Medical Management of Epilepsy

By Rodriguez, Diana

Epilepsy is a condition that causes seizures, temporary reactions that often include twitching and convulsions. These seizures happen when the brain's electrical impulses act abnormally and send erratic signals. Think of it as your brain getting confused by these haywire messages, and the result is a seizure.

Epilepsy can make driving, walking across the street, or cooking dinner a dangerous activity because you never know when a seizure may strike. But epilepsy can usually be managed well through medication and other treatments. Learning how to reduce your risk for a seizure through lifestyle changes and learning your triggers can also help you to better manage your epilepsy.

Facts about the medical management of epilepsy

As many as 80 percent of people are able to successfully manage epilepsy seizures with medication and certain types of surgery, but it’s important to remember that epilepsy can't be cured and that there's always a risk of having another seizure.

Epilepsy usually begins in young people, often between ages 5 and 20, although it can affect anyone. Most of the time, people with epilepsy have someone else in their family who has epilepsy or seizures.

Sometimes seizures can be triggered by something that's out of your control. Running a high fever may result in a seizure, despite taking medications to manage epilepsy. Having high or low blood glucose or sodium or taking certain medications can cause a seizure.

Symptoms of epilepsy

The primary symptom of epilepsy is a seizure. But there are different types of seizures with different symptoms. These are some symptoms of seizures:

  • Slight twitching of all or parts of the body, including arms, hands, and legs

  • Convulsions that affect the entire body

  • Loss of consciousness

  • Twitching of the face

  • Affected speech

  • Sudden stillness with a blank stare

Most seizures only last for a few minutes or even just a few seconds. If you've had a seizure, it may take you an hour or so to feel normal again. And you may not have any memory of having had a seizure or remember what was happening as the seizure started.

Diagnosis

A doctor may perform a neurological exam and a complete physical exam to pinpoint the cause of the seizures and diagnose epilepsy. Tests used to diagnose epilepsy include:

  • An electroencephalograph (EEG) to measure the electrical activity of the brain

  • A spinal tap to collect spinal fluid for analysis

  • Imaging tests, like an MRI or CT scan, of the head

These blood tests are also commonly used to help diagnose epilepsy:

  • Tests of liver and kidney function

  • Blood glucose tests

  • Complete blood count and chemistry of the blood

  • Tests to diagnose or rule out any infectious diseases

Treatment

Epilepsy can be treated through multiple strategies. Usually medication is needed to control seizures and treat epilepsy; these commonly prescribed drugs are called anticonvulsants.

Medication can't always stop or reduce seizures. A device called a vagus nerve stimulator may help treat epilepsy if you don’t get relief from medication. The stimulator is surgically placed in the chest. It electrically stimulates a large nerve (the vagus nerve) that runs through the neck. This device is successful in preventing seizures in some people, but even a vagus nerve stimulator can't totally stop seizures from happening.

Some doctors recommend a special diet high in fat and low in carbohydrates to help manage epilepsy. This is called a ketogenic diet, and it may help more than half of people who haven't improved on medicine alone.

If you can't get good control over seizures with medications, diet, or a vagus nerve stimulator, brain surgery to correct the problem might be an option.

Calling the doctor

If you have a seizure for the first time, you should see a doctor right away to try to pinpoint the cause. If you have already been diagnosed with epilepsy, tell your doctor about any changes in your seizures; it's a good idea to keep track of them and contact your doctor as recommended.

Prevention

Although there is no way to prevent epilepsy, you can take steps to help prevent seizures:

Your Guide to Epilepsy


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Epilepsy affects as many people as multiple sclerosis, Parkinson's disease, and cerebral palsy combined. It creates an estimated $15.5 billion in medical costs and lost earnings and production each year.