What to do When Medicines No Longer Control Seizures?
Epilepsy – One of the fourth most common neurological disease affects both adults and children alike. Each year millions of individuals across the worldare diagnosed with epilepsy. The disorder can develop at any age and is usually treated by medicine.
Primary symptoms commonly include seizures. Epileptic seizures are classified into two types – generalized and focal. Generalized seizures are a result of abnormal nerve cell firing and affect the whole brain while focal seizures begin in only one region of the brain. Seizures may look like:
- Uncontrolled shaking of a leg or an arm
- Nodding of the head
- A sudden feeling of panic or fear
- Brief periods of staring
- Twitching, stiffening, jerking and flexing of the upper body
pediatric neurologist at Max Healthcare says “about 2/3 of all children with epilepsy outgrow their seizures before teenage. Though, it is vital for the parents to ensure regular medical visits to help their child maintain a healthy lifestyle”. If a child is suffering from problems of the nervous system like epilepsy, a pediatric neurologist is the one who will offer accurate treatment for seizures, delayed speech, weakness, or headaches. They practice in a variety of medical settings including private clinics and multi-speciality hospitals.
What Happens When Medicines Do Not Work?
The first step in the management of seizures is usually through medication. Seizure prevention drugs known as anticonvulsant drugs or anti-epilepsy drugs (AEDs) are prescribed to manage the seizures. These medicines do not change or cure the brain’s underlying susceptibility to produce seizures. AEDs only treat the symptoms by dropping the rate of recurrence of seizures. These medications take time before showing signs of improvement and work properlyonly after they reach a certain level in the body. Thus, it is imperative to follow the instructions given by the doctor for the medicines to work. Parents should make sure the child does not stop taking medicines unless recommended by the pediatric neurologist.
If the child is suffering from ‘drug-resistant epilepsy’, other control options should be considered. This condition is diagnosed when the first few seizure medications do not control or stop the seizures. In this case, the chances of other drugs offering fruitful results are not so great. If the child does not respond to the first few classes of drugs, the other treatment options include:
It is now a recognized treatment to control seizures in adults and children alike. Many pediatric neurologists and hospitals offer dietary therapy. This therapy is often advised to those whose seizures are not showing any signs of improvement through medications and surgery is not an option. Mostly, dietary therapies are used in conjunction with other treatment options. One of the following diets can help in managing seizures.
It is a low carbohydrate, low protein and high-fat diet that work wonders in treating epilepsy in children. From what the child eats to the quantity consumed, everything is closely watched and regulated. Doctors emphasize on the fact that the diet should be closely supervised and treated like a serious medicine. Furthermore, because the diet is difficult to follow, it is vital for the parents and doctor to ensure that the child is not having any side effects such as dehydration and constipation.
Modified Atkins Diet (MAD)
Often abbreviated as MAD, Modified Atkins Diet has foods similar to the ketogenic diet but is less restrictive. MAD has no limitation or restriction on calorie or fluid intake and allows the patient to consume oils and dairy products. Though the foods are not measured and weighed, the carbohydrate count is regularly monitored as that in the ketogenic diet.
The RNS® System is a device similar to a pacemaker that monitors and responds to brain activity. This device is an excellent option for those with drug-resistant epilepsy. This device constantly tracks the brain’s activity and fires electrical signals through implanted wires to stop seizures.
Vagus Nerve Stimulation or VNS therapy is another treatment option to control seizures. Also referred to as the ‘pacemaker of the brain’, this device sends regular and mild pulses of electrical energy to the brain via the vagus nerve; thus, preventing seizures.
Some areas of the brain with abnormal brain tissue can lead to epilepsy. There are numerous reasons for an abnormality to occur and it may not be important unless it leads to seizures. The position and size of the area, known as the epilepsy focus, differs between individuals. Seizures can be cured if surgery can successfully remove the epilepsy focus. The chance of success and complications after the surgery also vary from patient to patient. Surgery is only advised when medications and other treatment options fail in suppressing the symptoms.