What is an effective treatment for epilepsy?

Written by Shi De Quan
Neurology
Updated on November 07, 2024
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To effectively treat epilepsy, it is crucial to adhere to the principles of medication use and cessation. First, epilepsy medication should generally be administered for one to two years without seizures before gradually reducing the dose. If seizures reoccur after dose reduction, or if there is significant worsening on electroencephalography (EEG), the dosage should be restored. If switching medications, take both medications concurrently for about a week, then gradually reduce the original medication to cessation while increasing the new medication to an effective dose. These are the principles of medication exchange and use. Then, consider the principles for attempting medication cessation. Generally, medication should not be ceased any earlier than one year and abrupt cessation should be avoided to prevent epilepticus status. If there is clear organic brain disease, persistent positive neurological signs, or continuous mental disorders with abnormal EEG readings, lifelong medication may be necessary. Some suggest that individuals older than 30 should be cautious about stopping medication. Since the recurrence rate upon cessation can exceed 50%, lifelong medication may be necessary.

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Written by Tang Bo
Neurology
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What precautions should epilepsy patients take?

Patients with epilepsy should pay attention to establishing regular daily routines and avoid staying up late. They should not participate in potentially dangerous activities such as climbing or swimming. Also, they should minimize consumption of stimulating beverages like cola, Sprite, Red Bull, and coffee. It is advisable to eat more vegetables and fruits and reduce the intake of spicy and stimulating foods. Maintaining a regular life schedule is important, and playing electronic devices or using mobile phones for extended periods should be avoided. All sorts of exciting situations can easily trigger an epileptic seizure, so it is crucial to eat regularly without becoming too hungry or too full. Moreover, taking anti-epileptic drugs regularly and following medical guidance from doctors at the hospital is necessary.

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Written by Tong Peng
Pediatrics
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What causes benign epilepsy in children?

There are multiple causes of benign epilepsy in children, with significant genetic factors often involved. It generally occurs during a specific developmental period in childhood due to localized diseases, and the prognosis is usually good. Such seizures in children may be caused by conditions like tuberous sclerosis, cerebral trigeminal angioma, and neurofibromatosis. Intracranial infections, such as viral encephalitis, bacterial meningitis, and tubercular meningitis, can also trigger benign epilepsy in children. Therefore, once diagnosed, early intervention treatments should be initiated to prevent the symptoms from worsening. Regular follow-ups with electroencephalograms are also necessary to understand the effects of epilepsy medications and treatments.

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Written by Li Jiao Yan
Neonatology
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What are the symptoms of epilepsy in children?

Seizures in children manifest in various forms, but they all share characteristics of sudden onset, sudden cessation, and periodic occurrence. Common types include grand mal seizures, absence seizures, and benign childhood epilepsy. During a grand mal seizure, the child suddenly loses consciousness, stops breathing, turns blue-purple, pupils dilate, limbs stiffen, hands clench into fists, followed by spasmodic convulsions, foaming at the mouth, with the episode generally lasting 1-5 minutes. Absence seizures in children present as sudden loss of consciousness, interruption of activity, staring or rolling of the eyes, but without falling down or convulsing, lasting 1-10 seconds, with consciousness quickly returning after the episode. Benign childhood epilepsy seizures often involve twitching of one side of the face, lips, or tongue, possibly accompanied by abnormal sensations in the area, inability to speak, drooling, generally with clear consciousness, with episodes occurring more frequently at night.

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Written by Yuan Jun Li
Neurology
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Can acquired epilepsy be treated?

Acquired epilepsy can be treated. Most cases of acquired epilepsy are due to some organic lesions, also known clinically as secondary epilepsy, primarily treated by addressing the underlying disease. Common clinical conditions include brain organic lesions such as cerebral hemorrhage, cerebral infarction, brain tumor, encephalitis, and brain parasitic infections. Systemic diseases like diabetes and hyperparathyroidism can also lead to epilepsy. If epilepsy persists or if there is a major epileptic seizure, it can lead to brain cell hypoxia and even brain edema in severe cases. When necessary, treatments to protect the brain and reduce intracranial pressure are required. Medications for brain protection include Cytidine Diphosphate Choline and Lacosamide, while drugs to lower blood pressure mainly include Mannitol, Glycerol Fructose, and Furosemide. Most patients potentially can be carefully cured through the treatment of the underlying disease, and if seizures persist after the treatment of the primary disease, antiepileptic drugs should be administered. (The use of medications should be under the guidance of a physician.)

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Written by Liu Shi Xiang
Neurology
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Can mild epilepsy be treated?

Mild epilepsy is treatable. If the patient is experiencing their first seizure or if the seizures are infrequent, it’s generally appropriate to observe clinically and not rush to use anti-epileptic drugs. Such patients typically experience only very mild neurological symptoms during a seizure, such as limb weakness, numbness, or facial droop. However, if the patient's seizures occur frequently, it is necessary to control the symptoms with anti-epileptic medications, which often include drugs such as levetiracetam, gabapentin, sodium valproate, and lamotrigine. Patients with mild epilepsy should also work on strengthening their exercise routines, maintaining a calm mind, and getting sufficient sleep to help prevent seizures to a certain extent. If the patient's condition worsens or becomes intractable epilepsy, surgical treatment methods may be considered to control the symptoms.