The Treatment of Epilepsy

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Based on your diagnosis, your doctor will discuss which therapies are likely to be most effective. These include:.

Treatments for Epilepsy

The brain is a very complex organ and everyone responds to medications differently, so it may take several tries to determine the most appropriate medication and dosage. High fat, very low-carbohydrate diets, when calibrated and administered by a doctor and followed precisely, can help ease recurrent seizures in some cases. Read more. Skip Navigation. The medicines work by stabilising the electrical activity of the brain. You need to take medication every day to prevent seizures.

These include: Carbamazepine , clobazam , clonazepam , eslicarbazepine , ethosuximide , gabapentin , lacosamide , lamotrigine , levetiracetam , oxcarbazepine , perampanel , phenobarbital , phenytoin , pregabalin , primidone , rufinamide , sodium valproate , tiagabine , topiramate , vigabatrin and zonisamide. They all come with different brand names.

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Sodium valproate is commonly used as a treatment for epilepsy. The Pregnancy Prevention Programme is a system of ensuring all female patients taking valproate medicines:. The success in controlling seizures by medication varies depending on the type of epilepsy. For example, if no underlying cause can be found for your seizures idiopathic epilepsy , you have a very good chance that medication can fully control your seizures. Seizures caused by some underlying brain problems may be more difficult to control. The overall outlook is better than many people realise.

The following figures are based on studies of people with epilepsy, which looked back over a five-year period. These figures are based on grouping people with all types of epilepsy together which gives an overall picture:. There are popular first choice medicines for each type of epilepsy. However, if one medicine does not suit, another may be better. A low dose is usually started. The aim is to control seizures at the lowest dose possible. If you have further seizures, the dose is usually increased.

Surgical Treatment of Epilepsy in Children with Focal Cortical Dysplasia

There is a maximum dose allowed for each medicine. In about 7 in 10 cases, one medicine can control all, or most, seizures. Medicines may come as tablets, soluble tablets, capsules or liquids to suit all ages. In about 3 in 10 cases, seizures are not controlled despite taking one medicine. This may be because the dosage or timing of the medication needs re-assessing. A common reason why seizures continue to occur is because medication is not taken correctly.

If in doubt, your doctor or pharmacist can offer advice. If you have taken a medicine correctly up to its maximum allowed dose but it has not worked well to control your seizures, you may be advised to try a different medicine. If that does not work alone, taking two medicines together may be advised.

However, in about 2 in 10 cases, seizures are not well controlled even with two medicines. The decision when to start medication may be difficult. A first seizure may not mean that you have ongoing epilepsy.

New Concepts in Classification

A second seizure may never happen, or occur years after the first. For many people, it is difficult to predict if seizures will recur. Another factor to consider is how severe seizures are. If the first seizure was severe, you may opt to start medication immediately. In contrast, some people have seizures with relatively mild symptoms. Even if the seizures occur quite often, they might not cause much problem and some people in this situation opt not to take any medication.

The decision to start medication should be made by weighing up all the pros and cons of starting, or not starting, treatment. A popular option is to wait and see after a first seizure. If you have a second seizure within a few months, more are likely. Medication is commonly started after a second seizure that occurs within 12 months of the first. However, there are no definite rules and the decision to start medication should be made after a full discussion with your doctor. All medicines have possible side-effects that affect some people. All known possible side-effects are listed in the leaflet which comes in the medicine packet.

If you read this it may appear alarming. However, in practice, most people have few or no side-effects, or just minor ones. Many side-effects listed are rare. Each medicine has its own set of possible side-effects.

Anti-epileptic drugs (AEDs)

Therefore, if you are troubled with a side-effect, a change of medication may resolve the problem. When you start a medicine, ask your doctor about any problems which may arise for your particular medicine. Two groups of problems may be mentioned:. Note : you should not stop taking a medicine suddenly. If you notice a side-effect, you should ask your doctor for advice. It is important to take your medicine as prescribed. Try to get into a daily routine. Forgetting an occasional dose is not a problem for some people; however, for others this would lead to breakthrough seizures. One of the reasons why seizures recur is due to not taking medication properly.

A pharmacist can be a good source of advice if you have any queries about medication. You will need an exemption certificate. Ask your pharmacist for details. Some medicines taken for other conditions may interfere with medication for epilepsy. If you are prescribed or buy another medicine, always remind your doctor or pharmacist that you take medication for epilepsy.

Epilepsy: Symptoms, causes, and treatments

Even preparations such as indigestion medicines may interact with your epilepsy medication, which may increase your chance of having a seizure. Some epilepsy treatments interfere with the contraceptive pill. You may need a higher-dose pill or an alternative method of contraception. For reliable contraception, it is best to seek advice from a doctor or nurse. They will be able to tell you if your epilepsy treatment affects any methods of contraception. For women with epilepsy, the risk of complications during pregnancy and labour is slightly higher than for women without epilepsy.

The small increase in risk is due to the small risk of harm coming to a baby if you have a serious seizure whilst pregnant. There is also a small risk of harm to an unborn baby from anti-epilepsy medicines. Before becoming pregnant it is important to seek advice from your doctor. Any potential risks can be discussed. For example, to go over your current medication and to see if it should be changed to minimise the risk of harm to a developing baby.

One important point is that you should take extra folic acid folate before becoming pregnant and continue it until you are 12 weeks pregnant. If you have an unplanned pregnancy, you should not stop epilepsy medication, which may risk a seizure occurring. Continue your medication and see a doctor as soon as possible. See the separate leaflet called Epilepsy and Planning Pregnancy for more details. You may wish to consider stopping medication if you have not had any seizures for two or more years.


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