What is an effective treatment for epilepsy?

Written by Shi De Quan
Neurology
Updated on November 07, 2024
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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 Liu Shi Xiang
Neurology
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What causes epilepsy?

The causes of epilepsy mainly include some congenital factors, such as pathological changes during pregnancy or childbirth, which can lead to the occurrence of epilepsy in children. In adults, epilepsy is generally secondary to severe head trauma, cerebrovascular disease, intracranial tumors, encephalitis, etc. Therefore, for patients with epilepsy, it is first necessary to actively remove various inducements and then to treat according to the type of epileptic seizures. Epilepsy mainly includes generalized seizures and partial seizures. Patients with generalized epileptic seizures can take medications such as sodium valproate and diazepam for treatment. Patients with partial epileptic seizures can take medications such as carbamazepine, oxcarbazepine, gabapentin, and levetiracetam for treatment. Generally, the symptoms of epilepsy can be effectively controlled after patients follow a standardized medication treatment regimen.

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Written by Tang Bo
Neurology
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Is epilepsy easy to treat?

Epilepsy is a disease for which the cause can be identified in some patients, while in others it may remain unknown. Initially, it is important to investigate the cause of epilepsy. Moreover, if an individual experiences multiple seizures, medication intervention becomes necessary. The primary goal of drug treatment for epilepsy is to control it and prevent further seizures, since each seizure can cause brain cell damage, potentially leading to long-term effects like memory decline and slower reaction times. Therefore, active control of epilepsy through medication is crucial. Whether epilepsy can be completely cured depends on its underlying cause. In some cases, identifying and eliminating the cause may prevent further seizures. However, for some patients, even if the cause is identified, such as a past stroke or tumors that induce epilepsy, seizures may continue even after the tumor is removed. Meanwhile, for epilepsy of unknown origins, the approach is to control the condition using medication to minimize the occurrence of seizures as much as possible, though it is not guaranteed that seizures will not happen again in the future.

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Written by Tang Bo
Neurology
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What is epilepsy?

Epilepsy is a common disease in neurology and includes many types, generally including primary epilepsy and secondary epilepsy. Primary epilepsy refers to cases where the cause is unknown, while secondary epilepsy has a clear cause. Common causes include developmental disorders of the cerebral cortex, tumors, and cerebrovascular diseases, traumatic brain injuries, and central nervous system infections, including encephalitis, meningitis. Cerebrovascular diseases such as cerebral hemorrhage and cerebral infarction can also induce epilepsy. Additionally, certain neurodegenerative diseases, such as motor neuron disease and late-stage Parkinson's disease can also trigger epileptic seizures. Patients with ischemic hypoxic encephalopathy and toxic encephalopathy may also experience epileptic seizures, and some systemic diseases may also lead to epileptic seizures.

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Written by Yan Xin Liang
Pediatrics
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What are the symptoms of epilepsy in children?

The typical symptoms of childhood epilepsy include sudden loss of consciousness, followed initially by tonic and then clonic convulsions, often accompanied by screaming, cyanotic facial complexion, frothing or bleeding at the mouth, dilated pupils, generally lasting 40 seconds or up to 15 minutes. The convulsive seizure stops naturally, followed by a state of coma. Of course, some affected children also display varying degrees of consciousness disorders, evident disruptions in thinking, perception, emotion, and psychomotor functions, and may show signs of conditions like somnambulism and noctambulism, among other automatisms.

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Written by Yan Xin Liang
Pediatrics
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Can children's epilepsy be effectively treated?

Can childhood epilepsy be cured? Firstly, it depends on the type of epilepsy. If the symptoms are not very severe, the frequency of convulsions is low, and comprehensive exams such as brain MRI and genetic testing show no problems, and the child's intellectual development is normal, then this type of epilepsy might be curable. Generally, after 2 to 3 years of effective antiepileptic drug treatment and then gradually discontinuing the medication if there are no further seizures, the condition can usually be controlled. However, some types of epilepsy are associated with underlying diseases, such as cerebral palsy, inherent metabolic genetic disorders, poor brain development, or organic brain lesions. The treatment outcomes for these types of epilepsy are not good, and they are generally difficult to control.