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Treatment Options


 
If I have seizures, do I need to see a neurologist who specializes in epilepsy?
  What can I expect from my neurologist or epileptologist?
  What are some of the possible treatment options?
  What are NEEs or (non-epileptic events), psychogenic seizures?

If I have seizures, do I need to see a neurologist who specializes in epilepsy?

Though you don't 'need' to see a neurologist who specializes in epilepsy, it is recommended. It is important to have a doctor who not only knows about epilepsy in depth, but also has a better understanding of treatment for different types of seizures. The treatment and drug therapy often depends on what type of seizure you have. Request that your primary doctor or pediatrician refer you to a neurologist who specializes in epilepsy. The neurologist or epilepsy specialist can work with your primary doctor to manage your seizures. Also, it is important to feel at ease with your doctor and to let him or her know exactly what's bothering you. Chances are, he or she has seen and heard similar situations before and may be able to advise and help you.

What can I expect from my neurologist or epileptologist?

The epilepsy specialist will work with your primary doctor to:

1 Verify that seizures are epileptic in nature. (Epilepsy isn't always the case especially if the seizure happens only once)

2 Define seizure types and the epilepsy syndrome. (This will enable the doctor to discern which treatment is best for you. 
    Different seizure types require different medicines sometimes.)

3 Prove the likely cause of epileptic seizures and stop trigger factors. (This will help to limit future seizures.)

4 Establish an early treatment plan based on #1 to #3 and discussions with the patient and family. (This helps to facilitate 
    epilepsy and seizure management plan. It also allows everyone involved to be on the same page.)

5 Monitor seizure control and recognize adverse effects of seizures and treatment on quality of life. (This process makes 
    sure that the plan and strategy taken is right for you. Be sure to tell your doctor(s) any concerns that you might have 
    regarding the treatment and/or seizures even if these concerns seem trivial to you...)

6 If the first treatment plan does not work, explore other treatment options. (There are more options and strategies than just 
    one. Don't give up if it doesn't work the first time...sometimes it will take time for your body to adjust to medicines...and 
    sometimes, different medicines or routines could have a more favorable result.)

What are some of the possible treatment options?

Medications
Click here to link to the national Epilepsy Foundation website for more information about medications, side-effects, generics, etc.

Surgery
Surgery is an option for some kinds of seizures. There are various types of surgeries. 
Click here to link to the national Epilepsy Foundation website for more information about surgeries for epilepsy.

Ketogenic Diet
The ketogenic diet is an old and a new treatment option. It has been used in the past and has now found new support and use primarily as a result of advocacy work by the Charlie Foundation and the desperate pleas of parents for more successful treatment options for their children.
Click here to link to the national Epilepsy Foundation website for more information about the Ketogenic Diet.

Vagal Nerve Stimulator
The most recent option for reducing and/or controlling seizures is the vagal nerve stimulator.
Click here to link to the national Epilepsy Foundation website for more information about the VNS.

What are NEEs or (non-epileptic events), psychogenic seizures?

An audience is usually present during hysterical or psychogenic seizures. Consciousness is preserved, amnesia is absent or patchy, and movements that simulate epileptic convulsions do not have tonic-clonic phases or in-phase clonic movements of the upper extremities. Movements are out of phase, chaotic,and bizarre without stereotype. Side-to-side head movements are observed in 1/3 of patients and forward pelvic thrusting in almost 1/2 of those experiencing psychogenic seizures. The attack ends abruptly with the patient alert and showing no post-ictal tiredness. A prior psychiatric history is usually present; psychogenic seizures are seldom the sole symptom and sign. Both psychogenic seizures and epileptic seizures can exist together in the same patient. An EEG and CCTV-EEG monitoring can be useful in differentiating the two.

 

 

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