Epilepsy Treatment

Most people can manage epilepsy. Your treatment plan will be based on severity of symptoms, your health, and how well you respond to therapy. Some treatment options include: Anti-epileptic (anticonvulsant, antiseizure) drugs: These medications can reduce the number of seizures you have

What is epilepsy?

Epilepsy is a chronic disorder that causes unprovoked, recurrent seizures. A seizure is a sudden rush of electrical activity in the brain.

There are two main types of seizures. Generalized seizures affect the whole brain. Focal, or partial seizures, affect just one part of the brain.

A mild seizure may be difficult to recognize. It can last a few seconds during which you lack awareness.

Stronger seizures can cause spasms and uncontrollable muscle twitches, and can last a few seconds to several minutes. During a stronger seizure, some people become confused or lose consciousness. Afterward you may have no memory of it happening.

There are several reasons you might have a seizure. These include:

  • high fever
  • head trauma
  • very low blood sugar
  • alcohol withdrawal

Epilepsy is a fairly common neurological disorder that affects 65 million people around the world. In the United States, it affects about 3 million people.

Anyone can develop epilepsy, but it’s more common in young children and older adults. It occurs slightly more in males than in females.

There’s no cure for epilepsy, but the disorder can be managed with medications and other strategies.

What are the symptoms of epilepsy?

Seizures are the main symptom of epilepsy. Symptoms differ from person to person and according to the type of seizure.

Focal (partial) seizures

A simple partial seizure doesn’t involve loss of consciousness. Symptoms include:

  • alterations to sense of taste, smell, sight, hearing, or touch
  • dizziness
  • tingling and twitching of limbs

Complex partial seizures involve loss of awareness or consciousness. Other symptoms include:

  • staring blankly
  • unresponsiveness
  • performing repetitive movements

A few of the most commonly reported triggers are:

  • lack of sleep
  • illness or fever
  • stress
  • bright lights, flashing lights, or patterns
  • caffeine, alcohol, medicines, or drugs
  • skipping meals, overeating, or specific food ingredients

What causes epilepsy?

For 6 out of 10 people with epilepsy, the cause can’t be determined. A variety of things can lead to seizures.

Possible causes include:

  • traumatic brain injury
  • scarring on the brain after a brain injury (post-traumatic epilepsy)
  • serious illness or very high fever
  • stroke, which is a leading cause of epilepsy in people over age 35
  • other vascular diseases
  • lack of oxygen to the brain
  • brain tumor or cyst
  • dementia or Alzheimer’s disease
  • maternal drug use, prenatal injury, brain malformation, or lack of oxygen at birth
  • infectious diseases such as AIDS and meningitis
  • genetic or developmental disorders or neurological diseases

How is epilepsy treated?

Most people can manage epilepsy. Your treatment plan will be based on severity of symptoms, your health, and how well you respond to therapy.

Some treatment options include:

  • Anti-epileptic (anticonvulsant, antiseizure) drugs: These medications can reduce the number of seizures you have. In some people, they eliminate seizures. To be effective, the medication must be taken exactly as prescribed.
  • Vagus nerve stimulator: This device is surgically placed under the skin on the chest and electrically stimulates the nerve that runs through your neck. This can help prevent seizures.
  • Ketogenic diet: More than half of people who don’t respond to medication benefit from this high fat, low carbohydrate diet.
  • Brain surgery: The area of the brain that causes seizure activity can be removed or altered.

Research into new treatments is ongoing. One treatment that may be available in the future is deep brain stimulation. It’s a procedure in which electrodes are implanted into your brain. Then a generator is implanted in your chest. The generator sends electrical impulses to the brain to help decrease seizures.

Another avenue of research involves a pacemaker-like device. It would check the pattern of brain activity and send an electrical charge or drug to stop a seizure.

Minimally invasive surgeries and radiosurgery are also being investigated.

Medications for epilepsy

The first-line treatment for epilepsy is antiseizure medication. These drugs help reduce the frequency and severity of seizures. They can’t stop a seizure that’s already in progress, nor is it a cure for epilepsy.

The medication is absorbed by the stomach. Then it travels the bloodstream to the brain. It affects neurotransmitters in a way that reduces the electrical activity that leads to seizures.

Antiseizure medications pass through the digestive tract and leave the body through urine.

There are many antiseizure drugs on the market. Your doctor can prescribe a single drug or a combination of drugs, depending on the type of seizures you have.

Common epilepsy medications include:

  • levetiracetam (Keppra)
  • lamotrigine (Lamictal)
  • topiramate (Topamax)
  • valproic acid (Depakote)
  • carbamazepine (Tegretol)
  • ethosuximide (Zarontin)

These medications are generally available in tablet, liquid, or injectable forms and are taken once or twice a day. You’ll start with the lowest possible dose, which can be adjusted until it starts to work. These medications must be taken consistently and as prescribed.

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