Epilepsy treatment mainly aims at epilepsy prevention by negating the chances of further episodes of seizures and at the treatment of the root causes that provoke epilepsy symptoms. Here are some measures implemented to control epilepsy:
- Treating the basic cause of seizures
- Reducing exposure to the factors that provoke seizure episodes
- Treatment in the form of medicines or surgery, depending upon the causes of epilepsy
- Specific treatment plans for individual cases (Treatment is based on the cause of seizures and the patient’s response to particular drugs)
- Multimodal therapy i.e. treatment that involves multiple measures
Epilepsy Treatment – What Needs To Be Done During A Seizure Episode
The abrupt onset of seizures may confuse the patient as well as the people present around him. A few important measures must be taken when one comes across a person experiencing seizures:
- Protect the person from falling down (To prevent head injuries and bone fractures)
- Stabilize the person in order to avoid trauma to his limbs
- Place some cylindrical object (e.g. pen, stick, spoon, etc.) in between the jaws of the person to ensure that he doesn’t bite his tongue
- Seek immediate help for mobilizing the person to the hospital
Epilepsy Treatment Measures
Treatment Of The Underlying Cause Of Seizures
Depending upon the underlying cause that triggers seizures, variable measures are taken to cure or avoid the cause.
- In the case of a seizure due to metabolic disturbance, the disturbance is corrected to alleviate the trigger and avoid further seizure episodes
- When the seizures are due to substances like cocaine and alcohol, it is adviseable to stop the consumption of such substances
- If the seizures are triggered by a defect in the neural (brain) tissue (e.g. Pus / Tumour/ Defective vessels), the lesion is removed to eliminate the trigger
Most of the cases falling under this category may not require medicines to cure seizures. Mere removal of the root cause prevents further episodes of epilepsy.
Avoidance Of The Seizure-Provoking Factors
Factors that provoke epileptic seizures are:
- High grade fevers
- Lack of sleep
- Neurological infections
- Overconsumption of alcohol
- Drug overdose
- Intense light
- Mental or physical stress
- Hormone imbalance, such as during menstruation
Epileptic patients are asked to avoid these factors, as avoiding them will automatically prevent epileptic spells.
The use of anti-epileptic medicines has been the principle mode of treatment for most of the cases of epilepsy.
Choice Of Medicine
The choice of drug for epilepsy treatment is mainly based upon the type of epilepsy (i.e. Generalized / Partial / Myoclonic / Absence).
The Effect Of Drugs On Epilepsy
Different drugs act in different ways to cure epilepsy. They regulate the electrical potentials over neuronal cells by stabilizing the channels that transport ions like sodium, potassium, and calcium across the membranes of these cells. This prevents the neurons from turning hyper-excitable. Some drugs act by increasing secretions of the neuro-chemical GABA (Gamma Amino Butyric Acid), which inhibits excess contractions in muscles.
Indications To Start Drug Therapy
Patients with recurrent seizures are prescribed medication when the cause of epilepsy is not known or when it is known but not reversible. Patients with known brain defects (tumour/ infection) and who are prone to repeated seizures are also candidates for medical treatment.
The frequency of medication may vary from once a day to 3-4 times a day, depending upon the type of seizure, the patient’s tolerance to the drugs, and the side effect of the drugs. Commonly used anti-epileptic drugs are Phenytoin, Carbamazepine, Lamotrigine, and Valproic acid.
Some common side effects of anti-epileptic drugs are:
- Suppression of the bone marrow
- Liver damage
- Enlarged gums & excess hair growth over the face (seen in the case of Phenytoin)
Monitoring Of Patients
When the patient is put on anti-epileptic drug therapy, he is regularly monitored for varying blood cell counts and the level of drugs in the blood. He is also subjected to various tests to assess liver function. The medication is modified based on these observations.
Time To Stop Medication
The doctor’s decision to stop drug therapy depends upon different criteria such as:
- The pattern of seizures, which is different for various types of epilepsy
- The neurological status of patient
- Absolute absence of seizure episodes for 1 to 5 years (the duration varies with the type of epilepsy)
- Normalized EEG (Electroencephalogram)
Surgery For Epilepsy
Around 20 % of epileptic patients may not respond to medicines, even after taking the most effective drug combinations. Such patients are usually required to undergo surgery.
Surgery involves the removal of the part of the brain that is suspected to be the focus of epilepsy (e.g. parts of structures like the amygdala, the hippocampus, etc. in the brain). The removal of this focal trigger point reduces or completely stops the occurrence of epilepsy.
Vagus Nerve Stimulation
The vagus nerve is one of the most important nerves in the body. An electrode that generates electrical stimuli is placed near the vagus nerve. The intermittent spikes it generates are intended to stimulate the vagus nerve and raise the threshold of the neurons to control the seizures.
Epilepsy treatment can bring visible results if the patient follows his doctor’s advice and adheres to the medication schedules, dosages, and tests as prescribed. If you’re undergoing epilepsy treatment, ensure that you keep a detailed record of all the epileptic episodes you’ve had and take the prescribed medication without fail. In any case, don’t discontinue the medication without consulting a doctor first.