Epilepsy - Treatment (2023)

Treatment can help most people with epilepsy have fewer seizures or stop the seizures altogether.

Treatments include:

• Medicines called antiepileptics (FAEs)
• Surgery to remove a small part of the brain that is causing the seizures
• a procedure in which a small electrical device is inserted into the body that can help control seizures
• a special diet (ketogenic diet) that can help control seizures

Some people need lifelong treatment. But you may be able to stop if your seizures go away over time.

You may not need treatment if you know yoursSeizure triggersand you can avoid them.

Talk to your specialist about the available treatments and which one may be best for you.

Antiepileptics (AEDs)

Antiepileptic drugs are the most widely used treatment for epilepsy. They help control seizures in about 7 out of 10 people.

AEDs work by changing the levels of chemicals in the brain. They do not cure epilepsy, but they can prevent seizures.

AED types

There are many DEAs.

Common types include:

• sodium valproate
• carbamazepine
• lamotrigine
• levetiracetam
• topiramate

The type that is best for you depends on the type of seizures you have, your age, and whether you are thinking of having a baby, among other things.

Some AEDs can harm the fetus; consultliving with epilepsyfor more information

If your doctor recommends using an AED, ask about the different types available and which one is best for you.

take AED

AEDs are available in a variety of forms, including tablets, capsules, liquids, and syrups. You usually need to take the medicine every day.

Your specialist will start you on a low dose and gradually increase it until the seizures stop. If the first drug you try doesn't work, your doctor may recommend trying another drug.

It is important that you follow all the advice on when and how much to take AEDs. Never stop using an AED suddenly, it could cause a seizure.

If you have not had a seizure for several years, ask your doctor if you can stop treatment. If they think it's safe, your dose will be gradually lowered over time.

Do not take any other medicines, including over-the-counter medicines or complementary medicines, while taking anti-seizure medicines without consulting your doctor or specialist. Other medicines can affect the way your AED works.

side effects

Side effects are common when starting AED treatment. Some may come back soon after starting treatment and go away in a few days or weeks, while others may take a few weeks to appear.

The side effects you may experience depend on the medicine you are taking.

Common side effects of AEDs include:

• drowsiness
• a lack of energy
• Agitation
• Headache
• uncontrollable tremors(Shaking)
• Hair lossor unwanted hair growth
• swollen gums
• Rash – Contact your doctor or specialist if you get a rash, as this could mean you are having a serious reaction to your medication.

Contact your GP or specialist if you have symptoms similar to those of poisoning, such as: B. Uncertainty, lack of concentration and nausea. This could mean that your dose is too high.

For information on the side effects of your medication, please refer to the accompanying leaflet.

Would you like to know more?

• Epilepsy Action:Taking medication for epilepsy
• Epilepsy Society:drugs for epilepsy

brain surgery

Surgery to remove part of your brain may be an option if:

• AEDs do not control your seizures
• Tests show that your seizures are caused by a problem in a small part of your brain that can be removed without serious effects.

In these cases, your seizures will most likely stop completely after surgery.

Tests before surgery

If your epilepsy is poorly controlled after trying several AEDs, you may be referred to a specialized epilepsy center to see if surgery is an option.

This usually involves various tests, such as:

• brain scans
• aelectroencephalogram (EEG)- a test of the electrical activity of your brain
• Tests of your memory, learning ability and mental health

The results of these tests will help you and your specialist decide if surgery is an option for you and what the outcome of surgery might be.

What happens during the operation

Operations for epilepsy are generally performed undergeneral anesthesiaYou were asleep

The surgeon makes a small incision in the scalp and creates an opening in the skull so that the affected part of the brain can be removed.

At the end of the surgery, the openings in the skull and scalp will be sealed.

Recovery and Risks

It may take a few weeks or months before you feel normal again after surgery.

Your seizures may not stop right away, so you may need to take AEDs for 1 to 2 years.

There is a risk of complications from the surgery, such as B. Problems with your memory, mood, or vision. These problems may improve over time or be permanent.

Before having surgery, be sure to talk to your surgeon about the potential risks.

More information

• Epilepsy Action:Epilepsy Surgery for Adults
• Epilepsy Society:Operation Epilepsy

Other procedures

If AEDs do not control your seizures and brain surgery is not right for you, there are other procedures that may help.

Vagus Nerve Stimulation (VNS)

In vagus nerve stimulation (VNS), a small electrical device similar to apacemakerit is placed under the skin of your breast.

The device is connected to a wire that goes under the skin and connects to a nerve in the neck called the vagus nerve. Electric shocks are sent along the wire to the nerve.

This is thought to help control seizures by altering electrical signals in the brain.

VNS usually doesn't stop seizures completely, but it can help make them less severe and less frequent. You probably still need to take AED.

Side effects of VNS include a hoarse voice, sore throat, and cough when the device is activated. This usually happens every 5 minutes and takes 30 seconds.

The VNS device battery typically lasts up to 10 years, after which another procedure is required to replace it.

Deep Brain Stimulation (DBS)

Deep brain stimulation (DBS) is similar to VNS. But the device, worn on the chest, is connected to wires that go directly to the brain.

The surges sent by these wires can help prevent seizures by altering electrical signals in the brain.

DBS is a fairly new procedure that is not used very often, so it is not yet clear how effective it is for epilepsy.

There are also some serious risks associated with it, including bleeding in the brain,Depressionand memory problems.

If your doctor suggests DBS as an option, be sure to discuss the potential benefits and risks with them.

More information

• Epilepsy Action:Deep brain stimulation and epilepsy
• Epilepsy Action:Vagus nerve stimulation therapy in epilepsy
• Epilepsy Society:deep brain stimulation
• Epilepsy Society:vagus nerve stimulation

ketogenic diet

A ketogenic diet is a diet that is high in fat, low in carbohydrates, and low in protein. In children, diet is thought to make seizures less likely by changing the levels of chemicals in the brain.

The ketogenic diet was one of the main treatments for epilepsy before AEDs became available. But now it's not widespread among adults, as high-fat diets are associated with serious health problems, such as:DiabetesYcardiovascular disease.

A ketogenic diet is sometimes recommended for children with seizures that are not controlled with AEDs. This is because it has been shown to reduce the number of seizures in some children.

It should only be used under the supervision of an epilepsy specialist with the help of a nutritionist.

More information

• Epilepsy Society:ketogenic diet

complementary therapies

There are several complementary therapies that some people with epilepsy can benefit from. But none have been conclusively shown in medical studies to reduce seizures.

Therefore, you should be careful if someone other than a GP or specialist advises you to reduce or stop taking your medication and try alternative treatments. Stopping your medication without medical supervision can cause seizures.

Herbal remedies should also be used with caution, as some of their ingredients may interact with epilepsy medications.

St. John's wort, an herbal remedy used for mild depression, is not recommended for people with epilepsy because it can affect the blood levels of the epilepsy medication and prevent the medication from working properly.

There are reports that some strong-smelling aromatherapy treatments, such as hyssop, rosemary, and sweet fennel, can trigger seizures in some people.

Stress can trigger seizures in some people with epilepsy. Relaxation and stress reduction therapies, such as exercise, yoga, and meditation, can help.

More information

• Epilepsy Action:complementary treatments