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Treatment Of Epilepy And Seizures

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Updated May 16, 2014

Do you know what is the correct treatment of epilepsy and seizures? There variety of treatment options available, and the use of a particular treatment depends on the type of seizures you are having and other co-existing conditions.

To treat a seizure disorder, your healthcare provider will perform a battery of tests in order to discover what may be causing your seizures. These tests would include an EEG, or electroencephalogram, blood tests, lumbar puncture, brain imaging, and a detailed medical history. Depending on the results, your seizures may be treated with medication, with surgery, or by removing the cause of the seizure.

There are many causes of seizures and epilepsy that can include:

  • a stroke
  • trauma to the head and brain
  • certain medications
  • fever
  • alcohol withdrawal
  • a tumor in the brain
  • an infection
  • certain metabolic conditions (like low blood sugar, low sodium, or low calcium levels)
  • neurodegenerative diseases (like Alzheimer’s disease or Parkinson’s disease)
  • inherited condition

Removing The Cause

Some seizure disorders can be treated if the source of the seizures is removed. An example of this would be certain metabolic conditions, like low blood sugar, low sodium, or low calcium levels. In this case, correcting the metabolic imbalance can usually treat seizures. For instance, if an individual had low blood sugar, giving them sugar would usually stop the seizures from occurring. Additionally, high fevers may cause seizures. In most cases, reducing the temperature and breaking the fever usually prevents the seizures from recurring.

Treating With Medications

Many medications, also known as anticonvulsants, can be used to treat and prevent seizures. Some of these medications have been on the market for a while, whereas others are fairly new. In any case, your healthcare provider will select the medications used to treat your epilepsy and seizures based upon the type of seizures you are having, in addition to any other conditions you may have or your ability to tolerate the medication.

The anticonvulsants include:

  • Phenobarbital
  • Dilantin (phenytoin)
  • Depakote (valproic acid)
  • Tegretol (carbamazepine)
  • Gabitril (tiagabine)
  • Neurontin (gabapentin)
  • Topamax (topiramate)
  • Keppra (levetiracetam)
  • Lamictal (lamotrigine)
  • Felbatol (felbamate)
  • Trileptal (oxcarbazepine)
  • Lyrica (pregabalin)
  • Zonegran (zonisamide)
Each drug is discussed in detail in a separate place on this site. Your healthcare provider will assess the effectiveness of the drug by checking the amount of the medication in your blood and the number and type of seizures you are having, if any.

Surgical Treatment

If the medications do not seem to control the seizures, surgical treatment may be warranted. Although this is rare, some surgical procedures can reduce, if not eliminate, the number of seizures experienced. Surgeries can include:
  • removing the offending area of the brain
  • removing a hemisphere, or one side of the brain
  • cutting the nerves that connect the two hemispheres, or sides, of the brain.
These surgical interventions involve removing the part of the brain identified as the source of the seizures or the fibers connecting the two hemispheres of the brain.

Other Treatments

While medications are the primary way that seizures are controlled, other treatments have shown favorable results when treating epilepsy. While no one really knows how they prevent seizures, they do work:
  • The ketogenic diet is a special diet that consists of a high amount of fat and carefully controlled, but very limited, intake of sugar and protein. While this diet is very limited in what you can eat, it has been effective in controlling, if not curing, seizures.
  • Vagal nerve stimulation involves the surgical placement of an electrode in the brain that fires periodically to prevent a seizure from occurring.

Source:

Costello DJ, Cole AJ. Treatment of acute seizures and status epilepticus. J Intensive Care Med. 22(6):319-47.

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