Blog #50: Epilepsy Management

(This blog was originally posted on September 25, 2014)

 

 

 

 

There are four primary types of epilepsy treatment of which patients and their families need to be aware. 1) Medications. 2) Devices that stimulate the nervous system. 3) Special diets and 4) Brain surgery. These treatments need to be considered since approximately one out of every three patients with epilepsy does not respond adequately to anti-convulsant medications.

Surgery that removes the offending brain area from which seizures originate can possibly cure epilepsy. The other treatments are not curative. Neurostimulators generally reduce, but do not eliminate, the number of seizures. Such stimulators include: vagus nerve stimulators (VNS) that have a small battery-powered stimulator implanted beneath the skin in the upper chest with its stimulating wires winding up to contact the vagus nerve in the neck. Other battery-operated neurostimulators currently approved for use in the United States are surgically placed in the skull bone with its stimulating wires contacting the brain cortex. It responds if the device detects the onset of seizure activity. It “short circuits” the seizure and minimizes or prevents that seizure. Diets that favorably affect epilepsy are very specialized and for the most part aid young children whose epilepsy is uncontrolled. These diets are extremely restrictive regarding the foods that can be eaten.

I urge patients and their families to consider this information and to discuss with their neurologists if any modality is appropriate for their treatment.

 

 

Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. DINGS is his first novel. It is a mother’s dramatic story that teaches epilepsy.