Current treatment options for epilepsy include medications, surgery, vagus nerve stimulation and diet. According to studies, the currently available treatment options are effective in controlling seizures in about 80% of people with epilepsy.
Epilepsy can be controlled with treatment in most patients. According to studies, the currently available treatment options are effective in controlling seizures in about 80% of people with epilepsy. After being diagnosed with epilepsy, it is important to begin treatment right away as delay in starting treatment makes it more difficult to control and treat.
Current treatments for epilepsy include:
- Vagus nerve stimulation.
Antiepileptic drugs are used most frequently to treat epilepsy. At present, there are more than 20 medications. Your doctor will choose the medication based on factors such as:
- Types of seizure.
- How frequently they occur.
- Lifestyle and age.
- In a woman, whether she is considering pregnancy or not.
Long-term drug therapy is usually started after the person has had two or more seizures. In most people, seizures can be controlled by a single drug therapy, but some patients may require two or more drugs to control the seizures.
Some of the commonly used anti-epileptic medications include:
- Carbamazapine- most effective for partial or tonic-clonic (grand mal) seizures.
- Clonazepam - used for treatment of myoclonic and atonic seizures not controlled by other drugs.
- Ethosuximide- effective for treating absence (petit mal) seizures.
- Phenobarbital-used for treating tonic-clonic (grand mal) and simple partial seizures.
- Phenytoin- used for treating tonic-clonic (grand mal) and simple and complex partial seizures.
- Valproate- usually, the first choice drug to treat all generalised seizures.
Some new drugs for treatment of seizures include lamotrigine, gabapentin and topiramate.
Surgery is used to control seizures if they cannot be controlled by medication. It is recommended as an option only after trying two or three different medications for a period of time without success.
Advances in imaging studies have made surgery safer. With recent brain imaging and surgical techniques, it is possible to identify the area of the brain where the seizures occur and operate to remove just that area. Aim of surgery is to remove just the damaged brain tissue so that the seizures are controlled. The various surgeries done for epilepsy include:
- Corpus callosotomy.
Vagus Nerve Stimulation
Electrical stimulation of the vagus nerve has been found to be helpful in controlling seizures that are not controlled with medications. Vagus nerve is a nerve that runs from the brain along the neck and throat to the gastrointestinal tract (stomach and bowels). There are two vagus nerves on each side (left and right). These nerves function to control swallowing and speech. They are widely connected in the brain and may also go to the parts that are affected by epileptic seizures.
Diet has been used to control seizures since ancient times. Initially, fasting was used to control seizures. In modern times, ketogenic diet is used for the treatment of difficult-to-control seizures. This diet is very low in sugar and proteins and high in fat. Hence, the body is forced to burn fats for energy instead of sugars. Using fats for energy increase ketones in the body and lead to a condition called ketosis. Ketones probably prevent irritation of the central nervous system and control seizures.
Use of ketogenic diet to control seizures was started in the 1920s, but its use decreased after the introduction of antiepileptic drugs. Currently, it is used to treat children with severe seizures, which do not respond to medications. It is, however, a difficult diet to follow as the child is allowed to eat only fat (butter, heavy cream) with very little meat and a limited range of low-sugar vegetables such as lettuce, celery and cucumbers. The diet is observed to be effective in young children (<8 years of age), but can be occasionally helpful for adults. According to studies, it has been seen to be effective in about 25% to 50% of children, who have uncontrollable seizures.
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