5 Things I Wish My Patients Knew About Epilepsy Treatment

  • With epilepsy, knowledge is power.
    Epilepsy is a complicated medical illness that causes people to have multiple seizures. Treatments are available that help most patients stop or control their seizures. However, many times a knowledge gap exists that prevents patients from optimal medical treatment. By understanding these five key factors, patients with epilepsy can take more control over their condition.

  • 1. It’s critical for friends and loved ones to know basic first aid.
    When you experience a seizure, you have to depend on the quick actions of the people around you. Make sure family members, coworkers, and anyone else you spend time with all understand first aid basics for epilepsy. Coach them on the steps to take if they’re with you during a seizure, such as moving you to a safe place, checking your breathing, protecting your head, clearing the scene of dangerous objects, and turning you with your mouth faced down. Advise again common misconceptions and teach friends never to restrain you during a seizure or attempt to put anything in or remove something from your mouth. Finally, tell loved ones they should call 911 if your seizures last more than 5 minutes, occur back-to-back or closer together than normal, breathing is difficult, or if an injury may have occurred.

  • 2. Following instructions on your medication will make it more effective.
    Nearly half of patients with epilepsy may not take their seizure medication correctly, and more than half of patients seen in emergency departments for recurrent seizures are noncompliant with their current medication regimen. To maximize the benefits of your seizure medication, make sure you know your exact dosage, when you need to take it, and whether you need to take your medication with food or on an empty stomach. Talk to your doctor about possible side effects, as well as whether a generic medication will work for you, or if you require a name brand for your treatment. Finally, ask if you need routine blood tests for monitoring, and find out when and how often you need to follow up with your doctor.

  • 3. You can take steps to decrease your risk of additional seizures.
    In addition to taking your medication regularly, you can decrease your risk of recurrent seizures by keeping a healthy daily routine. Eat nutritious foods, though talk to your doctor before starting a diet or weight loss program. Some diet plans, such as Atkins, can interfere with anti-seizure medications. Getting a good’s night sleep is important, as lack of rest or frequent awakenings can trigger seizures. Regular exercise can help prevent a number of seizure medication side effects, like weight gain and decreased bone density. (Let your doctor know about any significant weight changes, as this may impact your anti-seizure drug levels.)  Don’t use alcohol, tobacco or other drugs, and avoid any flashing lights, including videogames or strobes, that are known to trigger your seizures.

  • 3. If medication doesn’t work, you may benefit from surgery.
    Most patients are able to get their seizures under control with anti-seizure medicines. However, if you’re among those who do not achieve good control with anti-seizure medication, your doctor may discuss brain surgery or a device called a vagal nerve stimulator as other possible treatments.

    In a resective surgery, the part of the brain causing seizures is removed, while other surgical procedures may instead interrupt the brain pathway that allows seizures to spread.

    Vagal nerve stimulation involves placing a device in the chest that sends electrical impulses to the vagus nerve, a part of the nervous system that controls breathing, heart rate and other bodily functions not under your voluntary control. A vagal nerve stimulator can relieve seizures by regulating these impulses, acting like a pacemaker for the brain.

  • 4. If you want to get pregnant, talk to your doctor first.
    Most women with epilepsy can become pregnant, but it’s best to plan your pregnancy with your doctors so  you and your medical team can prepare for any special needs. Make sure your epilepsy doctor and ob/gyn work well together, and that your ob/gyn is comfortable and familiar with epilepsy.

    As with any pregnancy, it’s important to start taking prenatal vitamins and folic acid before becoming pregnant. You will also need to optimize your epilepsy treatment before trying to conceive, as fluctuating hormones may require frequent changes in your medical treatment. Your doctor may also recommend changes to your anti-seizure medications.

    As a new mother, breastfeeding is possible, but should be discussed with your medical team early. Additionally, you need to talk with your medical team about how epilepsy may impact you as a parent, and any specific steps you’ll need to take when you bring your baby home.

  • 5. If you’re feeling stressed about epilepsy, you can find help.
    While relaxation techniques like yoga and mediation may not decrease seizures, these activities may reduce your stress levels and increase your overall quality of life. You can also get advice and support from organizations like the Epilepsy Foundation. These groups can help with some of the day-to-day challenges of epilepsy, like dealing with insurance companies, work-related issues, and stress on relationships with friends and family. As a complement to your medical team, the epilepsy community can offer empathy for the emotional and social factors of the condition, and provide a well-rounded approach to your treatment plan.


5 Things I Wish My Patients Knew About Epilepsy Treatment
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THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.
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  • If your epilepsy treatment works just fine, there’s no reason to tinker with it. If it ain’t broke, don’t fix it, as the old wives’ tale goes. But if you’re having difficulty treating your epilepsy or are dissatisfied with the treatment, it may be time to consider switching to another one. For some, a new medication or set of medications may be just the ticket, while for others, surgery may be the best route.
  • If you’ve been diagnosed with epilepsy, you’re not alone. It’s the fourth most common neurological disorder in the United States. But not everyone with epilepsy experiences the same types of seizures or the same number of seizures. Over the years, researchers have tried to come up with ways of measuring how severe someone’s epilepsy is. For example, adults who are diagnosed with epilepsy may be measured with the Liverpool Seizure Severity Scale, but children may be assessed with information based on the Early Childhood Epilepsy Severity Scale (E-Chess). Regardless of the method or scale used, this information helps your neurologist plot the course of your treatment. But aside from the scales, what’s most important to you is how you understand your own epilepsy.
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