Test, Procedures, and Treatments of Epilepsy

Epilepsy can be treated and many people achieve good seizure control with medication. There are other treatments also available in case medication is not effective.

The common tests done diagnose Epilepsy are -

1. A complete physical and neurological examination of muscle strength, reflexes, eyesight, hearing, and ability to detect various sensations
2. Blood tests to check your general health and to rule out other possible causes for your seizures, such as low blood sugar levels or diabetes
3. An electrocardiogram (ECG) test to record the electrical activity in the heart
4. An electroencephalogram (EEG) tests to measure electrical impulses in the brain
5. Imaging studies of the brain, such as Magnetic Resonance Imaging(MRI)
6. Other tests, if required might include Magnetic Resonance Spectroscopy (MRS), Positron Emission Tomography (PET), and Single Photon Emission Computed Tomography (SPECT)

Treatment for Epilepsy

1. Medication

Epilepsy is mainly treated by medication, which particularly includes anticonvulsant drugs. Doctors prescribe medication for Epilepsy depending upon several factors such as the frequency and severity of the seizures and the person’s age, his overall general health and medical history. An accurate diagnosis of the type of epilepsy is also critical to choosing the best treatment. There are several drugs available to treat epilepsy. Brand name anticonvulsants are most preferred by doctors but many insurance companies may not cover the cost hence, it is better to start taking a generic anticonvulsant medication. But remember, if the desired control is not achieved the patient should start taking the brand name drug. Different types of epilepsy vary vastly, the use of medication in general can control seizures in about 70% of patients. Some of the commonly used medicines for Epilepsy are Dilantin or Phenytek, Phenobarbital, Tegretol or Carbatrol, Mysoline, Zarontin, Depakene, Depakote, Depakote ER, Valium and similar tranquillizers such as Tranxene and Klonopin, Felbatol, Gabitril, Keppra, Lamictal, Lyrica, Neurontin, Topamax,Trileptal and Zonegran.

Side effects of medication

The drugs used to treat epilepsy have certain side effects. Depending upon the dose, type of medication and the course of treatment the side effects vary. Patients with higher doses usually have more side effects, but they tend to lessen with time as the body adjusts to the medication. There are three types of side effects –

• Common side effects – These side effects occur with any epilepsy drug because it affects the nervous system. These side effects include blurry or double vision, fatigue, sleepiness, unsteadiness and stomach upset.
• Idiosyncratic side effects-These are rare and unpredictable reactions which are not dose-related which are mostly seen as skin rashes, low blood cell counts, and liver problems.
• Unique side effects-These are those that are not shared by other drugs in the same class. Your doctor will discuss any unique side effects before prescribing the medication.

In certain types of epilepsy, after a few years of medication the patients might be relieved of the treatment while some other might need a lifelong treatment. Patients who are seizure free for a certain period are recommended for a reevaluation to make sure the discontinuation of medicines. Remember, there are a few exceptions! Discontinuing a medication also depends on more than the length of the seizure-free period.

1. Surgery

Surgery is done to remove a small part of the brain which is the main cause of epilepsy. Surgery is considered only when seizures cannot be controlled with medication, especially focal seizures. However, Surgery is possible only for a minority of people with epilepsy. Surgery can have its own factors of risks as well.

1. Vagal nerve stimulation

Vagal nerve stimulation treatment is done by implanting a small generator under the skin below the left collarbone. The vagus nerve is stimulated to reduce the frequency and intensity of seizures. This treatment might be suitable for certain patients with seizures that are difficult to control with medication.

1. The ketogenic diet

This is a diet which is very high in fat, low in protein and almost carbohydrate-free. This diet can be effective in the treatment of difficult-to-control seizures in some children.

There are some other complementary therapies such as aromatherapy that may help the patient to relax and relieve stress. But, they have not been proven effective to control or on preventing seizures. Some patients suffering from epilepsy grow anxious or depressed due to their condition. In such cases, counselling might help to overcome such situations.