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About Seizure

Seizures are sudden uncontrollable electrical disruptions in the brain. A seizure can alter your behavior, movements, and awareness. Seizures are usually a singular occurrence. Suffering two or more unprovoked seizures at least 24 hours apart is known as epilepsy. Seizure types vary drastically in their range of symptoms and severity. On average, a seizure lasts from 30 seconds to 2 minutes.

Doctors divide seizures into two types: focal and generalized. The type of seizure depends on how and where the abnormal brain activity occurs. Seizures may be provoked by a head injury, a stroke, an infection (such as meningitis), or illness. Not everyone who has one seizure will have another. Because a seizure can be an isolated incident, your doctor may not decide to start treatment until you've had more than one.

Below are common treatment options for seizures. During your appointment, talk to your doctor about what treatment plan is right for you.
Some doctors recommend patients try a ketogenic diet (also known as the keto diet) to help control seizures. This diet consists of high-fat, low-carbohydrate foods. Because there is a limited range of foods allowed on the ketogenic diet, it might be difficult to stick to. Though less successful than the ketogenic diet, variations on a high-fat, low-carbohydrate diet, such as the low glycemic index and modified Atkins diets, may be beneficial. These diets are still being studied concerning the treatment of seizures.

If other treatments fail, surgery may be an option. People who experience seizures that always start in the same region in the brain benefit the most from surgery.

- Lobectomy: In this procedure, the part of your brain where seizures originate is located and removed.

- Multiple subpial transection (MST): MST may be used for patients whose seizures occur in a vital part of the brain that cannot be removed. This procedure involves making several shallow cuts in the grey matter of the brain.

- Corpus callosotomy: This surgery severs a band of fibers between the left and right halves of the brain. By severing this network of neurons, seizures cannot travel from one side of the brain to the other. It is possible, however, for seizures to occur on the side of the brain where they started, even after surgery.

- Hemispheric resection (hemispherotomy): This type of surgery is rare, as it involves completely removing or disconnecting one-half of the brain. Hemispherotomy is only utilized when medications fail to control seizures. After surgery, extensive rehabilitation is often required to recover lost brain function.

- Thermal ablation (laser interstitial thermal therapy): This is a minimally invasive procedure that concentrates highly focused energy on the specific area in the brain where seizures occur, killing the brain cells that produce them.

Anti-seizure medications are often used to treat seizures. Anti-seizure medications are available in many different types. The goal of medication is to find the best treatment for you with the least amount of adverse effects. The most common medications used to treat seizures include:

  • Carbamazepine (Carbatrol, Tegretol, others)
  • Phenytoin (Dilantin, Phenytek)
  • Valproic acid (Depakene)
  • Oxcarbazepine (Oxtellar, Trileptal)
  • Lamotrigine (Lamictal)
  • Gabapentin (Gralise, Neurontin)
  • Topiramate (Topamax)
  • Phenobarbital
  • Zonisamide (Zonegran)

Cannabidiol (Epidiolex), a seizure medication derived from marijuana, has been recently approved by the Food and Drug Administration.

Your doctor will consider your symptoms, the frequency of your seizures, your age, and other risk factors when determining which drug to prescribe. Finding the right medicine and dosage can be tricky. You may have to test a few different medications to find the drug that works best for you while producing the fewest side effects. Most of these medications won’t cure epilepsy or seizures, but they will help manage them.