Epilepsy & Seizures Treatment

Epilepsy & Seizures Treatment

Epilepsy & Seizures Treatment
In terms of epilepsy treatment, the most common therapy is antiseizure medications. If a patient doesn't respond to medication, it may be a sign of an underlying, treatable cause of the epilepsy, such as a brain tumor. These patients may be referred to a specialized epilepsy center for treatment with a surgical procedure. For children with epilepsy, doctors may suggest a high fat, low carbohydrate ketogenic diet. This diet can help prevent seizures in children who don't respond to antiepileptic medications and may reduce or end the need for medication. It's not clear why this diet is more effective in children than adults in the treatment of epilepsy.

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    Seizures can often be minimized or eliminated with appropriate anti-convulsant medications without significant side effects. Diets, such as the Hopkins-developed ketogenic diet (which should be done only under a doctor’s supervision) can also have dramatic effects.
    Another option is vagus nerve stimulation where a small pacemaker-like device is surgically implanted below the skin on the upper chest. The device delivers a small electrical current to the vagus nerve in the neck. An impulse continues up the nerve to the brain.
    Our doctors along with others have found that the vagus nerve stimulator can be helpful for children with epilepsy, especially when combined with the use of the ketogenic diet. In select cases, surgery may be required to stop the seizures. Some children will outgrow epilepsy.
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    A Neurology, answered on behalf of
    A modified Atkins diet can be helpful for those living with epilepsy. The Atkins diet is a high-protein, low-carbohydrate diet.

    This content originally appeared on http://www.mlive.com/

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    Please note, the information contained on this website is provided to supplement the care provided by your physician. It is not intended to be a substitute for professional medical advice. Always seek the advice of a qualified health care provider if you have questions regarding your medical condition or before starting any new treatment. In the event of a medical emergency always call 911 or proceed to your nearest emergency care facility.
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    Hemispherectomy is most commonly performed in children with severe epilepsy. This procedure is often called a functional hemispherectomy, since most of the tissue is not really removed but disconnected. The surgery is a combination of removal and disconnection of one hemisphere, including the temporal lobe (sides of the brain).
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    The goal of treatment is to be seizure free. This can be achieved with the first medication for up to 70 % of patients. However, the side effects of the anti-seizure medications can be significant, and may interfere with the patient's quality of life. Whether the anti-seizure medications are necessary depends on the severity and frequency of the seizures. The best treatment includes no or very few seizures with minimal adverse effects from the medications. 
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    Neurosurgeons use one of several surgical procedures to treat epilepsy. Most people experience a great reduction in seizure frequency and severity after surgery. Patients with certain types of epilepsy have a greater than 70 percent chance of complete freedom from seizures following surgery.

    • Multiple subpial transaction for epilepsy: If the source of the epileptic seizures is in an area of the brain that is critical to speech or movement, surgeons may use an approach called multiple subpial transection. Instead of removing brain tissue, surgeons interrupt nerve fibers on the surface of the brain that carry the impulses responsible for epileptic symptoms.
    • Resective surgery for epilepsy: This type of brain surgery removes the specific area of the brain that is generating the seizures. A resective procedure called temporal lobectomy, in which surgeons remove a portion of the temporal lobe (the most common source of epileptic seizures), is the brain surgery most often performed for epilepsy.
    • Vagal nerve stimulation for epilepsy: Vagal nerve stimulation is a treatment in which doctors place a small pacemaker under the skin near the vagal nerve in the side of the neck. Placement of the device does not involve surgery on the brain. This device regulates electrical activity in the brain, and in many patients with poorly controlled epileptic seizures, it can reduce their frequency and severity.
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    The vagus nerve stimulator (VNS) is a device, somewhat like a heart pacemaker, placed in the upper chest below the left collarbone. It is connected to a wire which leads to a nerve in the neck. By stimulating this vagus nerve, the device can help reduce the number of seizures. In fact, about a third of patients experience a thirty to fifty percent reduction of seizures. Around three percent of patients actually become seizure-free.

    The device stimulates automatically and periodically throughout the day and night. Patients can also learn to "turn on" the stimulator if they feel a seizure coming on, which can often stop the seizure from occurring. Because the vagus nerve affects the throat, patients may experience hoarseness or sore throat and may have difficulty speaking when using this device. Adjusting the strength of the stimulation can often address this side effect.

    Vagus nerve stimulator placement requires surgical implantation under general anesthesia. Patients need multiple clinical appointments after implantation to turn the VNS on and adjust stimulation strength.

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    A , Family Medicine, answered
    There are several different types of anticonsulsant drugs used for epilepsy and each drug may have its own side effects.  Work closely with your doctor to determine which drug you should take to control your seizures.  Ask your pharmacist or doctor about the side effects you may experience with that specific anticonvulsant drug.
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    The goal of epilepsy surgery is to identify an abnormal area of brain tissue from which the seizures originate and remove it without causing any significant impairment. The brain is divided into two sides, called "hemispheres." Each side of the brain is then divided into lobes. The major lobes are the temporal lobes (sides of the brain), frontal lobes (front of the brain), parietal lobes (middle of the brain), and occipital lobes (back of the brain). An operation to remove all or part of these lobes is called a lobectomy. A lobectomy may be performed when a person has seizures that start in the same lobe every time.
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    The team involved in epilepsy surgery includes neurologists, neurosurgeons, neuropsychologists, neuropsychiatrists, epilepsy nurses, neuro-clinical social workers, and electroencephalogram (EEG) laboratory technicians, all defined below.
    • Neurologist: a physician who specializes in the nervous system, specifically, epilepsy and the brain. After examination and treatment, he/she may recommend brain surgery for difficult-to-control seizures if there is a strong indication that the electrical discharge is coming from a focal area such as the left or right temporal lobe.
    • Neurosurgeon: a surgeon specializing in the brain who has expertise in epilepsy surgery. He/she works closely with the neurologist.
    • Neuropsychologist: a psychologist specializing in brain and behavior, focusing on the impact of memory, insight, and cognition through interview and neuropsychological testing.
    • Neuropsychiatrist: a psychiatrist specializing in neurological issues and the psychiatric impact of epilepsy.
    • Clinical nurse specialist: a nurse specializing in psychosocial manifestations, pre- and post-surgical care, medication treatment of epilepsy, and patient education.
    • Neuro-clinical social worker: a social worker specializing in the psychosocial issues of epilepsy, pre- and post-surgical care, resources, community programs, and patient education.
    • EEG laboratory technicians: technicians specializing in brain wave monitoring used for procedures, and required to capture seizures for further diagnosis.
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    There is no one single cure for seizures since seizures are caused by different things. Therefore the chance of a "cure" for seizures is dependent on what one suspects is the cause. For example, if seizures are due to alcohol or benzodiazepine withdrawal one can potentially cure their seizures by detoxing than abstaining from alcohol or benzodiazepines with a doctor’s supervision. If the seizure is caused by a meningioma or blood pushing down on or irritating the surface of the brain, then alleviation of those causes with surgery can potentially cure seizures. The prognosis for any individual's seizure disorder should be discussed on an individual level with their neurologist.

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