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Epilepsy Monitoring Unit: Option 2
Depending on what our epilepsy treatment specialists find during monitoring, they may recommend the following epilepsy treatment options:
Although no cure exists for epilepsy, medication can keep you seizure-free for significant periods. Your doctors will try to keep your epilepsy under control using a single, effective medication. If this is not successful, your doctor will prescribe a combination of medications. Your medical team will select the medications that are most effective for your type of seizure disorder.
Dietary Epilepsy Treatment
Approximately 30 percent of epileptic patients do not respond to medication trials. If you have tried several medications and have not found seizure relief, your seizures are known as intractable. Your doctors will provide you with more appropriate treatment options. Certain individuals are candidates for dietary treatments, which include the Ketogenic Diet
The Ketogenic Diet
Our bodies function on energy derived from glucose. When our glucose stores run out, our bodies begin to go into starvation mode and burn fat instead. This process is known as ketosis. The ketogenic diet continues this process by maintaining a low calorie count, while making fat the primary dietary component. The diet forces the body to remain in ketosis for long periods.
For reasons not fully understood, ketosis and the ketogenic diet can contribute to seizure control for some individuals. The diet is most often prescribed for children who have not responded well to medication. The success rates can vary:
- Full success: Approximately one-third of children on the diet gain excellent control over their seizures. They become seizure free or almost seizure free. If the diet appears to be successful for your child, doctors may recommend continuing it for about two years. You and your child will receive guidance and be followed closely by your medical team.
- Moderate success: One-third of children see significant reduction in seizure activity, but still experience occasional seizures.
- Unsuccessful: One-third of children see no improvement, either due to no response or to inability to maintain compliance. The diet can be difficult to adhere to, and children may need lots of encouragement to continue. If your child has failed to respond to both medication and the ketogenic diet, surgery may be recommended.
While there are some misconceptions about surgery for epilepsy treatment, there is no doubt that surgery can sometimes be the best epilepsy treatment for those patients who are drug-resistant to epileptic medications. In fact, if you have tried two or three anti-seizure medications that have not helped, you may want to consider pre-surgical monitoring to discover if epilepsy surgery might be right for you.
MedStar Health offers some of the most sophisticated surgical techniques to treat epilepsy worldwide, so if our doctors do recommend epilepsy surgery, you should know you are in the best possible hands. Brain surgery is very delicate and complicated work, and our highly skilled surgical team will work hard to ensure the best possible outcome for you.
- Temporal lobe resection removes all or part of the temporal lobe, where many partial seizures originate.
- Extratemporal cortical resection removes all or part of other lobes of the brain if seizure activity is traced to those locations.
- Lesion resection removes any brain lesions that are causing seizure activity. Brain lesions may be tumors or other brain abnormalities that have been detected by MRI during the diagnostic process.
- Corpus callosal section severs the nerve pathways connecting the two halves of the brain. Successful surgery ensures that any seizure activity originating in one-half of the brain will be unable to spread to the other half of the brain.
Dr. Christopher Kalhorn, epileptic neurosurgeon for MedStar Georgetown University Hospital, explains the benefits of having surgery to improve epilepsy seizures.
Epilepsy Treatment Devices
In recent years, technology has provided doctors with effective means of epilepsy treatment for difficult-to-control cases of epilepsy.
If you have intractable seizures that have not responded to medication, and you are not a suitable candidate for surgery, doctors may decide to treat your epilepsy with one of several sophisticated epilepsy devices, which may include
- Vagal nerve stimulation (VNS) prevents seizures by sending small electrical signals directly to your brain, via the vagus nerve in your neck. An electrical stimulator is inserted under your skin during a brief surgical procedure and provides the electrical signals to an outside magnet. The device resembles a cardiac pacemaker, but stimulates your brain instead of your heart. VNS is currently available to qualifying adults and children over the age of 12.
- Deep brain stimulator may be used to prevent seizure activity by sending small electrical signals directly to your brain. A surgically implanted neurostimulator, implanted in specific areas within your brain, delivers the electrical signals.
- Responsive neurostimulator (RNS) disrupts seizures by detecting abnormal electrical activity in the brain and delivering electrical pulses to interrupt the beginning seizure. A surgically implanted neurostimulator, implanted in specific areas within your brain, detects the seizures and provides the electrical pulses in order to stop them.
First Aid for Epilepsy
Watching someone you love go through a seizure can be quite frightening. It is important to remember, however, that first aid for seizures is actually very simple:
- Secure the environment: If the person experiencing the seizure begins to jerk, convulse, and fall to the ground, make sure that the area is free of dangerous or sharp objects that might harm them. Wait until they are no longer stiff and the seizure is at its end. Turn their entire body to the side and loosen anything that is tied around their neck, so that they can breathe easily. Do not attempt to hold the person down or restrain him or her in any way.
- Time the seizure: It is important to note how long the seizure lasts. Seizures should last no more than a minute or two. In general, the seizure will run its natural course—you can do nothing to shorten it. Rarely, drugs may be needed to stop a very lengthy seizure, but this is not typically the case.
- Remain calm: Seizures may look frightening, but are not usually a medical emergency. Stay calm, and wait for the seizure to end. As the person regains consciousness, stay with them and reassure them. Allow them to rest and recover afterwards. Most of the time, the person recovering from a seizure will be able to resume activities with minor assistance. However, do not let the person drive or operate dangerous equipment. If you find that this is not true for your loved one, seek emergency care.
If this was your first seizure, you will want to seek medical care and begin the diagnostic process. MedStar Health boasts an impressive team of epilepsy experts who will take you from early diagnosis to treatment, and make sure that you feel taken care of, every step of the way.
Epilepsy Treatment Specialists
In the video below, Dr. Gholam Motamedi answers some commonly asked questions about seizures and epilepsy, including the surgical treatments for epilepsy.