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Epilepsy

Alternative Names:
Seizure disorder

Treatment:

For treatment of seizures, please see Seizures - first aid.

If an underlying cause for recurrent seizures (such as infection) has been identified, the cause should be treated, and this may stop the occurrence of further seizures. This may include surgical repair of tumors or brain lesions, or other treatments.

Oral anti-convulsants may reduce the number of future seizures. Response is individual, and the medication used and dosage may have to be adjusted repeatedly. The type of medicine used depends on the seizure type, as some seizure types respond well to one medication and may respond poorly (or even be made worse) by others.

The need for follow-up depends on the seizure type and medications used. Some medications need to be monitored for side effects and blood levels.

For some patients, the use of several medications may still be inadequate. This is called refractory epilepsy. Some such people may benefit from brain surgery to remove the abnormal brain cells that are causing the seizures. For others, a vagal nerve stimulator is implanted in the chest, which can help reduce the number of seizures.

Patients should wear medical alert jewelry so that prompt medical treatment can be obtained if a seizure occurs.

Support Groups:
The stress caused by having seizures (or being a caretaker of someone with seizures) can often be helped by joining a support group. In these groups, members share common experiences and problems. See epilepsy - support group.

Expectations (prognosis):
Epilepsy may be a chronic, lifelong condition. In some cases, the need for medications may be reduced or eliminated over time. Certain types of childhood epilepsy resolve or improve with age. A seizure-free period of 4 years may indicate that reduction or elimination of medications is possible.

Death or permanent brain damage from seizures is rare, but can occur if the seizure is prolonged or 2 or more seizures occur in proximity (status epilepticus). Death or brain damage are most often caused by prolonged lack of breathing and resultant death of brain tissue from lack of oxygen. There are some cases of sudden, unexplained death in patients with epilepsy.

Serious injury can occur if a seizure occurs during driving or when operating dangerous equipment, so these activities may be restricted for people with poorly controlled seizure disorders.

Infrequent seizures may not severely restrict the person's lifestyle. Work, school and recreation do not necessarily need to be restricted.

Complications:
  • Prolonged seizures or numerous seizures without complete recovery between them (status epilepticus)
  • Injury from falls, bumps, or self-inflicted bites
  • Injury from having a seizure while driving or operating machinery
  • Inhaling fluid into the lungs and subsequent aspiration pneumonia
  • Permanent brain damage (stroke or other damage)
  • Difficulty with learning
  • Side effects of medications
  • Many anti-epileptic medications cause birth defects -- women wishing to become pregnant should alert their doctor in advance in order to adjust medications


Calling your health care provider:

Call your local emergency number (911) if this the first time a person has had a seizure or a seizure is occuring in someone without a medical ID bracelet (instructions explaining what to do). In the case of someone who has had seizures before, call the ambulance for any of these emergency situations:

  • This is a longer seizure than the person normally has, or an unusual number of seizures for the person
  • Repeated seizures over a few minutes
  • Repeated seizures where consciousness or normal behavior is not regained between them (status epilepticus)

Call your health care provider if any new symptoms occur, including possible side effects of medications (drowsiness, restlessness, confusion, sedation, or others), nausea/vomiting, rash, loss of hair, tremors or abnormal movements, or problems with coordination.



Review Date: 11/5/2002
Reviewed By: Joseph V. Campellone, M.D., Division of Neurology, Cooper Hospital/University Medical Center, Camden, NJ. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2003 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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