Epilepsy Facts – Treatment
Currently, there is no cure for epilepsy, although some people – notably children – do appear to outgrow it.
However, about 80% of epileptic seizures can be controlled partially or totally by medication. Once control has been established, many persons with epilepsy are virtually seizure-free for a lifetime, allowing them to hold most kinds of jobs and participate in most other kinds of activities.
New medications are available which do not cause as many side-effects as older drugs. The new drugs often make it possible to maintain or even improve seizure control with fewer side-effects, thereby improving the quality of life. Ask your doctor which of the new drugs are best for you.
The drugs used to control epileptic seizures are called antiepileptics. They act in two basic ways:
- By suppressing the undesirable activity of the damaged neurons, thus minimizing the electrical discharge.
- By reducing the responsiveness of neighboring normal neurons, thereby blocking the spread of the excess electrical discharge to other parts of the brain.
The aim of the person with epilepsy is to find the particular drug or combination of drugs that will maximize seizure control while minimizing side effects. This often requires a period of cooperative experimentation and observation during which drugs are tried and dosages adjusted until the desired results are attained.
Unfortunately, a significant percentage of persons with epilepsy have seizures that are not adequately controlled by medications. For many of these persons other treatment modalities are now available. Resective surgery is the preferred option for persons with partial seizures arising from a single focus that is in an operable location. Resective surgery involves identifying the portion of the brain where the seizures originates and removing it. For persons who are not good candidates for resective surgery, the vagus nerve stimulator is another option. This consists of implanting a pacemaker type device in the neck and chest which stimulates the vagus nerve and is effective in reducing seizure frequency and severity (though rarely completely eliminating them) in many persons. The ketogenic diet, a diet low in calories and high in fat is sometimes used, most commonly in children, in persons who do not respond to medications and are currently not candidates for resective surgery. This is a very restrictive diet which is initiated on an inpatient basis and requires careful supervision.
Persons who are candidates for any of these procedures undergo careful testing to determine if they are appropriate for these interventions. These procedures are generally available only at medical centers which specialize in the treatment of epilepsy.