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How To Manage Your Epilepsy

Everyday life can be challenging when you have epilepsy, especially when seizures happen often. Surgery is an option that allows patients to manage their seizures so they can get back to an active and fulfilling life. Here are some treatment options you’ll want to know.

What are the Different Types of Seizures?

Before determining treatment for a seizure, it's critical to understand the type of seizure a patient is experiencing. Seizures fall under two categories — generalized and partial. The following are the different types and symptoms:

Tonic-Clonic Seizures

Symptoms may include:

  • Loss of consciousness
  • Body stiffening (tonic phase)
  • Violent jerking (clonic phase)
  • Postictal state (similar to deep sleep)
  • Tongue biting
  • Urinary incontinence

Absence Seizures

Symptoms may include:

  • Blank expression
  • Episodes begin or end abruptly
  • May occur several times a day
  • Feeling of loss of time/ unaware of the seizure happening

Atonic

Also known as "drop attacks" or "drop seizures,” symptoms may include:

  • Sudden loss of muscle tone
  • Going limp and falling
  • Drooping eyelids
  • Seizures usually last less than 15 seconds

Partial Seizures

Symptoms may include:

  • Jerking or spastic movements
  • Heightening of senses (sight, hearing, smell, and touch)
  • Feelings of déjà vu or other emotions such as pleasure or fear
  • Patients may have an awareness of the seizure

Complex Partial

Symptoms may include

  • Patient seemingly "out of it."
  • Staring into space
  • Non-responsive when spoken to
  • Repetitive movements such as lip-smacking, fidgeting, or chewing

Myoclonic

Symptoms may include sporadic movements, usually on both sides of the body simultaneously. Myoclonic seizures may go undiagnosed, as movements are brief and may be attributed to a person having tics, tremors or clumsiness.

Surgery Options in Managing Seizures

Either curative or palliative surgery can help manage seizures. Curative surgery removes the seizures, and palliative surgery can prevent them from spreading. Some of the most common types of surgeries performed on epilepsy patients are:

 
  • Lobectomy is the most common surgery used to treat epilepsy by removing part of the lobe within the brain to eliminate the area where the brain seizures begin.
     
  • Lesionectomy involves finding lesion damage in the brain tissue and then removing it only if the lesion does not exist within the eloquent cortex. This is the part of the brain that if removed, the patient can suffer a loss of sensory processing, linguistic abilities, or paralysis.
     
  • Hemispherectomies remove part of the brain's cortex to help patients who suffer from brain damage that only affects specific parts of the body.
     
  • Corpus callosotomy surgery may be necessary to find problem areas in the brain that cannot be targeted or is to close to critical brain areas. This type of surgery is rarely performed and usually best for patients with an overwhelming burden of secondarily generalized tonic-clonic seizures. It does not stop seizures altogether but can limit seizures from spreading to other brain hemispheres.
     
  • Multiple subpial transection surgery consists of a series of small incisions to prevent seizures from spreading across brain hemispheres. Similar to corpus callosotomy, it does not eliminate seizures but prevents them from getting worse.
     
  • Responsive Neurostimulation (NeuroPace) is for patients who would have been considered good surgical candidates however cannot get a lobectomy or customized resection because the area where the seizures start involves eloquent cortex with too great a risk for major complications if removed. This involves implanting a device underneath the skull that places electrodes in and over the area where seizures start and detects when seizures begin and then responds by sending a train of electrical stimulation to the region to stop the seizure from spreading.
     
  • Vagal Nerve Stimulation (VNS) involves a minor surgical procedure that involves implantation of a device underneath the chest wall with electrodes placed on the left vagus nerve in the neck in order to help decrease the intensity and frequency of seizures.

When Epilepsy is Left Undiagnosed

There are many cases in which epilepsy can be diagnosed as another disorder — and some conditions may also be a co-disorder to epilepsy. Knowing the coexisting symptoms of epilepsy and other ailments can help doctors make the proper diagnosis of each.

Migraines

Patients who have migraines are more likely to have epilepsy, and those with epilepsy may also experience migraine headaches.

ADHD

Patients who are diagnosed with ADHD (attention deficit hyperactivity disorder) are more likely also to have epilepsy. A dual diagnosis of epilepsy and ADHD can pose many challenges, as some medications can make ADHD symptoms worse or trigger seizures.

Autism

Children with autism are more likely to have epilepsy and vice-versa. It may be hard to pinpoint seizure activity in a child with autism because some of the symptoms could mimic autistic behaviors such as:

  • Cognitive delay
  • Staring episodes
  • Stiffening
  • Shaking
  • Loss of attention

If you think you may have not been diagnosed properly, consulting an experienced neurologist can help provide you with a solution and proper treatment of your conditions.

Contact a specialized Neurology Center To Learn More About Managing Epilepsy

If you or someone you love is suffering from seizures, you aren't alone. We are committed to helping patients learn how to manage and cope with epilepsy. Contact Amor Mehta MD - Neurology Center for Epilepsy & Seizures, LLC today at (732) 800-4587 to learn more about how we can help you prevent or limit the occurrence of seizures.
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