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Is Epilepsy Curable? Here's How Seizures Are Treated

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Centuries ago, before modern medicine brought about better understanding of seizure disorders, epilepsy was referred to as “falling sickness.”

Epilepsy is one of the most common neurological diseases, affecting more than 65 million people worldwide and 3.4 million in the United States, according to statistics from the Epilepsy Foundation.

Over the years, physicians and scientists have reached a better understanding of the many different types of epilepsy and how abnormal electrical activity in the brain leads to seizures. This knowledge has led to an ever-increasing list of treatment options for patients who suffer from seizures. While we don’t yet have cures for all forms of epilepsy, a wider variety of medications, and, in some cases, surgical procedures, can improve the odds of seizure freedom and help patients live more normal lives.

What is epilepsy?

Seizures are caused by abnormalities in the patterns of electrical activity in the brain. Seizures can begin at any age and may be seen in anyone, from infants to the elderly. A patient who has two or more seizures in their lifetime or who has had one seizure with high risk of another seizure in the future is said to have epilepsy.

There are many types of seizures, some which begin in a single part of the brain and others that involve the entire brain all at once. Seizures may be caused by other sources, including genetic abnormalities, autoimmune disorders and infection. Seizures can look like many different things, from simple staring spells to dramatic, frightening convulsions. Patients may exhibit odd behaviors like lip smacking or repetitive limb movements. Seizures may cause a patient to say odd things, make unusual noises, bite their tongues, become incontinent, or appear profoundly confused. Commonly, patients have no memory of their seizures after they have occurred.

Diagnosis and treatment

Patients being evaluated for epilepsy commonly undergo several tests, including brain scans like CT scans or MRIs. Additionally, electroencephalograms (EEGs) look for abnormalities in brain activity. This is a painless test which uses sensors on the patient’s scalp to detect the electrical activity of the brain. Neurologists may ask many questions and details about a patient’s history before completing the diagnosis. Once a diagnosis is confirmed, the neurologist will guide the patient on their options for treatment. Where and how a seizure occurs in the brain affect which treatment options are best for a patient.

Some seizures are treated with medication alone. There are about two dozen medications that are prescribed to prevent seizures. Over half of patients with epilepsy reach rapid control of their seizures with medication. Some patients may require changes in dosages or different combinations of medications over time to control seizures.

When seizures begin in specific, isolated parts of the brain, patients may be candidates for surgical procedures to target the part of the brain causing seizures. These procedures include removal of abnormal brain tissue, the use of brain stimulator devices, and the use of laser therapies to target parts of the brain causing seizures. Many patients who undergo surgery do still require at least some medication to provide additional seizure control after surgery.

Other options, such as the ketogenic diet, a special, physician-supervised, high-fat, low-carbohydrate diet, may be appropriate for some patients.

The bottom line

Seizures can be scary, unpredictable and disruptive for patients who suffer from epilepsy. Treatment options are not one-size-fits-all and must be highly individualized to each patient. Medicine has made great strides in epilepsy care. With an ever-expanding list of treatment choices and a partnership between physician and patient, the likelihood that a patient’s seizures will be controlled is higher than ever before.

At Ochsner's Level IV Epilepsy Center, we take great pride in bringing the latest developments in epilepsy care to our patients across the Gulf South. While there is no definitive cure for epilepsy, advances in neuroscience are being made every day and bring more and more patients closer to a future free from seizure.

Learn more about neurologist Robin Davis, MD

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