There's good news for people with epilepsy: Treatment options have improved dramatically over the last decade. Although there's still no cure, epilepsy can usually be managed quite well with the right treatment, which now may include antiepileptic medications, surgery, and vagus nerve stimulator therapy. Understanding all of these options can help you talk knowledgeably with your doctor about finding the right treatment plan to manage your particular situation most effectively.
Epilepsy Medications
Antiepileptic medications are usually the first line of defense in treating epilepsy most of those with epilepsy respond well to drug therapy. In more than a decade, at least a dozen new medications have hit the market and more are in the pipeline, giving physicians more options than ever. There are now more than 20 different types of seizure medicines on the market.
Unfortunately, however, many people with epilepsy experience unpleasant side effects from their medications - dizziness, drowsiness, weight gain or loss, and/or headaches - but think they have to put up with them to keep the seizures at bay. In fact, a different medication might be a better solution for them. "The real goal is to get people to become both seizure- and side effect-free, which is why everyone needs to communicate with their physician if they're having any side effects," says Georgia Montouris, MD, assistant professor of neurology at the Boston University School of Medicine and director of epilepsy services at Boston Medical Center.
The individuals with epilepsy either don't tolerate medications or don't respond to the current medications, so they continue having seizures. Investigative clinical drug trials may offer new options to these individuals. And they also may be candidates for surgery or other types of therapy.
VNS Therapy for Epilepsy
With vagus nerve stimulator therapy, a pacemaker-like generator is implanted under the skin, usually on the chest. Then, an electrical wire is connected between the generator and the vagus nerve in the side of the neck. Electrical signals are sent from the generator to the vagus nerve and then on to the brain to block the type of cerebral activity that triggers seizures. While VNS has been shown to be effective in reducing the number of seizures a person has, it most likely will not stop seizures completely. VNS is typically tried when other types of treatments have been proven ineffective.
Surgery for Epilepsy
Surgery also is an option, although only a small percentage of those individuals who don't respond to medications actually qualify for it. "The problem is that you need to be able to identify the part of the brain where seizures are originating and then remove that section without causing speech problems, paralysis, or other complications - none of which is easy," explains Ilo E. Leppik, MD, adjunct professor of neurology at the University of Minnesota in Minneapolis, director of research at MINCEP Epilepsy Care in Minneapolis, and author of Epilepsy (Demos Medical Publishing, 2006).
Deep Brain Stimulation for Epilepsy
Finally, there's an experimental therapy called deep brain stimulation that's currently being tested. In this therapy, rather than connecting to the brain through the vagus nerve as VNS therapy does, an electrode is implanted in the brain itself and stimulates brain cells directly, Dr. Leppik says. This treatment, however, most likely would be reserved for people who are resistant to medication and who may not have had success with VNS therapy. While this technique has been approved for Parkinson's Disease and seems to be safe and effective in clinical trials, deep brain stimulation is still several years away from receiving approval from the Food and Drug Administration for epilepsy.
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Epilepsy Treatment Options - Epilepsy Cemter ...