✓ Evidence Based

Epilepsy Treatment Options & Risks

Epilepsy is a disorder of the nervous system which happens when the brain nerve cell activity becomes somewhat disrupted. There is no particular cure for it, but one is given the opportunity to be treated through a carefully planned seizure treatment.  This condition causes seizures or periods of strange, unusual behavior of the patient. Additionally, epilepsy may cause a strange sensation or even loss of consciousness.

The symptoms of this disorder vary and there are people who, when having an epileptic attack, simply stare while others often twitch legs or arms. When it comes to diagnosing this condition, people are considered to suffer from epilepsy if two or more unprovoked seizures have occurred.

Epilepsy Treatment

Seizures are a dangerous thing, especially if they occur during certain activities that need attention from the person performing them (such as swimming or driving). This is why it is crucial to treat any kind of epileptic seizure, no matter how mild or strong it is.

Treatment for epilepsy

Due to the fact that there is no cure for epilepsy, the goal of the treatments being recommended is to achieve a status that is seizure-free and there are no adverse effects. More than 60% of the total number of patients who suffer from this disorder require anticonvulsants treatment. However, there are still many that experience either adverse effects from these drugs or have refractory seizures from the therapy.

Monotherapy is a desirable treatment since it decreases the chances of adverse effects. Additionally, this treatment is more economical than polytherapy.

People who have seizures go through psychosocial adjustments after diagnosis, so vocational rehabilitation or social help is an addition to the recommended epilepsy treatment. Patients who have experienced having seizures can often fear all the time and anticipate the next seizure moment.

This condition in patients can make them feel different and it is recommended that they see a neurologist or an epileptologist for further workup, but also see a psychologist for complete treatment.

In most cases, doctors start treatment with medication. If these do not help in a case, a surgery or another treatment alternative is offered.

1. Epilepsy Medication

People diagnosed with epilepsy can be recommended to take one anti-seizure medication called anti-epileptic. If this does not help, frequency and intensity of seizures can be controlled by taking various medications, as recommended by the doctor. A doctor will also be the one to advise a patient of the appropriate time to start over or stop taking medications completely.

A cure for epilepsy is not defined, but there are many cases of children who do not experience epilepsy symptoms and can eventually stop using medication for epilepsy. Additionally, many adults who spend two or more years seizure-free can also be advised to discontinue the medication.

The process of finding the right dosage and treatment is very complicated. The factors to be considered are age, genetics, condition, seizure frequency, and seizure complexity.

Medications for seizures can have side effects such as fatigue, weight gain, dizziness, skin rashes, bone density loss, coordination loss, memory issues, and speech problems. In some cases, it may even cause more serious side effects such as suicidal behavior, depression, severe rash or organ inflammation.

This is why it is important to take medication as prescribed and contact the doctor for any changes in medications or any unusual reaction.

2. Epilepsy Surgery

If the seizures originate in a defined area of the brain that does not interfere with vital functions, surgery can be performed to cure epilepsy. In cases where the seizures originate in movement controlling the brain area, the patient may be awake during a certain part of the surgery.

In cases where the parts of the brain cannot be removed in order to remove seizures, doctors may decide to make multiple cuts in the brain (multiple subpial transactions) in order to prevent the seizures from spreading.

After surgery, most of the people continue to take medications for seizures, but a reduced dosage. The dosage can even be gradually reduced until finally stopped.

3. Epilepsy Therapies

There are two most commonly used epilepsy therapies:

Vagus nerve stimulation

This stimulation includes a device implant underneath the chest skin. The wires from this stimulator are connected to a nerve in the neck called vagus.

The device is powered with batteries and sends electrical energy bursts through the vagus to the brain. It is known to reduce seizures by 20-40 percent.

This treatment is usually effective, but most patients still need to take certain medications. There are some side effects that may occur and these involve throat pain, shortness of breath, coughing, and hoarse voice.

Ketogenic diet

A strict diet high in fats and low in carbohydrates can help epilepsy patients. This diet, which is also referred to as the ketogenic diet, helps the body break fats instead of carbohydrates in order to produce energy. Children are known to stop having seizures after a few years of maintaining this diet.

Side effects of this diet include constipation, slowed growth due to deficiencies of nutritional elements, uric acid buildup in blood, dehydration and kidney stones. These occur rarely, mostly in cases where the diet is not properly supervised.

Risk of Recurrence

After the first unprovoked seizure, there is a recurrence risk of 15-70% in the first 2 years. The main factors that can increase this risk are:

  • Abnormal MRI study

A finding of a focal abnormality in limbic or cortical regions indicates a possible substrate for the epileptogenic zone. The risk of recurring seizures here is increased.

  • Abnormal EEG

These include epileptiform discharges, focal slowing, intermittent diffuse slowing, and diffuse background slowing.

  • A partial-onset seizure

There are many reasons for the seizures and many people who suffer from this condition. Even though a specific cure for epilepsy is yet to be found, there are still certain cases where epilepsy seizes to exist and people are free to cut off medication from their daily routine. However, there are still many people out there who suffer from this disorder and they need professional medical help and expertise to determine the right treatment. Epilepsy left untreated can result in accidents and injuries and people who are aware of having this condition are often very concerned about it. Therefore, it is crucial that these patients should be regularly examined and helped by professionals that will help them understand that fear of the next seizure is not good for their health. And finally, the most important thing here is to determine the main cause for the seizures, in order to be able to prevent them from happening or at least set the seizures to a minimum.