Your neurology team at the Epilepsy Center, along with your primary care doctor, will design a treatment plan tailored to your condition and individual needs. You may require more than one kind of treatment — such as medication and surgery — and may be referred to other medical professionals.
Most seizures can be prevented with medication. The type of medication prescribed will depend on your condition. Your neurologist will explain how to take your medication and what side effects might occur. Over time, your medication may be changed to find the right drug and dose. Be sure to take your medication as directed. Call your neurologist if you have questions or experience any unexpected side effects.
For some patients, surgery may be recommended to prevent seizures or to implant devices that deliver medications or stimulators to emit electrical impulses. Your neurologist will explain the procedure as well as possible risks.
These procedures include:
- Focal Resections — These procedures are the most common operations for treating epilepsy and provide the best chance for patients to gain complete seizure control. They involve removing a small area of the brain where seizures originate. New brain monitoring techniques allow doctors to better pinpoint the brain tissue causing seizures. Types of resections include:
- Temporal lobectomy, where a portion of the temporal lobe is removed to control seizures.
- Lobar resection, where a portion of a seizure-producing lobe — frontal, parietal or occipital — is removed, if it can be done without damaging vital functions.
- Hemispherectomy, where one sphere of the brain is removed or disabled. The remaining half of the brain takes over many of the functions of the half that was removed. This procedure is used to treat severe conditions that have not responded to other treatments.
- Visualase Thermal Laser Ablation — In this procedure, a laser fiber is inserted through a small hole in the skull and guided toward the source of the patient's seizures. The laser then heats and destroys the small, well-defined area of abnormal brain tissue, leaving the surrounding tissue unharmed.
- Reactive Neural Stimulation — A small, battery-powered device is surgically implanted in the skull. The device detects abnormal electrical activity in the brain and delivers imperceptible levels of electrical stimulation to normalize brain activity before a seizure begins. The FDA approved the device in November 2014, and UCSF is one of the first centers on the West Coast to provide this new treatment option to patients.
- Disconnection Procedures — These procedures disrupt abnormal electrical activity that occurs in the brain and triggers epileptic seizures. There are two types:
- Corpus callostomy, which stop atonic and tonic seizures.
- Multiple subpial transections, which are performed when seizures are caused by parts of the brain that can't be removed.
- Vagal nerve stimulation — This minor surgery is a relatively new treatment that helps prevent or lessen the severity of seizures. An electrical stimulator is implanted that sends regular electrical pulses through the vagus nerve to the brain to reduce the onset or frequency of seizures. If a seizure occurs between doses of current, a magnet can be passed over the device to trigger an additional dose.
If you have a vagus nerve stimulator implanted, you'll continue to take medication but may be able to reduce the amount or number of medications. This procedure can treat a wide variety of seizure disorders when other surgical procedures aren't an option.
Most medical treatments may involve some risks or complications. Your neurologist will explain any possible risks or complications from the treatments you'll receive. Don't be afraid to ask your doctors, nurses or therapists about your treatment. If your treatment includes medication, be sure to take it exactly as the doctor has ordered. And remember to keep all your follow-up appointments with our doctors and other medical staff.
To help cope with epilepsy and reduce your chance of injury from seizures, we recommend these guidelines:
- Carry identification, including a bracelet, card or necklace that shows you have epilepsy. In an emergency, this information can ensure that you receive the right care.
- Explain to your family, friends and co-workers how to care for you if you have a seizure.
- Follow your state regulations about driving motor vehicles.
- If you are having regular or even occasional seizures, avoid dangerous situations at work and during leisure activities. For example, do not work in high places, on ladders or scaffolding, or near sharp or moving objects. Be careful when you play sports. Don't swim or go mountain climbing by yourself.
- Don't stop taking your seizure medication or change the dose without discussing it with your doctor.
- Talk with your doctor or pharmacist before taking any medication in addition to your seizure drugs.
- If you are pregnant or thinking of becoming pregnant, talk to your neurologist as soon as possible. You may need to take vitamin supplements to protect your baby.
Reviewed by health care specialists at UCSF Medical Center.
- Vanessa Ross
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