ABOUT EPILEPSY TREATMENT
Epilepsy treatment aims to treat and manage epilepsy, a neurological disorder that can cause seizures that can lead to loss of consciousness or strange behavior. Epilepsy occurs when there is an abnormality in the brain, whereby nerve cell activity increases and disrupts neuron activity.
Patients of any age can develop epilepsy, however it is more common in young children and older adults. In newborns and infants, epilepsy can be the result of drug abuse during pregnancy, brain malformations, low blood sugar levels, problems with the baby’s metabolism, infections, and brain tumors. In children and adults, genetic inheritance, brain diseases, trauma to the head, and congenital conditions can cause epilepsy. In older patients, epilepsy tends to occur in cases whereby the patient has suffered a stroke, trauma, or has developed Alzheimer’s disease.
There are 2 different categories of epilepsy, primary and secondary epilepsy. Primary epilepsy occurs for reasons that cannot be established. In some cases, primary epilepsy may often be attributed to a family history of the disorder, however there is no evident cause. Secondary epilepsy is usually caused by conditions such as a brain tumor, or as a result of damage to the brain caused by external factors such as trauma or drug abuse.
Epilepsy is characterized by seizures, which vary depending on the area of the brain that experiences abnormal brain cell activity. The different types of seizures include focal seizures and generalized seizures.
Focal seizures, which may also be referred to as partial seizures, are seizures involving only part of the brain. These seizures can be distinguished into 2 different categories, simple partial seizures and complex partial seizures. Simple partial seizures can have an effect on the patient’s senses and may cause the body to convulse. Complex partial seizures cause the patient to lose consciousness or awareness, and can also cause the patient to repeat certain movements such as smacking their lips together or chewing.
Generalized seizures involve the entire brain as opposed to part of it, resulting in 6 different types of seizures that can occur. These seizures include absence seizures, myoclonic seizures, clonic seizures, tonic seizures, and tonic-clonic seizures, all of which have different symptoms.
Absence seizures, which were formerly referred to as petit mal seizures, are seizures which cause the patient to become absent. The patient will lose awareness and may become temporarily vacant and have no memory of the seizure afterwards. Absence seizures are more common in children than in adults. Clonic seizures cause the patient to twitch and can last up to 2 minutes, with some patients losing consciousness in this time. Myoclonic seizures are similar to clonic seizures, however they do not last as long. Tonic seizures cause the muscles in the body to stiffen, usually affecting the arms and legs, which may cause the patient to fall over and become injured. Tonic-clonic seizures, formerly referred to as grand mal seizures, cause the body to twitch and convulse, and the patient will lose consciousness. Tonic-clonic seizures may cause the patient to bite down on their tongue during the seizure and may result in injury.
A patient must have 2 or more seizures before their condition is classified as epilepsy. Some people may experience one seizure in their life, but they will not be considered epileptic. Seizures can also be caused by other medical conditions, which is why a series of tests will usually be performed to establish the cause of a seizure and to check if is due to epilepsy. The doctor may perform an EEG (electroencephalogram), MRI scan (magnetic resonance imaging) a CT scan (computed tomography), or a PET scan (positron emission tomography). Seizures can be dangerous and even life-threatening if they occur in certain circumstances such as driving or swimming, which is why appropriate treatment is very important.
There are a variety of different epilepsy treatments available, which include medication, brain surgery, vagus nerve stimulation (VNS), and following a ketogenic diet. Some patients may become seizure free after a number of years of undergoing treatment, some patients may experience periods without seizures but still have seizures from time to time, whilst others may continue to have seizures even when undergoing treatment.
Recommended for
- Epilepsy
TIME REQUIREMENTS
- Number of days in hospital: 4 – 14 days.
If undergoing surgery, the patient will need to stay in hospital.
- Average length of stay abroad
The time spent abroad depends on the type of epilepsy treatment that the patient receives.
HOW TO FIND QUALITY TREATMENT ABROAD
BEFORE EPILEPSY TREATMENT ABROAD
Before beginning any treatment, the patient will usually undergo a series of tests to diagnose the epilepsy. An EEG (electroencephalogram) may be performed to establish the area of the brain responsible for the seizures. An EEG involves placing electrodes onto the scalp of the head which then measures the electrical activity taking place in the brain. Other types of diagnostic tests that may be used include MRI, CT or PET scan, which are types scans taken by using X-ray images to create images of the internal structure of the brain.
The patient may have the above tests carried out first, before meeting with a neurologist, or these tests may be ordered by the neurologist after the initial consultation. The neurologist will then discuss the different types of treatment options available. The patient should prepare a list of questions that they may have, which can be discussed at the consultation. The neurologist will take a full medical history of the patient and may ask a number of questions such as how long the patient has been having seizures for.
Patients with complex conditions may benefit from seeking a second opinion before beginning a treatment plan. A second opinion means that another doctor, usually an expert with a lot of experience, will review the patient’s medical history, symptoms, scans, test results, and other important information, in order to provide a diagnosis and treatment plan. When asked, 45% of US residents who received a second opinion said that they had a different diagnosis, prognosis, or treatment plan.
HOW IS IT PERFORMED
Epilepsy treatment varies, depending on the type of seizures the patient experiences and on the cause of the epilepsy.
Many patients can manage their epilepsy by taking medication which is referred to as anti-epileptic drugs (AEDs). This medication is prescribed by the neurologist and can control the seizures. It is usually the first type of treatment which is used to treat epilepsy and can be ingested as tablet, capsule, or liquid form. While this works for many patients, medication can cause a variety of side effects such as drowsiness and headaches, or may not work in controlling the patient’s seizures, which is why there are a variety of different types of medications. The neurologist may need to change the medication or the dosage until they find one that works for the patient.
Surgery is another method of treatment for epilepsy and is usually an option in cases whereby the epilepsy originates in one small area of the brain. If the patient is a suitable candidate for the surgery, it may be performed when medication has failed to control the seizures. The most common type of surgery is called resective surgery.
Resective surgery involves removing the part of the brain responsible for causing the seizures. This is only considered in cases where removing part of the brain will not compromise speech or movement, or any other major function of the brain. It is most commonly performed by making an incision in the scalp and opening up the brain to remove part of the skull bone. Tissue from the temporal lobe is then removed to gain access to the part of the brain that needs to be removed. Part of the brain is then removed and the skull bone is then put back into place and the incision site is closed with sutures.
Another method of treatment is vagus nerve stimulation (VNS) which involves implanting a vagus nerve stimulator that beneath the skin near the collarbone. The device, which resembles a pacemaker for the heart, is then connected to the vagus nerve which is located in the neck. It functions by using the device to transmit electrical energy to the brain so help reduce seizures. This type of treatment is usually used in combination with taking medication to optimize controlling the seizures.
Another method of treatment is to alter the patient’s diet and nutrition, in order to help reduce seizures. A ketogenic diet involves following a high fat and low carbohydrate diet. This type of treatment is usually used for treating children under the guidance of a nutritionist.
WHAT TO EXPECT AFTER EPILEPSY TREATMENT
Post procedure care
Patients may experience side effects of medication that they are taking and should consult their doctor should this happen.
After surgery, will need some time to recover and will need to rest and avoid any strenuous activities for the first few weeks.
Possible discomfort
After surgery, patients may experience headaches and feel nauseous for the first few hours.
IMPORTANT THINGS TO KNOW ABOUT EPILEPSY TREATMENT
Potential risks
- Headaches
- Drowsiness
- Rashes
- Stroke
- Memory loss
- Unsuccessful surgery
