Epilepsy & Seizures Treatment

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• QWhat type of diet can help control epilepsy?

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  A Dr. Adriana S. Tanner, MD , Neurology, answered on behalf of Mercy Health

  One dietary therapy considered for people with epilepsy, the ketogenic diet, dates back to the early 1900s. Until the early 2000s, the ketogenic diet was traditionally used for children.

  The ketogenic diet is very high in fat and low in carbohydrates, and begins with a period of fasting. Through this approach, fat becomes the main source of energy. Combined with the low intake of carbohydrates, the body makes ketones–a substance made when the body breaks down fat for energy. The body uses ketones when there is not enough insulin to deliver sugar from the blood to the body's cells.

  The ketogenic diet offers adequate amounts of protein for body growth and repair while supplying a sufficient number of calories for maintaining a healthy weight. Foods included in this diet are butter, cream, lard, olive oil and duck fat. Grains, bread and pasta are typically avoided.

  A modified Atkins diet is another version of a high-protein, low-carbohydrate diet that can be helpful for those living with epilepsy. This diet differs from the ketogenic diet in that it allows more carbohydrates and protein, doesn't limit fluids and calories and doesn't contain a fasting period.

  When a patient starts a diet, a two-month trial period is typically recommended for testing its effectiveness. If successful, then the diet is usually continued for two years. While dieting, some individuals are able to reduce the amount of medication they take.

  Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.

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• QWhat is a hemispherectomy?

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  A Dr. Aria Fallah, MD , Neurosurgery, answered on behalf of UCLA Health

  A hemispherectomy is a procedure that involves removing one half of a person's brain to control epilepsy. It is a highly effective operation for curing epilepsy when all medications fail.

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• QWhat is vagus nerve stimulation?

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  A Dr. Eric H. Sincoff, MD , Neurosurgery, answered on behalf of Regional Medical Center Bayonet Point

  

  Vagus nerve (vagal) stimulation uses electricity to decrease the frequency of seizures in patients with epilepsy, says Eric Sincoff, MD, from Regional Medical Center Bayonet Point. Learn more in this video.
• QHow can surgery help with epilepsy?

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  A Discovery Health answered

  Patients are candidates for surgery if seizures are isolated in one part of the brain. For instance, in an anterior temporal lobectomy, the front portion of the temporal lobe is removed. This is the most common type of epilepsy surgery.

  Surgeons also can remove parts of other lobes or disconnect parts of the brain that are not properly communicating. One such surgery is called a corpus callosotomy, which cuts away the white matter that connects the hemispheres of the brain.

  These surgeries can be performed on children and adults. These surgeries remove only the damaged part of the brain, and do not seem to result in either brain damage or new seizure centers.

  In some cases, patients show intellectual improvement after surgery.

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• QHow is epilepsy (seizure disorder) treated?

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  A NewYork-Presbyterian Hospital answered

  Medication to prevent epileptic seizures is the most common treatment approach for the disease. Medication controls seizures in half or more of patients for substantial periods of time, and significantly reduces the number of seizures in another thirty percent. Doctors can choose from a number of different anti-seizure medications depending on the patient's type of epilepsy. If epileptic seizures are not controlled after treatment with several different agents, doctors may consider medications available through clinical trials or surgical treatment. About a third of epilepsy patients do not respond to medications.
  
  Neurosurgeons may use one of several surgical procedures to treat epilepsy. Most patients 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.

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• QWhat is a vagus nerve stimulator?

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  A Discovery Health answered

  The Food and Drug Administration approved a device in 1997 called the vagus nerve stimulator to help people with epilepsy.

  The device is implanted. It sends regular waves of electricity to the brain; much like a cardiac pacemaker creates rhythmic pulses to help the heart.

  Vagus nerve stimulation usually does not result in full seizure control, so some medication may be necessary. The lowered dosage of the required medication, however, cuts down on the drug's wearying side effects.

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• QWhat is a ketogenic diet?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered

  The Ketogenic diet consists of consuming foods that are high in fat  and low in carbohydrates and proteins.   The restriction on carbohydrates  and proteins causes the body to use fat as an alternative of source of energy.

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• QWhat is the goal of epilepsy surgery?

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  A Brigham and Women's Hospital answered

  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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• QWhat are the different types of epilepsy surgery?

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  A Brigham and Women's Hospital answered

  The following are different types of surgical procedures commonly used to treat epilepsy:
  

  • Temporal lobectomy: This is the most successful type of epilepsy surgery, especially in the non-dominant side of the brain. Success rates of 60 to 80 percent have been reported, with or without anti-epilepsy drug (AED) therapy.

  • Extratemporal resection: In this procedure, dysfunctional brain tissue is surgically removed from areas outside the temporal lobes (sides of the brain). It is generally less successful unless a clear-cut tumor, vascular malformation, or other lesion is present. It can be particularly difficult to localize seizures in the frontal lobes (front of the brain) since this represents such a large portion of the brain.

  • Corpus callosotomy: It interrupts the spread of seizures by cutting the nerve fibers that connect one side of the brain (hemisphere) to the other. This nerve bridge is called the corpus callosum. The corpus callosotomy is indicated in some patients with drop attacks. In this procedure, the corpus callosum is sectioned or disconnected, usually at the front of the nerve bridge. The goal of this surgery is to prevent the spread of seizure discharges to both sides of the brain. This procedure does not stop seizure activity, but it lessens the risk of injury because it may limit the frequency and severity of seizures, especially those that cause falls.

  • 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.

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• QWhat should I do for a person who is having a seizure?

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  A American Red Cross answered

  • Do not try to stop the seizure.
  • General principles of managing a seizure are to prevent injury, protect the person’s airway and make sure that the airway is open after the seizure has ended.
  • Do not hold or restrain the person.

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