Treatment

Drug Therapy
Medication for epilepsy: The standard treatment for epilepsy is the regular use of one or more chemical substances called anti–epileptic or anti–convulsant drugs. The ideal situation is when a person takes as little medication as possible while maintaining seizure control.
Drug options: Over the past decade there have been a number of developments, with new more specific drugs becoming available. This is not to say that the older drugs have become obsolete. In fact, the newer preparations may not be at all suitable for some people. Each drug has two names, the generic, or chemical name (for example carbamazepine) and the trade name (for example Tegretol), given by the manufacturer. It is helpful for a person to know the generic names of his/her drugs, especially when travelling abroad.
Team work: Co–operation between you and your doctor is essential in establishing optimum control of your epilepsy. The more accurately you, or a family member, can describe your seizures and the effects of the medication, the more precise the doctor’s prescription can be. It is important that drugs are taken exactly as prescribed. Compliance is a major factor in the overall results that can be achieved. Your pharmacist is also able to assist with information and advice about your medication.
Side–effects: Like all drugs, anti–convulsants may have some side–effects. The appearance of these depends on each person’s individual response to the drug as well as how much of it he or she is taking. With only a few exceptions, side–effects associated with anti–convulsants drugs are mild and usually occur at the beginning of therapy, usually disappearing as the person becomes used to the drug. If side–effects do occur, they should be reported. Depending on the type of drug involved, the most frequent side–effects are drowsiness, irritability, nausea, rash, thickening of facial features, increase in body hair, physical clumsiness, overgrowth of gum tissue, and hyperactivity in children. Some drugs may produce emotional changes; occasionally a drug will actually increase rather than decrease the number of seizures a person experiences. However, many people are able to take the medication for years without experiencing any of these effects.

What Are the surgical treatments for epilepsy?
Standard surgical procedures
If drug therapy fails to control seizures, particularly partial, over a two or three year period, surgery may be appropriate. Children and young adults are the preferred candidates, because older people have more difficulty with rehabilitation. Tests for Surgical Decision Making. Advances in imaging and monitoring, new surgical techniques, and a better understanding of the brain and epilepsy in infants as well as in older individuals have made surgery a more viable option than in previous decades. The general approach is first to locate the brain tissue that triggers the epileptic event using long term EEG monitoring, usually with added information from imaging techniques, such as MRI or PET scans.

If such tests detect a specific area in the brain as the location for the seizure, then surgery is possible. The physician then tries to determine if the offending nerve cells perform vital functions usually with the use of advanced MRI techniques. The surgeon’s goal is to remove just enough damaged tissue and no more in order to prevent seizures and limit brain injury. If the diagnostic tests indicate that more than one site is involved or they have conflicting results, then more invasive monitoring of the brain is required.

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