Medication, surgery can help treat epilepsy

Special to the Herald-LeaderNovember 2, 2013 

Dr. Khan, UK

Epilepsy is a brain disorder in which a person has repeated seizures over time.

Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. A single seizure that does not happen again is not epilepsy.

Most often, patients with epilepsy have had an injury to the brain or a pre-existingmedical condition. In other cases, epilepsy can be the result of stroke, dementia, infections, congenital brain defects, brain tumors, abnormal blood vessels in the brain or a metabolic disorder called phenylketonuria.

Epilepsy can also be a side effect of certain medications such as antidepressants or amphetamines. Cocaine use is also known to cause seizures.

Epileptic seizures are not always present as shaking of the body. The type of seizure is dependent on the cause of the epilepsy and the part of the brain that is affected.

Some people may have loss of alertness, staring spells, body stiffness or generalized shaking of the body.

Some people with epilepsy may have a strange sensation before each seizure, such as bad smell, bad taste in the mouth or dizziness. This is called an aura.

If a physician suspects a patient has epilepsy, a number of tests can be used to assist in making a diagnosis. A head CT or MRI scan can help find the cause and location of the problem in the brain. An electroencephalogram, or EEG, checks the electrical activity in the brain.

Other tests include blood glucose and chemistry, blood counts, tests for infections, kidney and liver function tests, and lumbar puncture (or "spinal tap.")

Epilepsy is often treated with medications known as anticonvulsants, used to prevent further seizures. Children may follow a special diet to help prevent seizures. A diet low in carbohydrates may be helpful to some adults.

Epilepsy that does not respond to two or three anti-seizure medications is called medically refractory epilepsy. Surgical interventions, including surgery, to remove abnormal brain or to place a device called a vagus nerve stimulator may be recommended. This device may help in reducing the number of seizures.

Surgery also may be needed if the seizures are being caused by a tumor, abnormal blood vessel or a brain bleed.

In general, there is no known way of preventing the seizure in patients with epilepsy. Proper diet, sleep, and avoiding alcohol and street drugs can help lessen the occurrence of seizures. Taking prescribed medications as directed may decrease the likelihood of triggering seizures.

Recommendations for people with epilepsy:

■ People who have epilepsy should wear medical alert jewelry so that prompt medical treatment can be obtained if a seizure occurs.

■ Those with poorly controlled seizures should not drive. They should follow the driving laws of their own state, as these laws differ in different state.

■ Avoid machinery or activities where loss of awareness would cause great danger, such as climbing to high places, or biking and swimming alone.

Dr. G. Qutubuddin Khan is assistant professor of neurology in the University of Kentucky College of Medicine.

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