How is epilepsy treated?

Written by Tang Bo

Neurology

Updated on September 22, 2024

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Epilepsy treatment can be divided into the following aspects: First is etiological treatment. If epilepsy is caused by tumors or cerebrovascular diseases, surgical removal of the lesion can relieve epilepsy, but seizures often still occur, so medication must not be stopped. Secondly, pharmacological treatment is necessary for epilepsy induced by unclear causes or genetic metabolic diseases. Treatment involves taking and adjusting medications under medical guidance, based on different types of seizures and individual patient circumstances. Additionally, for some cases where the cause cannot be clearly identified and no epileptic foci are found, functional surgery can be performed for treatment.

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Written by Liu Shi Xiang

Neurology

1min 13sec

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What causes epilepsy in children?

The causes of epilepsy in children primarily include congenital factors and acquired factors. Congenital factors are mainly due to premature birth, difficult labor, umbilical cord around the neck, neonatal intracranial hemorrhage, drug factors, etc. Acquired factors mainly include brain trauma, central nervous system infections, cerebrovascular disease, intracranial tumors, and other causes. Therefore, when a child exhibits symptoms of epilepsy, it is necessary to promptly visit the department of neurology to conduct relevant examinations to determine the cause. The examination methods mainly include CT, MRI, EEG, cerebrospinal fluid analysis, etc. After identifying the cause, symptomatic treatment methods should be adopted to control the symptoms of epilepsy episodes. In clinical practice, controlling epilepsy is mainly achieved through drug treatment, with commonly used medications including carbamazepine, sodium valproate, gabapentin, etc. For some patients with refractory epilepsy, surgical treatments may also be used to control symptoms.

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Written by Yuan Jun Li

Neurology

1min 16sec

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Does epilepsy have symptoms when it is not causing seizures?

When epilepsy is not active, there are no symptoms. Patients mainly show recurrent epileptic seizures, usually lasting three to five minutes. After the seizure stops, the patient does not exhibit any symptoms or signs. Clinically, epilepsy is categorized into primary and secondary types. For primary epilepsy, if a patient experiences more than two episodes, routine use of anti-epileptic drugs is recommended. The choice of medication varies depending on the type of epilepsy. Typically, monotherapy is preferred initially. However, if monotherapy is ineffective or causes substantial side effects, a combination of two or more anti-epileptic drugs may be used to try to control the seizures. In cases of secondary epilepsy, which often has a clear cause, the primary focus is on treating the underlying condition. This includes long-term cerebrovascular diseases like cerebral hemorrhage and cerebral infarction, as well as conditions like encephalitis and brain tumors. Treatment should be tailored to the specific disease.

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Written by Tang Bo

Neurology

1min 10sec

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What are the clinical manifestations of epilepsy?

Epilepsy is caused by abnormal discharges of brain cells, and the symptoms and clinical manifestations vary depending on the area of discharge. Main symptoms can include sudden loss of consciousness, rigidity followed by clonic convulsions, and may also involve cyanosis or purpling of the face, tongue biting, frothing at the mouth, urinary incontinence, dilated pupils, continuing for several seconds to minutes before stopping. This condition is called a generalized tonic-clonic seizure. Some patients may also experience sudden brief loss of consciousness and interruption of ongoing actions, with a blank stare and unresponsive to calls. They may perform simple automatic actions like swallowing or chewing. Generally, there is no falling, and the patient has no memory of the episode afterwards. This type of seizure is known as an absence seizure. Additionally, some may experience rigidity and clonic convulsions in one limb or a localized area, etc.

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Written by Shi De Quan

Neurology

1min 17sec

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What is an effective treatment for epilepsy?

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 Li Jiao Yan

Neonatology

41sec

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What are the symptoms of epilepsy in children?

Epilepsy is a chronic brain disorder caused by various etiologies, characterized by repetitive, episodic, and transient central nervous system dysfunction due to abnormal and excessively synchronized discharges of brain neurons. The clinical manifestations of childhood epilepsy are complex and varied, commonly including loss of consciousness, localized or generalized muscular rigidity or clonic convulsions, and sensory abnormalities; there may also be abnormal behaviors, emotional and perceptual disturbances, memory changes, and autonomic nervous system dysfunction.