Treating epilepsy

There are different kinds of treatment for epilepsy that may be alternated or modified depending on the diagnosis and how each patient responds. Generally speaking, 90% of patients manage to prevent seizures with one of the existing treatments and just 10% continue to suffer seizures in spite of their symptoms improving through treatment.

 

ANTIEPILEPTIC DRUGS

Epilepsy medication has been evolving over time. The purpose is to adequately control the frequency of patients' seizures and make it possible to progressively improve

the quality of life of the patient and their family.

  • Traditional drugs: the first antiepileptic drugs from the beginning of the twentieth century proved effective in controlling seizures in many kinds of epilepsy. However, these medications had short- or medium-term side-effects such as increased toxicity or drowsiness. These were barbiturates such as phenobarbital or phenytoin.
  • New drugs: since the 1990s, new antiepileptic drugs have come out that are highly effective in controlling seizures and have fewer side-effects.

 

Drug resistance

Patients themselves and their individual responses to each of the medicines determines the diagnosis and the active ingredient that should be used. 

50% of patients become seizure-free with the use of the first medicine they use. If that does not work, they try another, and so on.

Once they have tried three medicines without responding to treatment, patients are considered to have minor drug resistance.

If the seventh medicine is unable to eliminate seizures, the patient may opt for other treatments such as surgery or neurostimulation.

Nevertheless, at the end of the entire process, almost all patients see improvements in their condition and the majority of them are seizure-free.

Video EEG for drug treatment

Video EEG can now be used for enhanced selection of epilepsy drugs. This system makes it possible to detect which of the 20 available drugs may be best for a specific patient, which makes it quicker to find the best treatment.

 

EPILEPSY SURGERY 

In many cases, surgery is the best alternative when the patient is resistant to epilepsy drugs. It is normally advised for patients who do not respond to drugs and whose seizures affect their daily life as they are highly frequent or the symptoms they suffer during seizures are severe (absence, falls, etc.).

Surgery requires a prior broad study to find out the type of epilepsy each patient has. Since it is being carried out in such a sensitive area, it is necessary to first ensure that surgery does not pose significant risks to the patient. It is therefore necessary to detect which area is affected by epilepsy and the risks involved in cutting it out. 

Tests that patients must undergo:

  • Video EEG monitoring with electrodes
  • High-field magnetic resonance
  • Neuropsychological assessment

If it is possible to precisely locate the epileptic focus and cutting it out will not cause deficits or intolerable neurological damage, surgery may be advised. This kind of surgery is called curative surgery because it may completely eliminate seizures. 

In some cases, due to the characteristics of epilepsy, surgery may only minimise the number of seizures. In this case it would be palliative surgery.

 

OTHER TREATMENTS

If medication does not prevent seizures, your doctor may try other forms of treatment:

1) Ketogenic diet: there are also specific diets that may improve symptoms, in particular diets that are high in fat with a normal amount of protein and very low in carbohydrates. Such a diet may be prescribed by a highly specialised team and should not be taken lightly. It should not be an initial treatment option.

2) Neurostimulation

3) Corticoid treatment

 

Make a donation to Spanish Epilepsy Association. Meet our support groups for patients and families.