Epilepsy - Treatment
Cases of symptomatic epilepsy are treated by treating the basic cause that brought on the seizure disorder. Treatment of idiopathic epilepsy involves two steps. The first step involves protecting the patient during an attack. The second step involves the use of medications to reduce the frequency and severity of symptoms.
Patients with absence epilepsy usually require little protection. They may need help in case they lose consciousness for long enough to lose their balance and fall. Attacks of tonic-clonic epilepsy require somewhat more attention. The patient should be made comfortable during an attack by loosening clothing around the neck and providing a pillow under the head. A soft object, such as a folded handkerchief, should be placed between the teeth. The object prevents the patient from biting his or her tongue. No effort should be made to hold the tongue, however.
Several medications are now available for the treatment of epilepsy. Most of these drugs fall into the category of anticonvulsants. That is, they tend to prevent or minimize the shaking and thrashing that accompanies a seizure. Some examples of these drugs are phenobarbital (pronounced FEE-no-bar-bih-tall), primi-done (pronounced PRIM-ih-doan), trimethadione
(pronounced TRI-meth-uh-DIE-own), and valproate (pronounced val-PRO-ate).
No one drug is effective for all patients or for any one form of epilepsy. In fact, effective treatment of epilepsy requires finding exactly the right dose of exactly the right drug (or combination of drugs) for each individual patient. Most patients go through a period of testing in which various drugs in various combinations are tried. Eventually, the most suitable dose and combination are determined.
Medications have made it possible for most patients with epilepsy to lead relatively normal lives. However, there is one problem with drug therapy. Many drugs have side effects that can range from mild to severe for any one patient. The most common side effects are drowsiness, nausea, lethargy, and skin rash.
An important aspect of treating epilepsy is teaching the patient and his or her family how to live with the disorder. Patients are encouraged to pursue a normal life with moderate exercise and regular social activities. Families are encouraged not to become overprotective and, insofar as possible, to treat the patient as if he or she had no disorder.
Intractable seizures are seizures that cannot be controlled without medication or without sedation or other unacceptable side effects. Surgery may be used to eliminate or control intractable seizures. This treatment is not very common as only seizures meeting very specific criteria can be controlled this way.
Relaxation techniques can help people with epilepsy avoid some of the pressures that may bring on an attack. Yoga, meditation, hydrotherapy, aromatherapy, and acupressure may be helpful in this regard. These approaches, however, should never be substituted for the patient's regular program of medication.
For people with symptomatic epilepsy, dietary changes may be essential. Patients may need to identify the foods to which they are allergic and then eliminate those foods from their diets.