Epilepsy

Anti-seizure medication (ASD) is doctors’ first go-to treatment for epilepsy. Two-thirds of patients treated with medication eventually become seizure-free. For other patients, medication, in conjunction with other potential treatments, can help a patient become seizure-free.

Adults and children who remain seizure-free for two years or more may sometimes be advised by their doctor to discontinue their anti-seizure medicine.

Anti- seizure medications can have some mild side effects:

• Tiredness
• Lightheadedness
• Weight gain
• Diminished bone density
• Skin rash
• Speech and memory problems
• Coordination difficulties

Some serious side effects could be:

• Depression and suicidal thoughts or behavior
• Rash
• Inflammation of organs, such as the liver

Notify your doctor if any of these side effects occur. In addition:

• Medications should be taken as prescribed by your doctor. Never stop taking your medication unless advised by your doctor.
• Notify your doctor if you experience depression, mood changes, or suicidal thoughts.
• Advise your doctor of any other medications, including over-the-counter drugs or herbal supplements.
• Report any co-existing medical concerns, such as migraines. Some anti-seizure medications can treat both seizures and migraines, eliminating the need for additional medication.

If medication is not successful in treating epilepsy, doctors usually suggest minimally invasive procedures to address the source of epilepsy. Some patients have found a decrease in their seizures when dietary changes are combined with added nutritional guidance from a registered dietician.

Advanced brain imaging tests and treatments, along with clinical trials, are available to patients who may not have been eligible for surgery.

Surgeries and therapies for epilepsy treatment include:

• Vagus nerve stimulation (VNS) is used when various anti-seizure medications have not controlled seizures. VNS involves the insertion of a pulse generator (stimulator) inside the body and connecting it to the left vagus nerve in the neck. The stimulator releases electrical pulses through the vagus nerve to help regulate abnormal electrical brain activity, causing seizures.
• Responsive neurostimulation (RNS) for epilepsy does not require surgically removing brain tissue. Instead, an intracranial RNS device is implanted into the skull, and electrodes are placed on the brain to detect abnormal electrical brain activity. It was developed to detect and prevent seizures before they happen, like an indwelling EEG that can detect and stimulate brain rhythms that might convert into seizures.
• Deep brain stimulation. The surgeon uses an MRI to guide the permanent implantation of a device deep inside the brain. This device releases electrical impulses designed to disrupt abnormal activity, causing the seizures. The generator that sends electrical signals to this device is inserted inside the chest.
• Respective surgery is the most common surgery for epilepsy. The surgeon removes a small section of the brain. The section removed is usually the site of the tumor, brain injury, or malformation. Most surgeries of this type are done on one of the temporal lobes—the area of the brain that controls vision, memory, speech, comprehension, and emotions.
• Laser interstitial thermal therapy (LITT) is considered less invasive. The surgeon uses an MRI to guide and locate the area of brain tissue causing the seizures. The surgeon uses a laser to remove this area if the areas is small and limited in scope.
• Corpus callosotomy. This surgery is usually performed on children whose abnormal brain activity spreads from one side of the brain to the other. The surgery involves either partial or complete removal of the part of the brain connecting the nerves on the right and left sides of the brain, called the corpus callosum. This type of surgery can help prevent falls and injury in patients with more violent motor features.
• Hemispherectomy is an option for those children with broad areas of seizure onset that occur in utero or in early development as an infant
• Functional hemispherectomy is used primarily in children;  The procedure disconnects sections of the brain that might contribute to seizure production. Sections of the brain are not removed but rather disconnected from forming seizures.