- Epilepsy is the syndrome of two or more unprovoked seizures that occurs more than 24 hours apart.
- Treating epilepsy consists of three main goals. These goals include controlling the patient’s seizures, avoiding side effects of treatment, and maintaining or restoring the patient’s quality of life.
- To accurately treat epilepsy, the patient’s seizure type must be accurately diagnosed.
- Treatment can consist of medications, surgical interventions, and nonpharmacologic modalities.
Focal seizures are located in one part of the brain . They are also referred to as partial seizures. There are three different types of partial seizures. The first type is called simple focal seizures. These seizures affect a small part of the brain and can cause twitching or changes in sensation. Examples of changes in sensation include strange tastes or smells. The second type of partial seizures is complex focal seizures. These seizures can make the patient confused or dazed. The person may be unable to respond for up to a few minutes while having a complex focal seizure. The third type of partial seizure is secondary generalized seizures. These seizures begin in one section of the brain but then spread to both sides of the brain. To accurately treat partial seizures, it is important to understand which type of seizure they are. Most of these localized-related seizure disorders are the result of structural brain abnormalities .
Antiepileptic drugs help treat partial seizures. One meta-analysis that included 29 total publications and 11 different antiepileptic drugs found that patients were more than 7 times more likely to obtain seizure freedom status on levetiracetam than placebo . Overall, the study found that treatment of partial seizures with antiepileptic drugs was significantly better than treatment with placebo. Nonpharmacologic treatments for epilepsy include managing stress, sleeping sufficiently, a ketogenic diet, and surgical interventions. Ketogenic diets can help treat epilepsy because they put the body into a state known as ketosis. Ketosis is when the body breaks down fats to form ketones. Ketones are more efficiently used by the brain than is glucose and therefore can add benefit to patients with epilepsy. A ketogenic diet consists of mainly healthy fats and protein, and lower carbohydrate intake. This combination is necessary to initiate a state of ketosis in the body.
Overall seizure treatment is complex and can be difficult. The type of seizure must be accurately diagnosed to effectively treat the seizures. Treatment of epilepsy includes antiepileptic drugs, surgical intervention, and other nonpharmacologic therapies. Antiepileptic medications have shown to be more beneficial in treating seizures than placebo has and should be considered in patients suffering from all types of seizures.
- Types of seizures. (2020, September 30). Retrieved May 06, 2021, from https://www.cdc.gov/epilepsy/about/types-of-seizures.htm
- Localization-related (focal) Epilepsy: Causes and Clinical Features. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc.
- Slater J, Chung S, Huynh L, et al. Efficacy of antiepileptic drugs in the adjunctive treatment of refractory partial-onset seizures: Meta-analysis of pivotal trials. Epilepsy Res. 2018;143:120-129. doi:10.1016/j.eplepsyres.2017.10.004