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Treatment options for people with epilepsy

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If you or a loved one has recurring seizures due to epilepsy, a personalized treatment plan and ongoing medical supervision from your health care team are essential. That's because the right combination of interventions can stop or reduce the frequency and severity of seizures. This can give you and your loved ones a greater sense of control over your lives.

From anti-seizure medications to at-home strategies you can use to enhance your doctor's recommendations, we will discuss some of the most effective types of treatment for seizures. Read on to learn more.

Medications to help manage seizures

Treatment of seizures typically starts with an oral medication. Medications prescribed by doctors to prevent or control seizures are known as "anti-seizure" medications. These generally work by reducing abnormal electrical activity in the brain. They are highly effective and can completely control seizures in two-thirds of patients, but they can come with side effects. However, these are usually mild and tolerable. On rare occasions, the side effect can be serious and require stopping the medication. Some drugs can interact with other types of medications, such as oral contraceptives.

A single medication (monotherapy) may be sufficient to control seizures. In some cases, doctors  will need to try different types, combinations and dosages of anti-seizure drugs to find the right approach for each individual patient. The goal is for the seizures to be adequately controlled with as few side effects as possible. 

Surgery and implantable devices

For the third of patients who are unable to control seizures using medication, surgery offers the best hope for a cure. However, it is only possible for patients with seizures arising from a single, “non-eloquent” part of the brain, i.e., an area that is not critically important for language, vision or strength. Doctors perform various tests to evaluate whether removal of the epileptic region of the brain risks causing major neurological complications. 

Surgical techniques include removal or alteration of parts of the brain where seizure activity occurs, including resection, disconnection, and minimally invasive laser interstitial thermal therapy.

Patients who are not surgical candidates may obtain reduction in the frequency and intensity of seizures through implanted neurostimulation devices such as the vagus nerve stimulator, responsive neurostimulator and deep brain stimulator. 

Dietary modifications 

Several decades of research have shown that a dietary approach known as the ketogenic or "keto" diet can help prevent or reduce seizures, especially in children who don't respond well to medications.

The ketogenic diet features a high consumption of dietary fats (found in things like butter, avocado, meats and full-fat dairy) and a very low consumption of dietary carbohydrates (found in things like whole grains, refined sugar and some fruits). While it can be effective, the keto diet is considered extremely restrictive and, for this reason, can be difficult to sustain. 

Another effective diet that is easier to maintain is the modified Atkins diet. It includes less fat consumption and allows more protein and carbohydrates.

At-home remedies and self-care for people with seizures

Taking all your medications as instructed by your health care provider is one of the most important things you can do to prevent seizures. You may also choose to practice other healthy self-care habits. These habits may help prevent seizures and will improve your physical and mental well-being overall. 

  • Learn your triggers. Keeping a seizure journal or seizure log—in which you write down key details surrounding your seizure activity, including what precipitated it—can help you understand what factors may trigger you so you'll know to avoid them. Common seizure triggers include alcohol withdrawal , high fever or infection, lack of sleep, bright flashing lights, emotional stress, hormonal changes associated with menstruation and dehydration. 
  • Stay physically active. Exercise supports a healthy mood and body and can minimize stress, so choose activities you enjoy and can do regularly. Be aware that you may need to employ some extra safety precautions if you have recurring seizures, such as never swimming alone and always using a helmet when bike-riding. If stress is a major trigger, use relaxation exercises, deep breathing, yoga, or other strategies. 
  • Get enough sleep. A healthy diet and regular exercise can improve your sleep, but you can also try getting in and out of bed at the same times every day, keeping your bedroom dark and cool and starting a relaxing wind-down routine at night to help you relax. 

Always talk to your doctor before making any changes to your lifestyle or physical activity.

Life with epilepsy can be full and fulfilling

If you or a loved one has epilepsy, managing the condition through personalized treatment can have a tremendous impact on your quality of life. Find a doctor today at SIU Medicine who can help. 

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