General Practice 2022

As é treatment for epilepsy

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As é treatment for epilepsy
As é treatment for epilepsy

Treatment for epilepsy is done with the aim of reducing the frequency and intensity of epileptic seizures, since there is no cure for this disease. Thus, the use of medication, electrostimulation and even brain surgery can be recommended by the neurologist, according to the intensity of each person's crises.

In addition to these proven techniques, there are still some methods that are being tried, such as cannabidiol, which is a substance extracted from marijuana and which may help regulate the brain's electrical impulses, reducing the chances of having a crisis.

1. Medicines

The use of anticonvulsant drugs is usually the first treatment option, since many patients stop having frequent seizures only with the daily intake of one of these drugs.

Some examples include:

  • Phenobarbital;
  • Valproic acid;
  • Phenytoin;
  • Clonazepam;
  • Lamotrigine;
  • Gabapentin
  • Semi-sodium valproate;
  • Carbamazepine;

However, the medication and the correct dose can be difficult to find and, therefore, it is necessary to record the emergence of new crises, so that the doctor is able to assess the effect of the medication over time, changing it if necessary.

Although they have good results, the continuous use of these drugs can cause some side effects such as tiredness, loss of bone density, speech problems, memory impairment and even depression. Thus, when there are few crises for 2 years, the doctor can stop using the drug.

2. Vagus nerve stimulation

This technique can be used as a substitute for drug treatment, but it can also be used as a complement to medication, when crisis reduction is still not enough.

In this method of treatment, a small device, similar to a pacemaker, is placed under the skin in the chest area, and wires are placed up to the vagus nerve that passes through the neck.

The electrical current that passes through the nerve can help relieve up to 40% of the intensities of epileptic seizures, but it can also cause some side effects such as a sore throat or feeling short of breath, for example.

3. Ketogenic Diet

This diet is widely used in the treatment of epilepsy in children, as it increases the amount of fat and reduces carbohydrates, causing the body to use fat as a source of energy. By doing this, the body does not need to transport glucose across the brain barrier, which lowers the risk of having an epileptic seizure.

In these cases, it is very important to have regular follow-up by a nutritionist or doctor, to ensure that the amounts of nutrients are being well respected. After two years without attacks, the doctor can slowly remove the children's dietary restrictions, because, in many cases, the attacks disappear completely.

Understand how the ketogenic diet should be done.

4. Brain surgery

Surgery is usually only performed when no other treatment technique has been sufficient to decrease the frequency or intensity of attacks. In this type of surgery, the neurosurgeon can:

  • Remove the affected part of the brain: as long as it is a small part and does not affect the overall functioning of the brain;
  • Implanting electrodes in the brain: help regulate electrical impulses, especially after the onset of a seizure.

Although it is most often necessary to continue taking medication after surgery, doses can usually be reduced, which also reduces the chances of suffering from side effects.

How treatment is done in pregnancy

Treatment for epilepsy during pregnancy with medication should be avoided, as anticonvulsants can cause changes in the baby's development and malformations.

Women who have regular epileptic seizures and need medication to control them should seek advice from their neurologist and change their medication to medications that do not have as many side effects on the baby. They should also take 5 mg of folic acid before and during pregnancy and vitamin K should be given in the last month of pregnancy.

One way to control seizures in pregnancy is to avoid factors that cause epilepsy in women and use relaxation techniques to avoid stress.

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