Epilepsy

“Epilepsy is a complex neurological condition that requires more than just a prescription medication as a treatment. I evaluate each person’s case and situation as an individual and work to manage their epilepsy to optimize their long-term health, safety, and independence.”

- Dr. Lawrence Seiden

What is Epilepsy?

Epilepsy is a neurological condition of the brain that produces brief disturbances in the normal electrical functions of the brain which causes seizures. That is why epilepsy is sometimes called a seizure disorder. 

Someone is said to have epilepsy if they experience two or more unprovoked seizures separated by at least 24 hours or after one seizure with a high risk for more.

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Diagnosing Epilepsy

The primary tool for a doctor to diagnose Epilepsy is a detailed medical history with as much information as possible about what the seizure looked like and what happened just before it began. 

A secondary tool is an EEG, electroencephalograph. This machine records electronic brain waves via wires taped to a patient’s head. The electric signals from brain cells are recorded as wavy lines by the EEG.

Imaging methods such as CT, computerized tomography, or MRI, magnetic resonance imaging, scans can help a doctor search for growths, scars, or other physical conditions in the brain that may be causing the seizures. 

Preventing Additional Seizures

The most important factor in deciding whether to begin drug treatment for a single seizure is the probability of future seizures. 

When a child or adult has a seizure for the first time it should be immediately followed by a visit to a doctor to review their medical history and recommend a treatment plan. Non-medical issues, such as restrictions to driving or potential impacts on employment, may also be considered. 

A person with Epilepsy can help control their likelihood of having a seizure by taking the prescribed medication recommended by their physician in a class of medications called Anti-Seizure Drugs, maintaining regular sleep cycles, avoiding excessive alcohol consumption, and avoiding unusual stress. However, seizures may occur even when someone is doing everything he or she is supposed to do.

CLASSIFICATION OF SEIZURE TYPES, BASIC VERSION

Treating Epilepsy

No Seizures, No Side Effects – that is the goal of Epilepsy treatment.

Treatment Options

Epilepsy experts, called epileptologists, can help you explore treatment options. Physicians use a variety of methods to treat Epilepsy including drugs, surgery, and special diets. Drug therapy is the most common and usually the first method tried. 

 

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Medication

Seizure preventing drugs are also known as anti-seizure drugs or anticonvulsants. They do not work properly until they reach a certain level in the body and that level has to be maintained. There are more than 30 anti-seizure drugs currently approved to treat Epilepsy. About 6 in 10 people may control their seizures with the first or second medicine they try. 

Surgery

Certain types of surgery may be used for people whose seizures do not respond to medication. Surgery may be recommended when a seizure focus can be found and removed without hurting vital functions like speech or movement.

Vagus Nerve Stimulation (VNS)

A small device (generator) is implanted under the skin in the left side of the chest. A small thin wire or electrode goes from the generator and is attached to the vagus nerve in the neck. VNS may be an option if surgery doesn’t work or is not right for you. The benefits of the VNS appear to improve over time. For example, about 45% of people have seizures decreased by 50% or more within one to two years.

Responsive Neurostimulation (RNS)

A device to treat seizures that is implanted under the scalp in a small area of the skull or bone surrounding the brain. One or two wires from the device are placed under or on the surface of the brain where seizures start. The device is able to sense a seizure and sends small pulses of electrical current through the wires to help stop or lessen seizures. RNS also may help people who can’t have surgery or when surgery doesn’t work well enough. Like the VNS, the RNS does not cure epilepsy and it may not work right away. Yet it can help stop or lessen the number of seizures a person has by 40% to 60% after one to three years.

Deep Brain Stimulation (DBS)

DBS is a newer type of device that also helps control seizures when surgery doesn’t work or cannot be done. Electrode wires are placed in a specific area of the brain. The device is programmed, like VNS, to give stimulation to interrupt or stop seizures.

Dietary Therapies 

Dietary therapies can help control seizures in both children and adults, although they are used primarily in children and infrequently or rarely in adults. They are usually used when seizures do not respond to medicine. The most common diet therapy is the ketogenic diet. This is a medically supervised high fat and low carbohydrate diet. There are other diets that can help control seizures in some people, such as Medium-chain triglyceride diet (MCT), Modified Atkins Diet (MAD), and Low Glycemic Index Treatment (LGIT). Most people who use a diet therapy continue taking medicine.

Living with Epilepsy

Understanding & Managing Triggers

Management Tools

Triggers

There are a number of tools you can use to help you manage your seizures such as:

  • Seizure event diary – note the time of day, what was taking place at the time of the seizure, describe the environment, and note what commonly reported triggers were present. Share and discuss your seizure diary with your doctor.
  • Seizure action plan – have a plan for yourself and your caretakers for when a seizure occurs.

A trigger is something that occurs fairly consistently before seizures and more often than by chance. Modifying your lifestyle to reduce or eliminate triggers is an important part of seizure preparedness. Some lifestyle modifications may involve a change in behavior, environment, or schedule. Discuss your plan with your doctor or health care professional for the best outcome. Below are some common triggers and ideas on how to manage them.

Communicate with Your Medical Team

When you review your Epilepsy with your doctor, he or she should:

  • Ask at each visit how many different types of seizures you have and how often you have each type. If you are not seizure free, your health care provider should discuss a change in treatment to improve seizure control or why a treatment change is not indicated or needed.
  • Ask at each visit whether you have any medication side effects and then takes steps or actions to improve them.
  • Review at each visit the cause of your epilepsy or the name of your epilepsy syndrome.
  • Discuss each year seizure safety that is relevant to your type of seizures, your age, and other circumstances.
  • Ask about depression, developmental problems, or similar problems at each visit.
  • Discuss the effects of seizure medication on pregnancy each year if you are a woman who could get pregnant.
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FAQs & Resources for Patients

FAQs

Resources for Patients and Caregivers

Check out our list of resources that we recommend to our patients and caregivers.