If your doctor suspects an infection as the cause of a seizure, you may need to have a sample of cerebrospinal fluid removed for testing. From medication and diet changes to implants and surgery, learn about the various options for epilepsy treatment. Brain imaging tests such as an MRI or CT scan can help narrow down a possible cause you could treat. Drugs called anticonvulsants can stop or lessen seizures for people with epilepsy. If you can't treat the cause of your seizures, or you don't know what it is, your doctor may also.
seizure disorders treat To
Two or more unprovoked seizures separated by more than 24 hours One unprovoked seizure with an underlying predisposition to seizures recurrence risk over the next 10 years that is similar to the recurrence risk after two unprovoked seizures Diagnosis of an epilepsy syndrome Symptomatic epilepsy: See provoked seizure for details.
Epilepsy Unprovoked seizure epileptic seizure: Provocative factors for epilepsy Situational factors that can trigger epileptic seizures in epilepsy patients: Excessive physical exertion Sleep deprivation Strobe light flashing Loud music Provoked seizures Acute symptomatic seizures that are secondary to acute conditions: Metabolic and electrolyte disturbances: Common causes according to age group References: Ictal phase Sudden onset Rapid progression of symptoms Duration usually 1—3 minutes Postictal phase Varying degree of confusion , impaired alertness Residual neurologic symptoms e.
Focal seizures Origin Ictal phase Post-ictal phase Focal seizure with intact consciousness simple partial seizures Focal cerebral regions confined to one hemisphere Prodromal symptoms: Ictal phase Post-ictal phase Generalized motor seizure Tonic-clonic seizure Prodromal symptoms may occur hours before seizure onset e.
Brief loss of consciousness Interrupted motion or activity, blank stare , unresponsiveness Can occur several hundred times a day and usually ceases after 5—20 seconds Very subtle automatisms often go unnoticed!
Confirm a seizure Patient history: If no epileptiform discharges are detected, diagnosis of pseudoseizures should be considered. In every patient with loss of consciousness during an ictal event , cardiogenic causes e. West syndrome , benign epilepsy with centrotemporal spikes , juvenile absence epilepsy Constellation: Vasovagal syncope Stokes-Adams attack Carotid sinus syndrome Cardiac failure Orthostatic hypotension Stroke including transient ischemic attack Migraine Sleep disorders REM sleep behavior disorder Narcolepsy Breath-holding spell benign condition Occurs in children 6 months—6 years Strong association with iron deficiency anemia Clinical features Episodes of prolonged expiratory apnea Followed by loss of consciousness syncope Transient paroxysms of cyanosis or pallor Possibly generalized stiffness and jerky movements of the limbs anoxic seizure Triggers: Only if atypical presentation of BHS: CBC , serum ferritin rule out iron deficiency anemia Treatment: Acute management Cardiopulmonary resuscitation ABCs Avoid hazards Monitor vital signs especially oxygenation via pulse oximetry First seizure Long-term medical therapy is usually not required, unless there are abnormalities seen on EEG or MRI or the patient is in status epilepticus.
Remove cause or provoking factors e. Generalized convulsive status epilepticus GCSE: GCSE is a medical emergency and must be addressed as soon as possible! Coma , tonic-clonic movements, generalized convulsions After extended seizure activity, the clinical features may become less obvious but seizure activity may still be seen on EEG Nonconvulsive status epilepticus NCSE: Place patient in recovery position to prevent injury.
Quick neurological examination to determine type and cause of status epilepticus and general medical evaluation particularly airway , breathing, and circulation Establish secure IV access two, if possible , collection of blood for routine blood tests particularly electrolytes and glucose levels , toxicology screen, antiepileptic drug levels, and arterial blood gas ABG analysis Supportive therapy as necessary e. IV lorazepam ; se cond line: Risk of seizure recurrence Overall risk of recurrence After the first unprovoked seizure within 2 years: State law may require that patients who have had a seizure not be permitted to drive or operate heavy machinery for a certain length of time.
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Traumatic brain injury Encephalitis Genetic disorders Illicit substance abuse. Alcohol withdrawal Traumatic brain injury Illicit substance abuse Brain tumors. Alcohol withdrawal Stroke or TIA Traumatic brain injury Brain tumors Metabolic disorders Vascular encephalopathies and vascular dementia in the elderly.
Focal cerebral regions confined to one hemisphere. Residual neurologic deficits depending on the affected cerebral region Todd's paralysis: These features include the age that seizure begin, the seizure types, EEG findings, among others. Identifying an epilepsy syndrome is useful as it helps determine the underlying causes as well as what anti-seizure medication should be tried.
The ability to categorize a case of epilepsy into a specific syndrome occurs more often with children since the onset of seizures is commonly early.
These are associated with frequent seizures that are resistant to treatment and severe cognitive dysfunction, for instance Lennox—Gastaut syndrome and West syndrome. Simple and complex modes of inheritance have been identified for some of them. However, extensive screening have failed to identify many single gene variants of large effect.
Syndromes in which causes are not clearly identified are difficult to match with categories of the current classification of epilepsy. Categorization for these cases was made somewhat arbitrarily.
Others are included in symptomatic despite a presumed genetic cause in at least in some cases , for instance Lennox-Gastaut syndrome.
Angelman syndrome were categorized symptomatic but it was argued to include these within the category idiopathic.
An electroencephalogram EEG can assist in showing brain activity suggestive of an increased risk of seizures. It is only recommended for those who are likely to have had an epileptic seizure on the basis of symptoms. In the diagnosis of epilepsy, electroencephalography may help distinguish the type of seizure or syndrome present. In children it is typically only needed after a second seizure.
It cannot be used to rule out the diagnosis and may be falsely positive in those without the disease. In certain situations it may be useful to perform the EEG while the affected individual is sleeping or sleep deprived.
Diagnostic imaging by CT scan and MRI is recommended after a first non-febrile seizure to detect structural problems in and around the brain. For adults, the testing of electrolyte, blood glucose and calcium levels is important to rule out problems with these as causes. A high blood prolactin level within the first 20 minutes following a seizure may be useful to help confirm an epileptic seizure as opposed to psychogenic non-epileptic seizure.
Diagnosis of epilepsy can be difficult. A number of other conditions may present very similar signs and symptoms to seizures, including syncope , hyperventilation , migraines , narcolepsy , panic attacks and psychogenic non-epileptic seizures PNES.
Children may have behaviors that are easily mistaken for epileptic seizures but are not. These include breath-holding spells , bed wetting , night terrors , tics and shudder attacks. While many cases are not preventable, efforts to reduce head injuries, provide good care around the time of birth, and reduce environmental parasites such as the pork tapeworm may be effective. Epilepsy is usually treated with daily medication once a second seizure has occurred,   while medication may be started after the first seizure in those at high risk for subsequent seizures.
Rolling a person with an active tonic-clonic seizure onto their side and into the recovery position helps prevent fluids from getting into the lungs. The mainstay treatment of epilepsy is anticonvulsant medications, possibly for the person's entire life. There are a number of medications available including phenytoin , carbamazepine and valproate. Low-quality evidence suggests that phenytoin, carbamazepine, and valproate may be equally effective in both focal and generalized seizures.
Slowly stopping medications may be reasonable in some people who do not have a seizure for two to four years; however, around a third of people have a recurrence, most often during the first six months. Epilepsy surgery may be an option for people with focal seizures that remain a problem despite other treatments.
Neurostimulation may be another option in those who are not candidates for surgery. There is tentative evidence that a ketogenic diet high- fat , low-carbohydrate , adequate- protein decreases the number of seizures and eliminate seizures in some; however, further research is necessary. Avoidance therapy consists of minimizing or eliminating triggers. For example, those who are sensitive to light may have success with using a small television, avoiding video games, or wearing dark glasses.
Exercise has been proposed as possibly useful for preventing seizures,  with some data to support this claim. As an add-on therapy in those who are not well controlled with other medications, cannabidiol appears to be useful in some children. Alternative medicine, including acupuncture ,  psychological interventions ,  routine vitamins ,  and yoga ,  have no reliable evidence to support their use in epilepsy.
Melatonin , as of [update] , is insufficiently supported by evidence. People with epilepsy are at an increased risk of death. Mortality is often related to: Epilepsy is one of the most common serious neurological disorders  affecting about 39 million people as of [update]. The estimated prevalence of active epilepsy as of [update] is in the range 3—10 per 1,, with active epilepsy defined as someone with epilepsy who has had a least one unprovoked seizure in the last five years.
The oldest medical records show that epilepsy has been affecting people at least since the beginning of recorded history. The oldest known detailed record of the disease itself is in the Sakikku , a Babylonian cuneiform medical text from — BC. The ancient Greeks had contradictory views of the disease.
They thought of epilepsy as a form of spiritual possession, but also associated the condition with genius and the divine. The Greeks thought that important figures such as Julius Caesar and Hercules had the disease. In the fifth century BC, Hippocrates rejected the idea that the disease was caused by spirits.
In his landmark work On the Sacred Disease , he proposed that epilepsy was not divine in origin and instead was a medically treatable problem originating in the brain. In Ancient Rome people did not eat or drink with the same pottery as that used by someone who was affected. In northern Italy, epilepsy was once traditionally known as Saint Valentine's malady.
In the mids, the first effective anti-seizure medication, bromide , was introduced. Stigma is commonly experienced, around the world, by those with epilepsy. Seizures result in direct economic costs of about one billion dollars in the United States.
Those with epilepsy are at about twice the risk of being involved in a motor vehicular collision and thus in many areas of the world are not allowed to drive or only able to drive if certain conditions are met. Those with epilepsy or seizures are typically denied a pilot license.
There are organizations that provide support for people and families affected by epilepsy. Seizure prediction refers to attempts to forecast epileptic seizures based on the EEG before they occur. Gene therapy is being studied in some types of epilepsy. Epilepsy occurs in a number of other animals including dogs and cats and is the most common brain disorder in dogs.
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list of anti-epileptic drugs
Witnessing someone with epilepsy having a seizure can be truly frightening. But most Focal onset seizures start in a single part of the brain. Her arm might . WebMD does not provide medical advice, diagnosis or treatment. Epilepsy is a chronic disorder that causes unprovoked, recurrent seizures. A seizure is a sudden rush of electrical activity in the brain. There are. Medication used to treat epilepsy may also cause biotin or vitamin D deficiency, and worsen your symptoms. In these cases, your doctor may recommend.