26 October 2014

Treatment for Epilepsy

Epilepsy should be accurately diagnosed so that an effective treatment can be given.

Diagnosis is by a good clinical evaluation from a doctor who is familiar with the disease. In addition, other tests like an EEG (electroencephalogram, recording of brain waves) may be requested to confirm and classify the epilepsy; as well as a CT Scan or MRI of the brain, to find out what is causing it.

Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. Research suggests that medication and other treatments may be less successful in treating epilepsy when delayed and when seizures and their consequences have become established.

Doctors who treat epilepsy come from many different fields of medicine. They include neurologists, pediatricians, pediatric neurologists, internists, and family physicians, as well as neurosurgeons and doctors called epileptologists who specialize in treating epilepsy.

People who need specialized or intensive care for epilepsy may be treated at large Epilepsy centers (at St Luke’s Medical Center, Makati Medical Center, Philippine General Hospital, Medical City, Philippine Children’s Medical Center) and neurology clinics at hospitals or by neurologists in private practice.

An EEG costs from between 800- 2500 pesos; while an CT scan costs 5,000- 6,000 pesos; an MRI 7,000 – 12,000 pesos.

Medications and other treatments help manage seizures. More than 12 different antiepileptic drugs are now on the market in the Philippines, all with different benefits and side effects.

The choice of which drug to prescribe, and at what dosage, depends on many different factors, including the type of seizures a person has, the person’s lifestyle and age, how frequently the seizures occur, and, for a woman, the likelihood that she will become pregnant. People with epilepsy should follow their doctor’s advice and share any concerns they may have regarding their medication.

For most people with epilepsy, seizures can be controlled with just one drug at the right dose.

Using too many drugs in combination can worsen or aggravate side effects such as fatigue and decreased appetite, so doctors usually prescribe monotherapy, or the use of just one drug, whenever possible. Combinations of drugs are sometimes prescribed if monotherapy fails to effectively control a patient’s seizures.

Patients have to take medications 1-3x/day, everyday, for several years and other cases, for their lifetime.

Most side effects of antiepileptic drugs are relatively minor, such as fatigue, dizziness, or weight gain. However, severe and life-threatening side effects such as allergic reactions can occur.

Epilepsy medication also may predispose people to developing depression or psychoses. People with epilepsy should consult a doctor immediately if they develop any kind of rash while on medication, or if they find themselves depressed or otherwise unable to think in a rational manner.

If seizures are controlled within 2-5 years of medications, medications are eventually tapered and discontinued upon the advise of the doctor.

Some 20-30% of patients continue to have seizures that impact their daily lives in spite of medications.

People taking epilepsy medication should be sure to check with their doctor and/or seek a second medical opinion if their medication does not appear to be working or if it causes unexpected side effects.

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