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Treatment of Epilepsy

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Treatment of Epilepsy The neurology team will design a treatment plan according to medical condition, state of health and individual needs. They may also refer to additional doctors or other medical professionals. Most medical treatments can involve some risks or complications. The neurologist will explain any possible risks or complications involved. Don’t be afraid to ask the doctors, nurses or therapists about your treatment.

Drug Therapy
In many cases, seizures can be successfully prevented with medications. The type of medication you will receive depends on many factors. Your neurologist will explain how the medication should be taken and the side effects that may occur. Over a period of time medication regimen may be changed. It is very important that you take the medication exactly as directed. Call your neurologist if you have any questions about the medications or you experience some unexpected side effects. Some patients do not respond to medications and continue having seizures. In these cases, other treatments may be recommended.

The standard treatment for epilepsy is the regular use of one or more chemical substances called anti–epileptic or anti–convulsant drugs. The ideal situation is when a person takes as little medication as possible while maintaining seizure control.

Anti–epileptic drugs like phenytoin sodium, phenobarbitone, benzodiazepines are commonly used to control epilepsy. However the blood levels of these medicines need to be closely monitored so that adequate levels are constantly maintained. The most commonly used treatments are probably Dilantin, or Eptoin, Carbamazepine or Tegreto, and Phenobarbital, an older medication. The 1st two drugs are, in general well tolerated. Dilantin, is very effective as it is long acting and needs to be taken only once a day, the side effects are mostly cognitive and can cause problems with thought and memory, can lead people to tire easily and cause a kind of rash. Since it has been around for a long time it has been well researched and we are aware of its uses and limitations. The most common medication worldwide for seizures is Tegreto or carbamazepine. Chemically, it is very similarly to Dilantin but taken twice a day. But it is a different drug. The side effects are a bit different. If the dose is too high it can cause sedation and double vision.

Drug options
Over the past decade there have been a number of developments, with new more specific drugs becoming available. This is not to say that the older drugs have become obsolete. In fact, the newer preparations may not be at all suitable for some people. Each drug has two names, the generic, or chemical name (for example carbamazepine) and the trade name (for example Tegretol), given by the manufacturer. It is helpful for a person to know the generic names of his/her drugs, especially when travelling abroad.

Team work
Co–operation between you and your doctor is essential in establishing optimum control of your epilepsy. The more accurately you, or a family member, can describe your seizures and the effects of the medication, the more precise the doctor’s prescription can be. It is important that drugs are taken exactly as prescribed. Compliance is a major factor in the overall results that can be achieved. Your pharmacist is also able to assist with information and advice about your medication.

Like all drugs, anti–convulsants may have some side–effects. The appearance of these depends on each person’s individual response to the drug as well as how much of it he or she is taking. With only a few exceptions, side–effects associated with anti–convulsants drugs are mild and usually occur at the beginning of therapy, usually disappearing as the person becomes used to the drug. If side–effects do occur, they should be reported. Depending on the type of drug involved, the most frequent side–effects are drowsiness, irritability, nausea, rash, thickening of facial features, increase in body hair, physical clumsiness, overgrowth of gum tissue, and hyperactivity in children. Some drugs may produce emotional changes; occasionally a drug will actually increase rather than decrease the number of seizures a person experiences. However, many people are able to take the medication for years without experiencing any of these effects.

Ketogenic Diet
Special high–fat, low–protein, no–carbohydrate diet has been recommended for people with epilepsy who do not respond to medications. The diet mimics certain effects of starvation, which helps to prevent seizures. Dietician can help you to incorporate this diet into your family’s lifestyle. Strict adherence to the diet is essential for the treatment to be successful.

Surgery for Epilepsy
If seizures are confined to a part of the brain or if they are due to growths, surgical resection may cure the condition. Surgery helps lessen seizures after they’ve been on a couple of medications. Medications just suppress epilepsy, while surgery can be a cure. The best cases for surgery are patients with temporal lobe epilepsy. The temporal lobe lies next to the ear and can be removed without any effects that we are aware of. Conclusive testing is required before the person goes for surgery, as to define the exact area in the brain that is causing the seizures and that area is not important for other functions. Many of the patients don’t need to take anti–epileptic medications after surgery.


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