively affects the attention of patients, and oxytocin helps improve the child's cognitive abilities and memory, and correct behavior.
True, some hormones are indispensable here, especially when it comes to children. Angelman syndrome shows behavioral therapy, work with a psychologist and speech therapist (teaching non-verbal ways of communication and sign language). The training of such children should be based on an individual program with the participation of specially trained teachers, a psychologist and parents. Unfortunately, this is not possible everywhere, and families remain alone with their problem.
Since many small patients with CA suffer from low muscle tone and joint problems, much attention is paid to physiotherapeutic treatment. Most often, doctors resort to the use of paraffin applications, electropherosis, magnetotherapy.
Active toning massage and special exercises of physiotherapy will help the sick child after a while to stand confidently on his feet and walk. Especially useful in this regard aquagymnastics, which is recommended in CA in cool water. It increases the tone of the muscles and teaches the baby to own his body, coordinate movements.
The most dangerous symptom in Anghelman's syndrome is seizures, similar to epileptic seizures. This symptom is observed in 80% of patients, which means that all of them should be prescribed effective anticonvulsant treatment.
Treatment of epileptic seizures is carried out with the help of vitamins and anticonvulsants. In Angelman syndrome, accompanied by convulsive syndrome, B vitamins, as well as vitamins C, D and E will be helpful . But prescribing vitamin therapy alone is very dangerous in this case, because uncontrolled intake of vitamins can reduce the effectiveness of antiepileptic drugs and provoke new, more severe and prolonged seizures.
The choice of anticonvulsant drugs and the appointment of their effective dosage should also be handled by a specialist doctor. He also decides whether there will be enough of one drug or the patient will have to take 2 or more medicines for a long time .
For most patients, doctors prescribe valproic acid preparations (Valproic Acid, Depakin, Convuleks, Valparin, etc.), which prevent seizures, improve the mood and mental state of patients.
Valproic acid is available in the form of tablets, syrup and injectable solutions. The most popular drug is the drug of prolonged action "Depakin" in tablets and as a solution for intravenous administration. The dosage of the drug is determined by the doctor individually depending on the weight, age and condition of the patient.
Take the drug during meals 2 to 3 times a day. The average daily dose is 20-30 mg per 1 kilogram of the patient's weight, the maximum is 50 mg / kg per day.
Contraindications. It is not used for violations of the liver and pancreas, hemorrhagic diathesis, hepatitis, porphyria and hypersensitivity to the drug.
Among the side effects can be distinguished hand trembling, digestion and stool, changes in body weight.
"Topiramate" is also a drug of choice in CA. It is made in the form of tablets and is used as a part of monotherapy, and in combination with other medicines.
Method of application and dosage. Take pills inside without regard to food intake. The initial daily intake for adults is 25-50 mg, for children 0.5-1 mg / kg. Each week, the dosage is increased according to the prescription of the doctor.
The drug should not be taken during pregnancy and lactation, as well as with increased sensitivity to its components. The medicine has many different side effects.
Drugs that can be prescribed by a doctor in Angelmann's syndrome: Clomazepam, Rivotril, Lamotrigine, Seizar, Lamictal, Levetiracetam, Keppra, Epitera, and others.
Alternative treatment and homeopathy
Alternative medicine, like homeopathic drugs, certainly differ comparative safety, but here the effectiveness of such treatment in relation to Angelholm's syndrome can be considered controversial.
Although some alternative treatments can still help. It's about stopping epileptic seizures. In this regard, herbal therapy can be quite effective.
A good effect is provided by a medicinal fee based on peony, licorice and duckweed (components are taken in equal amounts). Grasses need to be ground into flour. After 2 weeks from the beginning of the reception, you can notice a significant decrease in the frequency of convulsive attacks.
Useful for cramps and a decoction of lavender (1 tsp for a glass of boiling water). The formulation is boiled for 5 minutes and insisted for half an hour. Take the medicine overnight for 14 days.
Effective for epileptic attacks is considered water (or alcohol) infusion motherwort.
From preparations of homeopathy for the prevention of convulsive attacks in the Angelman syndrome, you can use medicines based on chamomile and motherwort, Acidum hydrocyanicum, Argentum nitricum, Kalium bromatum, Arsenicum album. But it is necessary to consider that effective and safe doses of preparations in each concrete case can appoint only the doctor a homeopathist.