Treatment of epilepsy

Epilepsy treatment serves to decrease the number and intensity of epileptic seizures, since there is no cure for this disease.

Treatment can be done with medications, electrostimulation and even brain surgery and, therefore, the best form of treatment should always be evaluated with a neurologist, according to the intensity of each patient's crises, for example.

In addition to these proven techniques, there are still some methods that are being tried, such as cannabidiol, which is a substance extracted from marijuana that can help regulate brain electrical impulses, decreasing the chances of having a crisis. This medicine is not yet marketed in Brazil with this therapeutic indication, but in some cases and with the proper authorization, it can be imported. Learn more about cannabidiol remedies.

1. Medicines

The use of anticonvulsant drugs is usually the first treatment option, since many patients stop having frequent attacks with just one daily intake of these drugs.

Some examples include:

• Phenobarbital; Valproic acid; Phenytoin; Clonazepam; Lamotrigine; GabapentinValproate semisodium; Carbamazepine;

However, the medication and the correct dose can be difficult to find and, therefore, it is necessary to register the appearance of new crises, so that the doctor is able to assess the effect of the medication over time, changing it if find it necessary.

Although they have good results, the continuous use of these medications can cause some side effects such as tiredness, loss of bone density, speech problems, altered memory and even depression. That way, when there are few crises for 2 years, the doctor can stop using the medication.

2. Vagus nerve stimulation

This technique can be used as a substitute for drug treatment, but it can also be used as a complement to the use of medicines, when the reduction of crises is still not enough.

In this treatment method, a small device, similar to a pacemaker, is placed under the skin, in the chest region, and wire is placed up to the vagus nerve that passes through the neck.

The electrical current that passes through the nerve can help relieve up to 40% the intensity of epilepsy attacks, but it can also cause some side effects such as sore throat or feeling short of breath, for example.

3. Ketogenic diet

This diet is widely used in the treatment of epilepsy in children, as it increases the amount of fats and reduces carbohydrates, causing the body to use fat as an energy source. In doing so, the body does not need to carry glucose through the brain barrier, which decreases the risk of having an epilepsy attack.

In these cases, it is very important to have regular monitoring by a nutritionist or doctor, to ensure that the amounts of nutrients are being well respected. After two years without seizures, the doctor can slowly remove the children's food restrictions, because in many cases, the seizures disappear completely.

Understand how the ketogenic diet should be done.

4. Brain surgery

Surgery is usually done only when no other treatment technique has been sufficient to decrease the frequency or intensity of attacks. In this type of surgery, the neurosurgeon can:

• Remove the affected part of the brain: provided it is a small part and does not affect the overall functioning of the brain; Implant electrodes in the brain: they help regulate electrical impulses, especially after the onset of a crisis.

Although most of the time it is necessary to continue using medications after surgery, doses can usually be decreased, which also reduces the chances of suffering from side effects.

How treatment is done in pregnancy

Treatment for epilepsy in pregnancy with medication should be avoided, as anticonvulsants can cause changes in the baby's development and malformations. See more about risks and treatment here.

Women who have regular epileptic seizures and need medication to control them should seek advice from their neurologist and change the medication to medications that do not have as many side effects on the baby. They should also take 5 mg of folic acid before and during pregnancy and vitamin K should be administered in the last month of pregnancy.

One way to control seizures in pregnancy is to avoid the factors that cause epilepsy in women and use relaxation techniques to avoid stress.