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epilepsy_awareness

 
Epilepsy Awareness Program - Treatment and Care of Epilepsy

Overview:

Epilepsy is a common neurological condition in which a person has a tendency to have recurring seizures. Treatment may include medication, lifestyle changes and surgery. surgical procedures are another dimension in treatment and it can be an option if medication fails to control seizures.
Medication can successfully control seizures in many people. Avoiding known triggers and paying attention to lifestyle issues, such as getting adequate sleep, can also help.

 

The majority of epileptic seizures are controlled through drug therapy, particularly anticonvulsant drugs. The type of treatment prescribed will depend on several factors including the frequency and severity of the seizures as well as the person's age, overall health, and medical history. An accurate diagnosis of the type of epilepsy is also critical to choosing the best treatment.
Treatment aims to prevent seizures, which usually leads to improved quality of life. When the doctor has made a diagnosis of seizures or epilepsy, the next step is to select the best form of treatment. The doctor will usually prescribe regular use of seizure-preventing drugs. If drugs are not successful, other methods may be tried, including surgery, a special diet or vagus nerve stimulation (VNS). The goal of all epilepsy treatment is to prevent further seizures, avoid side effects, and make it possible for people to lead active lives.

Management

 


Epilepsy is usually treated with medication prescribed by a physician. However, it has been stressed that accurate differentiation between generalized and partial seizures is especially important in determining the appropriate treatment.
Neurosurgical operations for epilepsy can be palliative, reducing the frequency or severity of seizures; or, in some patients, an operation can be curative.
In summary, The primary treatment options for patients with epilepsy are medications, surgery and vagus nerve stimulation. The same treatment does not work for every patient because the type and severity of epilepsy varies.

 

Avoiding triggers

In some cases, a very specific trigger such as reading can provoke seizures. In these rare cases, avoiding the trigger may prevent seizures. There are a number of other factors that may provoke seizures in some people. These can vary from person to person. Avoiding or reducing triggers may help to reduce seizures in some people, but not all triggers can be avoided and seizures can still occur without any obvious triggers.

Some possible triggers include:

* Lack of sleep
* Missed medication
* Alcohol
* Certain drugs (prescription and recreational)
* Flickering lights or patterns
* Stress
* Menstruation
* Illness (especially with diarrhoea or vomiting)
* Significant variation in temperature and overheating.


Treatment Options

 


The primary treatment options for patients with epilepsy are medications, surgery and vagus nerve stimulation. The same treatment does not work for every patient because the type and severity of epilepsy varies.

              • For many patients, medication taken regularly and as prescribed will prevent seizures.
              • When medications fail to control or substantially reduce the frequency of seizures, brain surgery may be                 recommended.
              • The ketogenic diet helps some children and adults with epilepsy.
              • Investigational treatments (treatments being tested in clinical trials to determine their effectiveness)                     may be an option for eligible patients.
              • Potential interplay among hormones, seizures and medications may create additional treatment                             considerations for women.

 

What Are the Treatments for Epilepsy?

 


(A) Anticonvulsant medications:

They are used for the treatment of epilepsy. Often, anticonvulsant medication treatment will be lifelong. The choice among anticonvulsants and their effectiveness differs by epilepsy syndrome. Mechanisms, effectiveness for particular epilepsy syndromes, and side effects differ among the individual anticonvulsant medications.

Medications used to treat epilepsy include:

Dilantin or Phenytek
Phenobarbital
Tegretol or Carbatrol
Mysoline
Zarontin
Depakene
Depakote, Depakote ER
Valium and similar tranquilizers such as Tranxene and Klonopin

Felbatol
Gabitril
Keppra
Lamictal
Lyrica
Neurontin
Topamax
Trileptal
Zonegran

 

Side Effects of Epilepsy Drugs:

The occurrence of side effects depends on the dose, type of medication, and length of treatment. The side effects are usually more common with higher doses but tend to be less severe with time as the body adjusts to the medication. Anti-epileptic drugs are usually started at lower doses and increased gradually to make this adjustment easier.
Some examples include double vision, fatigue, sleepiness, unsteadiness, stomach upset and mood changes. Some anticonvulsant medications have "idiosyncratic" side effects that can not be predicted by dose. anticonvulsant medications have unique side effects. These are those that are not shared by other drugs in the same class.


(B) Surgical treatment

Most patients with epilepsy do not require surgery. However, if seizures are not controlled after a trial of two or three medications (usually accomplished within two years) then re-evaluation is suggested. In another words, Epilepsy surgery is an option for patients whose seizures remain resistant to treatment with anticonvulsant medications who also have symptomatic localization-related epilepsy; a focal abnormality that can be located and therefore removed. The goal for these procedures is total control of epileptic seizures, although anticonvulsant medications may still be required.
Epilepsy is sometimes caused by an area of abnormal brain tissue, frequently located in the temporal lobe of the brain. If surgery can remove this tissue, seizures can often be prevented. The success of surgery and the risks of complications differ for each person. Surgery is not intended to be a substitute for medication – it is usually investigated as a treatment option when medication fails to prevent seizures, especially for people with focal onset seizures.


(C) Ketogenic diet

It is one of the oldest treatments for epilepsy and was developed in the 1920s.
It is effective for treating certain types of epilepsy. Specifically, it is used most frequently in children with seizures that have not responded to medical therapy.
The high fat, low carbohydrate and protein diet creates ketones when the body burns fat for a source of energy. This state is known as ketosis and causes changes in body chemistry that may help to control seizures. Children on the diet often will not gain weight or grow much during the time the diet is in use. After that, however, growth is expected and should be carefully monitored.
It is most often recommended for children ages 2 through 10 or 12 years old who have been diagnosed with a generalized type of epilepsy, and who have failed to respond to a variety of drugs. Recent studies have shown that the diet may also be effective in those with partial seizures.
This diet must be carried out under medical supervision.


(D) Vagus nerve stimulation (VNS)

The vagal nerve stimulator is a computerized electrical device similar in size, shape and implant location to a heart pacemaker that connects to the vagus nerve in the neck (it is implanted just beneath the pectoral or chest muscle on the left side of the chest and it is about the size of a stopwatch). it has leads that attach to the vagus nerve in the neck – these leads convey a regular electric pulse up the vagal nerve to the brain. By stimulating the vagus nerve, the brain’s potential to generate or spread abnormal seizure activity can be reduced.
Efficacy has been tested in patients with localization-related epilepsies demonstrating that 50% of patients experience a 50% improvement in seizure rate. Case series have demonstrated similar efficacies in certain generalized epilepsies such as Lennox-Gastaut syndrome.
It is very rare for the VNS to stop someone’s seizures completely but some people have fewer and less severe seizures, which results in an improved quality of life. It can take up to 18 months to achieve maximum effectiveness.
This procedure is not a substitute for medication and is only performed when medication is not effective.
VNS is a very expensive treatment.


(E) Deep brain stimulation (DBS)

It consists of a computerized electrical device implanted in the chest in a manner similar to the VNS, but electrical stimulation is delivered to deep brain structures through depth electrodes implanted through the skull. In epilepsy, the electrode target is the anterior nucleus of the thalamus. The efficacy of the DBS in localization-related epilepsies is currently under investigation.


(F) Complementary therapies

Complementary therapies may help a person with epilepsy by improving overall health and wellbeing. However, research does not suggest that complementary therapies are likely to improve seizure control in most cases. In some situations, they have been shown to trigger seizures.


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Disclaimer: Epilepsy Awareness Program - Treatment and Care of Epilepsy is a personal effort derived from a need to motivate people to share knowledge, specially medical ones as well to find a healthy environment where credible medical information is available and free to be utilized every time and anywhere. we are not responsible for the accuracy of the contents, nor liable for any errors and readers are encouraged to confirm the information contained herein with other sources. Biomedresearches will not be liable for any direct, indirect, Consequential, special, exemplary, or other damages arising from the site. The information mentioned here or in any related pages does not replace the patient/physician relationship.
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See Also: See Also: Epilepsy Diagnosis on the Clinical Practic

See Also: Neurophysiology Health Corner

Back to: Epilepsy Awareness Program

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