Materiały źródłowe

• #1 Epilepsy – AANS

  https://www.aans.org/patients/conditions-treatments/epilepsy/

  Epilepsy may be treated with antiepileptic medications (AEDs), diet therapy and surgery. Medications are the initial treatment choice for almost all patients with multiple seizures. […] The medications treat the symptoms of epilepsy (the seizures), rather than curing the underlying condition. They are highly effective and completely control seizures in the majority (approximately 70%) of patients. […] Diet therapy may be utilized in some patients with specific forms of epilepsy. The most common diets utilized are the ketogenic diet and the modified Atkins diet. […] While approximately 70 percent of patients have well-controlled seizures with these modalities, the remaining 30 percent do not and are considered medically-resistant. Patients with medically-resistant epilepsy are often treated at specialized epilepsy centers in a multi-disciplinary fashion.

• #1 Epilepsy

  https://www.nhs.uk/conditions/epilepsy/

  If you have epilepsy you’ll be supported by your GP and a team of specialists. You’ll have check-ups at least once a year. […] The main treatment for epilepsy is medicine to prevent seizures, called anti-epileptic or anti-seizure medicine. […] You may also be given medicine to use as emergency treatment if you have a seizure that lasts longer than usual. A family member or carer will need to give this to you. […] There are different anti-epileptic medicines. The medicine recommended for you depends on the type of seizures and things like your age, sex and any other conditions you have. […] You may need to try different medicines to find what works for you. […] For most people medicines work well to prevent seizures. Rarely, you may need other treatments. These can include: surgery on your brain, putting a small electrical device under the skin on your chest to help reduce seizures (vagus nerve stimulation), a specialist diet that can reduce seizures (ketogenic diet).

• #2 Epilepsy – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/drc-20350098

  Treatment can help people diagnosed with epilepsy have fewer seizures or even completely stop having seizures. Possible treatments include: […] Most people with epilepsy can become seizure-free by taking one anti-seizure medicine, which is also called an anti-epileptic medicine. Others may be able to decrease the number and intensity of their seizures by taking more than one medicine. […] When medicines do not provide enough control of seizures, epilepsy surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that’s causing seizures. […] In vagus nerve stimulation, a device placed under the skin of the chest stimulates the vagus nerve in the neck. This sends signals to the brain that lessen seizures. […] Deep brain stimulation involves putting an electrode deep within the brain. The amount of stimulation delivered by the electrode is controlled by a device placed under the skin in the chest.

• #2 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  An implanted vagus nerve stimulation […] In vagus nerve stimulation, a device placed under the skin of the chest stimulates the vagus nerve in the neck. This sends signals to the brain that lessen seizures. […] Deep brain stimulation involves putting an electrode deep within the brain. The amount of stimulation delivered by the electrode is controlled by a device placed under the skin in the chest. A wire that travels under the skin connects the device to the electrode. […] The goal in seizure treatment is to find the best therapy that stops seizures with the fewest side effects. […] Treatment of seizures often involves antiseizure medicines. There are many types of antiseizure medicine. […] Finding the right medicine and dosage can be hard. Some people try several medicines before finding the right one in the right dosage.

• #3 Epilepsy and Seizures Treatment & Management: Approach Considerations, Anticonvulsant Therapy, Anticonvulsants for Specific Seizure Types

  https://emedicine.medscape.com/article/1184846-treatment

  The goal of treatment in patients with epileptic seizures is to achieve a seizure-free status without adverse effects. This goal is accomplished in more than 60% of patients who require treatment with anticonvulsants. Many patients experience adverse effects from these drugs, however, and some patients have seizures that are refractory to medical therapy. A 2017 study found that fewer than two thirds of patients with newly diagnosed epilepsy are seizure-free after 1 year. A smaller study published in 2000 found the seizure-free rate to be 64%, which is almost identical to the rate found in the newer study. […] […] Monotherapy is desirable because it decreases the likelihood of adverse effects and avoids drug interactions. In addition, monotherapy may be less expensive than polytherapy, as many of the older anticonvulsant agents have hepatic enzymeinducing properties that decrease the serum level of the concomitant drug, thereby increasing the required dose of the concomitant drug. […]

• #4 Patient education: Treatment of seizures in children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-seizures-in-children-beyond-the-basics/print

  Patient education: Treatment of seizures in children (Beyond the Basics) […] This article discusses common medications and treatments used to treat children with seizures. […] Seizures are treated if they recur or appear likely to recur. Not all children will require ongoing treatment for seizures, especially if the child only has one seizure and the electroencephalogram (EEG) and magnetic resonance imaging (MRI) (or other imaging test) are normal. […] Medications used to prevent seizure are called antiseizure medications, antiepileptic medications, or anticonvulsant medications. […] Most medications are started at a low dose and slowly increased until seizures no longer occur. […] A second antiseizure medication may be added or substituted if the first medication was only partially effective in stopping seizures, or if there were significant side effects with the first medication.

• #5 Seizure: What It Is, Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/22789-seizure

  If certain types of treatment aren’t successful, your provider may recommend changing the foods you eat. A low- or no-carb (ketogenic) diet may reduce how often you have seizures. Studies are ongoing to learn more about the effectiveness of dietary changes in relation to seizures. […] Medications can help you manage seizures by: Stopping a seizure as it happens. Preventing future seizures. Reducing the severity of seizures. Reducing the frequency of seizures. […] Common medications for seizures include but aren’t limited to the following: Benzodiazepine. Carbamazepine. Diazepam. Gabapentin. Lamotrigine. Oxcarbazepine. Phenytoin. Pregabalin. Valproic acid. […] A healthcare provider will offer regular follow-up appointments after you start taking a new medication to measure its effectiveness. It could take several months before you and your provider find the medication and dosage that’s right for you. Always continue taking your medications as directed, even if you feel better. […] Studies show that an estimated 33% of people who take antiseizure medications notice that seizure symptoms completely stop. Another 33% say they see less frequent symptoms after taking antiseizure medications.

• #6 Seizure Treatment

  https://www.nationwidechildrens.org/specialties/epilepsy-center/seizure-information-for-parents/seizure-treatment

  The primary treatment for seizures is antiepileptic medicine. Seizure medications do not cure seizures, they control seizures. Your child needs to take the medicine on a regular basis every day to keep an even level of medication in their body. Most medications are taken two (2) times each day but some may be taken only once a day and some may need to be taken three (3) or four (4) times a day. The type of medicine used for your child will depend on the type of seizures, your child’s age and health, and possible side effects of the medications. For example, one medicine can cause an increase in hunger and weight gain so if possible we avoid using this medication in children who are already overweight. […] There are many medications available to help children with epilepsy. Medications used most often include: Levetiracetam (Keppra), Valproic acid (Depakene, Depakote), Topiramate (Topamax), Lamotrigine (Lamictal), Oxcarbazepine (Trileptal).

• #7 Seizure: What It Is, Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/22789-seizure

  If certain types of treatment aren’t successful, your provider may recommend changing the foods you eat. A low- or no-carb (ketogenic) diet may reduce how often you have seizures. Studies are ongoing to learn more about the effectiveness of dietary changes in relation to seizures. […] Medications can help you manage seizures by: Stopping a seizure as it happens. Preventing future seizures. Reducing the severity of seizures. Reducing the frequency of seizures. […] Common medications for seizures include but aren’t limited to the following: Benzodiazepine. Carbamazepine. Diazepam. Gabapentin. Lamotrigine. Oxcarbazepine. Phenytoin. Pregabalin. Valproic acid. […] A healthcare provider will offer regular follow-up appointments after you start taking a new medication to measure its effectiveness. It could take several months before you and your provider find the medication and dosage that’s right for you. Always continue taking your medications as directed, even if you feel better. […] Studies show that an estimated 33% of people who take antiseizure medications notice that seizure symptoms completely stop. Another 33% say they see less frequent symptoms after taking antiseizure medications.

• #8 Treatment of Epilepsy | Epilepsy | CDC

  https://www.cdc.gov/epilepsy/treatment/index.html

  Anti-seizure medicines are used to stop seizures. […] Other treatments may help some people with epilepsy. […] See a neurologist or epileptologist (a neurologist who specializes in epilepsy) if your seizures don’t stop. […] The most common treatments for epilepsy are medicine, surgical procedures, seizure devices, and a special diet. […] Anti-seizure medicines limit the spread of seizures in the brain. […] Medicines work for about 2 in 3 people with epilepsy. […] If your seizures continue while taking medicine, tell your health care provider right way. […] They may want to change the amount or type of medicine you take. […] You should not skip or stop taking your seizure medicine without talking to your provider. […] Suddenly stopping your medicine might cause withdrawal symptoms, including life-threatening seizures.

• #9 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  Following a ketogenic diet can improve seizure management. A ketogenic diet is high in fat and very low in carbohydrates. […] If treatment with at least two antiseizure medicines doesn’t work, you might have surgery to stop the seizures. […] Surgery works best for people who have seizures that always begin in the same place in the brain. […] If surgeons can’t remove or separate the area of the brain where seizures start, devices that provide electrical stimulation may help. […] Researchers study other therapies that might treat seizures. These include therapies to stimulate the brain without surgery. […] One area of research showing promise is MRI-guided focused ultrasound. The therapy involves pointing ultrasound beams, which are sound waves, to an area of the brain that’s causing seizures.

• #10 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  Following a ketogenic diet can improve seizure management. A ketogenic diet is high in fat and very low in carbohydrates. […] If treatment with at least two antiseizure medicines doesn’t work, you might have surgery to stop the seizures. […] Surgery works best for people who have seizures that always begin in the same place in the brain. […] If surgeons can’t remove or separate the area of the brain where seizures start, devices that provide electrical stimulation may help. […] Researchers study other therapies that might treat seizures. These include therapies to stimulate the brain without surgery. […] One area of research showing promise is MRI-guided focused ultrasound. The therapy involves pointing ultrasound beams, which are sound waves, to an area of the brain that’s causing seizures.

• #11 Epilepsy and Seizures Treatment & Management: Approach Considerations, Anticonvulsant Therapy, Anticonvulsants for Specific Seizure Types

  https://emedicine.medscape.com/article/1184846-treatment

  A ketogenic or modified Atkins diet and vagal nerve stimulation (VNS) are nonpharmacologic methods for managing patients with seizures that are unresponsive to antiepileptic drugs. The ketogenic diet is typically used in children. […] […] The 2 major kinds of brain surgery for epilepsy are palliative and potentially curative. […] Several curative surgeries are possible, including lobectomy and lesionectomy. […] […] Outcomes of temporal-lobe surgeries are better than those for surgeries in other areas. If a patient has unilateral temporal-lobe seizures (as observed on video-EEG) and unilateral hippocampal sclerosis (as observed on brain magnetic resonance imaging [MRI]), the likelihood of a class I outcome (no seizures or only auras) at 2 years is about 85%. […] […] After a person has been seizure free for typically 2-5 years, the physician may consider discontinuing that patients medication. Many patients outgrow many epileptic syndromes of childhood and do not need to take anticonvulsants. […]

• #12 Treatment Options | Trinity Health System

  https://www.holycrosshealth.org/services/neurosciences/neurosurgery/epilepsy/treatment-options

  Thermal Laser Ablation is an advanced surgical treatment option for epilepsy. […] Temporal lobectomy is the most common surgery used to control seizures. In this procedure, neurosurgeons remove the area of the brain that produces seizures. […] Split-brain surgery is a procedure used for patients in which there are multiple sources for their seizures. […] Deep brain stimulation (DBS) is designed to help in the management of seizures, in combination with other treatments. […] Patients also may consider having a vagal nerve stimulator implant. In this procedure, the neurosurgeon implants a small device in the upper chest. The device produces vagal stimulation by sending pulses of electrical energy to the brain through the vagus nerve in the neck. This stimulation can reduce seizure activity. […] Some patients are candidates for treatment using special dietary medical therapy with the ketogenic diet. The diet is high in fat and low in carbohydrates and can help control seizures in some people with epilepsy that don’t respond to other treatments.

• #13 Epilepsy and Seizures Treatment & Management: Approach Considerations, Anticonvulsant Therapy, Anticonvulsants for Specific Seizure Types

  https://emedicine.medscape.com/article/1184846-treatment

  A ketogenic or modified Atkins diet and vagal nerve stimulation (VNS) are nonpharmacologic methods for managing patients with seizures that are unresponsive to antiepileptic drugs. The ketogenic diet is typically used in children. […] […] The 2 major kinds of brain surgery for epilepsy are palliative and potentially curative. […] Several curative surgeries are possible, including lobectomy and lesionectomy. […] […] Outcomes of temporal-lobe surgeries are better than those for surgeries in other areas. If a patient has unilateral temporal-lobe seizures (as observed on video-EEG) and unilateral hippocampal sclerosis (as observed on brain magnetic resonance imaging [MRI]), the likelihood of a class I outcome (no seizures or only auras) at 2 years is about 85%. […] […] After a person has been seizure free for typically 2-5 years, the physician may consider discontinuing that patients medication. Many patients outgrow many epileptic syndromes of childhood and do not need to take anticonvulsants. […]

• #14 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  An implanted vagus nerve stimulation […] In vagus nerve stimulation, a device placed under the skin of the chest stimulates the vagus nerve in the neck. This sends signals to the brain that lessen seizures. […] Deep brain stimulation involves putting an electrode deep within the brain. The amount of stimulation delivered by the electrode is controlled by a device placed under the skin in the chest. A wire that travels under the skin connects the device to the electrode. […] The goal in seizure treatment is to find the best therapy that stops seizures with the fewest side effects. […] Treatment of seizures often involves antiseizure medicines. There are many types of antiseizure medicine. […] Finding the right medicine and dosage can be hard. Some people try several medicines before finding the right one in the right dosage.

• #15 Epilepsy – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/drc-20350098

  Treatment can help people diagnosed with epilepsy have fewer seizures or even completely stop having seizures. Possible treatments include: […] Most people with epilepsy can become seizure-free by taking one anti-seizure medicine, which is also called an anti-epileptic medicine. Others may be able to decrease the number and intensity of their seizures by taking more than one medicine. […] When medicines do not provide enough control of seizures, epilepsy surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that’s causing seizures. […] In vagus nerve stimulation, a device placed under the skin of the chest stimulates the vagus nerve in the neck. This sends signals to the brain that lessen seizures. […] Deep brain stimulation involves putting an electrode deep within the brain. The amount of stimulation delivered by the electrode is controlled by a device placed under the skin in the chest.

• #16 Epilepsy and Seizures Treatment & Management: Approach Considerations, Anticonvulsant Therapy, Anticonvulsants for Specific Seizure Types

  https://emedicine.medscape.com/article/1184846-treatment

  A meta-analysis of VNS clinical studies reported an average reduction in seizures of at least 50% in approximately 50% of patients at last follow-up. Although VNS was not initially FDA approved for children or patients with generalized epilepsy, the authors also found that these groups benefitted significantly from VNS.

• #17 Seizures – treatments, symptoms, causes and prevention | healthdirect

  https://www.healthdirect.gov.au/seizures

  Sometimes surgery can remove a small piece of brain tissue in the area that the seizures start from. This may be an option if your seizures don’t get better with other treatments, and if your seizures always happen in the same area in of the brain. […] Vagus nerve stimulation involves putting a small device in to the chest wall (similar to a pacemaker). The device sends out electrical signals to the brain through the vagus nerve. This can reduce the number and severity of seizures. Your doctor might recommend this if your seizures don’t respond to medicines and can’t be treated with surgery.

• #18 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  An implanted vagus nerve stimulation […] In vagus nerve stimulation, a device placed under the skin of the chest stimulates the vagus nerve in the neck. This sends signals to the brain that lessen seizures. […] Deep brain stimulation involves putting an electrode deep within the brain. The amount of stimulation delivered by the electrode is controlled by a device placed under the skin in the chest. A wire that travels under the skin connects the device to the electrode. […] The goal in seizure treatment is to find the best therapy that stops seizures with the fewest side effects. […] Treatment of seizures often involves antiseizure medicines. There are many types of antiseizure medicine. […] Finding the right medicine and dosage can be hard. Some people try several medicines before finding the right one in the right dosage.

• #19 Epilepsy – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/drc-20350098

  Treatment can help people diagnosed with epilepsy have fewer seizures or even completely stop having seizures. Possible treatments include: […] Most people with epilepsy can become seizure-free by taking one anti-seizure medicine, which is also called an anti-epileptic medicine. Others may be able to decrease the number and intensity of their seizures by taking more than one medicine. […] When medicines do not provide enough control of seizures, epilepsy surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that’s causing seizures. […] In vagus nerve stimulation, a device placed under the skin of the chest stimulates the vagus nerve in the neck. This sends signals to the brain that lessen seizures. […] Deep brain stimulation involves putting an electrode deep within the brain. The amount of stimulation delivered by the electrode is controlled by a device placed under the skin in the chest.

• #20 A New Hope for Patients With Epilepsy > News > Yale Medicine

  https://www.yalemedicine.org/news/epilepsy-deep-brain-stimulation

  The FDA approved Medtronic’s 2018 DBS device for epilepsy based on data gathered from the SANTE (Stimulation of the Anterior Nucleus of the Thalamus in Epilepsy) clinical trial. […] The study followed patients for seven years. In the first year after the device was implanted, 43% of participants with it had experienced half as many seizures as they’d been having when the study began. […] For his part, Dr. Quraishi hopes that when reams of data have been collected from enough people, neurologists may have better insight into how to more accurately predict a patient’s risk of a seizure. […] Our goal is to have an app connected to the device that tells patients they have, for example, a 90% chance of having a seizure that day. […] Or even better, says Dr. Hirsch, they may be able to take extra medications based on the prediction algorithm to prevent that seizure from even happening.

• #21 10 epilepsy treatments – from lowest to highest risk | Brain | UT Southwestern Medical Center

  https://utswmed.org/medblog/epilepsy-treatments/

  If epileptic seizures are coming from one specific region of the brain, and they cannot be stopped with medications or other therapies we have discussed, the patient can be a candidate for intracranial neurostimulation. […] DBS is similar to RNS, but the electrodes are implanted in a deep brain region called the thalamus. […] Brain surgery to remove the seizure focus is the most effective method to completely stop seizures. […] About 60 percent to 80 percent of patients become seizure-free with this type of surgery. […] The goal is to stop all seizures and to avoid any side effects that would affect the quality or safety of the patient’s life.

• #22 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  Following a ketogenic diet can improve seizure management. A ketogenic diet is high in fat and very low in carbohydrates. […] If treatment with at least two antiseizure medicines doesn’t work, you might have surgery to stop the seizures. […] Surgery works best for people who have seizures that always begin in the same place in the brain. […] If surgeons can’t remove or separate the area of the brain where seizures start, devices that provide electrical stimulation may help. […] Researchers study other therapies that might treat seizures. These include therapies to stimulate the brain without surgery. […] One area of research showing promise is MRI-guided focused ultrasound. The therapy involves pointing ultrasound beams, which are sound waves, to an area of the brain that’s causing seizures.

• #23 Natural remedies for epilepsy: Diet, herbs, vitamins, and more

  https://www.medicalnewstoday.com/articles/317922

  In addition, some anecdotal evidence suggests that some people use cannabis or products containing cannabidiol (CBD) to help manage their seizures. […] However, larger scientific studies have not shown that cannabis and most CBD-based products are effective in treating epilepsy. […] There is some evidence to suggest that a ketogenic, or keto, diet which is a high fat, low carbohydrate diet could help prevent seizures in people who do not find antiepileptic drugs effective. […] Many people around the world use herbal remedies for epilepsy. […] However, there were no studies specifically showing an effect on epilepsy in humans. […] When antiepileptic drugs do not work, some people use biofeedback therapy to reduce seizures. […] Biofeedback is a noninvasive therapy that shows promise for people with epilepsy, but it needs more research.

• #24 Seizure Treatment

  https://www.nationwidechildrens.org/specialties/epilepsy-center/seizure-information-for-parents/seizure-treatment

  The Ketogenic Diet and Modified Atkins Diet are very restrictive low carbohydrate diets that may be used to treat epilepsy. […] This treatment involves placing a device that looks like a pacemaker in the chest. […] If a child has partial seizures which come from one area of the brain, surgery can sometimes be performed to remove the affected area. This type of surgery may cure epilepsy and the child may be able to stop all of their seizure medication over time.

• #25 10 epilepsy treatments – from lowest to highest risk | Brain | UT Southwestern Medical Center

  https://utswmed.org/medblog/epilepsy-treatments/

  Patients with epilepsy have many treatment options, from lifestyle changes to brain surgery. […] The medical community continually tests and approves new treatments. Here are 10 treatments, both basic and advanced, that I’ve tried to rank from least to most risk. However, almost all treatments involve some degree of risk. Discuss your options carefully with your neurologist to pick the best treatment for you. […] The complementary and alternative therapies below can be added to your treatment plan. Because there is not a lot of medical research on their effectiveness for epilepsy, it’s important to discuss each treatment with your neurologist: Acupuncture, Aerobic exercise, Biofeedback (training to voluntarily control seizures), Meditation, Yoga. […] The ketogenic diet is strict. It severely limits carbohydrates and maximizes fats and proteins. This low-carbohydrate diet triggers ketosis, an alternate metabolic pathway in the body that somehow works against seizures.

• #26 How Epilepsy Is Treated

  https://www.verywellhealth.com/epilepsy-treatments-1204498

  If surgery isn’t an option for you or you simply want to try other alternatives first, you have some other treatments to consider. […] Vagus nerve stimulation, also known as VNS therapy, is FDA-approved to treat seizures in adults and children over 4 years old whose seizures aren’t controlled after trying at least two medications. […] Responsive neurostimulation is like a pacemaker for your brain. […] In deep brain stimulation (DBS), electrodes are placed in a specific part of your brain, often the thalamus. […] Dietary changes may help in the management of your condition but should never be considered a sole treatment option. […] The ketogenic diet is often prescribed in cases where seizures aren’t responding to two or more medications, particularly in children. […] Adopting healthy habits may help control your epilepsy, as well.

• #27 Seizures: Causes, Symptoms, and Treatment

  https://www.webmd.com/epilepsy/understanding-seizures-basics

  Responsive nerve stimulation. A device implanted into your brain spots and then stops seizures. […] Deep brain stimulation. Surgeons put devices into certain brain areas and then implant a pacemaker-like machine in your chest. It can send electrodes to those regions to prevent or stop seizure activity. […] […] […] Seizure Prevention […] To reduce the chance that you’ll have a seizure, you can: […] Talk to your doctor about following a ketogenic diet, which is high in fat and protein and very low in carbohydrates. It’s been shown to be helpful in reducing how often you have seizures. […] Get good sleep. Lack of rest can be a trigger for seizures. […] Take any medications as directed. […] Try rescue medications. These don’t take the place of daily medications and should only be used to help stop a seizure quickly in emergency situations. Depending on the circumstance, they can be taken several ways and include:

• #28 Epilepsy – AANS

  https://www.aans.org/patients/conditions-treatments/epilepsy/

  In patients whose seizures are medically resistant, surgery provides the best chance of complete control of seizures. […] Surgery for the treatment of epilepsy involves resection, disconnection, stereotactic radiosurgery or implantation of neuromodulation devices. […] The vagus nerve stimulator (VNS) is an FDA-approved device for the treatment of epilepsy that is not controlled with antiepileptic medications. […] The NeuroPace responsive neurostimulation (RNS) device was approved by the FDA in 2014 as a treatment for adults with partial-onset seizures with one or two seizure onset-zones, whose seizures have not been controlled with two or more antiepileptic drugs. […] Improved technology and testing has made it possible to identify more accurately where seizures originate in the brain (epileptogenic regions), and advances in surgery have made operative management safer for all forms of surgery for epilepsy. Of the surgeries presented, surgical resection offers the best chance of rendering a patient seizure-free. However, the benefits of surgery should always be weighed carefully against its potential risks.

• #29 Nonepileptic seizures: Symptoms, causes, treatment, and tips

  https://www.medicalnewstoday.com/articles/non-epileptic-seizures

  Several clinical trials have shown varying levels of success in treating NES with cognitive behavioral therapy (CBT). […] The following additional therapies may have some benefit for people with NES: Prolonged exposure psychotherapy: A type of CBT that focuses on people with NES and PTSD. Interpersonal and psychodynamic psychotherapy: Helps individuals work through unconscious processes. Mindfulness-based psychotherapy: Addresses the relationship between the way the person thinks and the way they feel. Family therapy: An add-on therapy for families with children who have NES. […] NES do not respond to antiseizure medication. However, research suggests that sertraline, an antidepressant, shows promise as a treatment option alongside therapy. Additionally, if a person who has NES also has epileptic seizures, adjusting their antiseizure medication for better epileptic seizure control may help reduce their NES.

• #30 Psychogenic Non-Epileptic Seizures | Boston Medical Center

  https://www.bmc.org/patient-care/conditions-we-treat/db/psychogenic-non-epileptic-seizures

  Psychogenic non-epileptic seizures (PNES) are seizures that are caused by psychological distress, rather than abnormal electrical activity in your brain. The two types of seizures may look similar, but need different treatments. […] The main treatment for PNES is talk therapy, especially cognitive behavioral therapy. You may also need treatment for co-occurring psychiatric conditions.

• #31 Cognitive Behavioral Therapy Reduces the Impact of Psychogenic Nonepileptic Seizures – CURE Epilepsy

  https://www.cureepilepsy.org/news/cognitive-behavioral-therapy-reduces-the-impact-of-dissociative-seizures/

  Scientists have found that adding cognitive behavioral therapy (CBT) to standardized medical care gives patients with psychogenic nonepileptic seizures (PNES) longer periods of seizure freedom, less bothersome seizures and a greater quality of life, in a study published in Lancet Psychiatry today and by the Cognitive behavioral therapy for adults with PNES study group funded by National Institute for Health Research (NIHR). […] In the largest treatment trial to date for PNES, 368 patients from centers across England, Scotland, and Wales were followed up 6 months and 12 months after treatment courses began. Researchers found patients treated with PNES specific CBT alongside standardized medical care reported the highest number of consecutive dissociative seizure-free days in the previous 6 months, along with greater functional status, self-rated and doctor-rated change in global impression scores, and satisfaction with treatment when compared with standardized medical care alone.

• #32 Nonepileptic seizures: Symptoms, causes, treatment, and tips

  https://www.medicalnewstoday.com/articles/non-epileptic-seizures

  Several clinical trials have shown varying levels of success in treating NES with cognitive behavioral therapy (CBT). […] The following additional therapies may have some benefit for people with NES: Prolonged exposure psychotherapy: A type of CBT that focuses on people with NES and PTSD. Interpersonal and psychodynamic psychotherapy: Helps individuals work through unconscious processes. Mindfulness-based psychotherapy: Addresses the relationship between the way the person thinks and the way they feel. Family therapy: An add-on therapy for families with children who have NES. […] NES do not respond to antiseizure medication. However, research suggests that sertraline, an antidepressant, shows promise as a treatment option alongside therapy. Additionally, if a person who has NES also has epileptic seizures, adjusting their antiseizure medication for better epileptic seizure control may help reduce their NES.

• #33 Psychogenic nonepileptic seizure: An empathetic, practical approach | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/5/252

  PNES-specific counseling interventions often include education about types of seizures, identifying and managing common seizure triggers, aura interruption methods, and improved emotion management skills using relaxation training and other CBT techniques. […] Although counseling is the best intervention, antidepressants are often used to treat PNES, particularly in patients with low psychological insight or poor engagement with counseling for other reasons. […] Continuing antiseizure medications in patients with PNES has been associated with poor outcome.

• #34

  https://www.nonepilepticseizures.com/epilepsy-psychogenic-NES-faqs-forms-treatments.php

  In the last ten years, a number of psychological interventions have been studied in patients with PNES and many of them are becoming gradually and broadly available. They are summarized here: […] Cognitive behavioral therapy (CBT) is the most widely studied form of psychotherapy for PNES. CBT is a type of therapy where patients learn and apply skills to change thoughts and behaviors that facilitate the development of PNES, therefore reducing their frequency. […] Mindfulness based psychotherapy (which usually include elements of dialectical-behavioral therapy, acceptance and commitment therapy, mindfulness-based stress reduction, mindfulness-based cognitive therapy or some combination of these) is also a type of therapy where patients learn and apply skills to relate effectively to internal experiences such as thoughts and feelings. By improving awareness of these relationships, there is improved control of behaviors and symptoms, including PNES.

• #35

  https://www.nonepilepticseizures.com/epilepsy-psychogenic-NES-faqs-forms-treatments.php

  Interpersonal and psychodynamic psychotherapy (regarded as „talk therapy” by some) aims to help patients identify the underlying emotional conflicts thought to lead to PNES. By expressing these internal conflicts in a more effective way, PNES are less likely to occur. […] Prolonged exposure (PE) is a specific type of CBT for patients that suffer from both PNES and PTSD. PE helps patients emotionally process past traumatic experiences by confronting distressing memories and situations in a safe context. […] Family therapy is an adjunct to any of the above therapies, especially when working with children or adolescents presenting with PNES. An important component is therapy with the parent or caregiver, separate from the child, to address coping with symptoms, improving the child’s functioning and identifying and managing contributing family stressors.

• #36 Testing a promising treatment for functional seizures in children – UAB Reporter

  https://www.uab.edu/reporter/patient-care/advances/item/9668-testing-a-promising-treatment-for-functional-seizures-in-children

  Patients do not feel that they have control over functional seizures; but we tell them, You retrain your control over it. […] The therapy is adaptive, with weekly training and goals based on the patients individual responses to treatment. […] After the first [ReACT] session, she reported being able to prevent the onset of two functional seizures. […] In a pilot study published in August 2020, ReACT resulted in a significant decrease in functional seizures in children, even in the absence of decreased anxiety or depression symptoms. […] In July 2021, Fobian was awarded a multimillion-dollar R61/R33 grant from the National Institute of Mental Health that will allow for an expanded randomized controlled trial of the therapy in children diagnosed with functional seizures who are between 11 and 18 years old.

• #37 Seizures: Causes, Symptoms, and Treatment

  https://www.webmd.com/epilepsy/understanding-seizures-basics

  Responsive nerve stimulation. A device implanted into your brain spots and then stops seizures. […] Deep brain stimulation. Surgeons put devices into certain brain areas and then implant a pacemaker-like machine in your chest. It can send electrodes to those regions to prevent or stop seizure activity. […] […] […] Seizure Prevention […] To reduce the chance that you’ll have a seizure, you can: […] Talk to your doctor about following a ketogenic diet, which is high in fat and protein and very low in carbohydrates. It’s been shown to be helpful in reducing how often you have seizures. […] Get good sleep. Lack of rest can be a trigger for seizures. […] Take any medications as directed. […] Try rescue medications. These don’t take the place of daily medications and should only be used to help stop a seizure quickly in emergency situations. Depending on the circumstance, they can be taken several ways and include:

• #38 Natural remedies for epilepsy: Diet, herbs, vitamins, and more

  https://www.medicalnewstoday.com/articles/317922

  Vagus nerve stimulation (VNS) involves implanting a device in the chest that sends electrical signals to the brain. […] The effect of VNS varies widely among people with epilepsy. […] For people with epilepsy, stress and anxiety may increase the risk of having a seizure. […] According to a 2023 review of research, acupuncture may be useful for treating epilepsy alongside conventional treatment, like medications. […] Knowing and avoiding their triggers may help people reduce the risk of experiencing a seizure. […] Learning about epilepsy may improve quality of life for people who have seizures and their families. […] Some of the ingredients in essential oils can cross the blood-brain barrier, which means that they may be either helpful or harmful, depending on the substance. […] However, these are not a substitute for antiepileptic drugs, and more studies are needed to confirm that they are safe and effective for managing epilepsy.

• #39 First Aid for Seizures | Epilepsy | CDC

  https://www.cdc.gov/epilepsy/first-aid-for-seizures/index.html

  Seizures are common, affecting 1 in 10 people. […] You can learn to recognize a seizure, keep someone safe during a seizure, and when to call 911 for help. […] There are easy steps to help someone during and after a seizure. […] Time the seizure to track if it lasts more than 5 minutes. If it does, seek immediate medical attention or call 911. […] To help someone with this type of seizure, follow these steps to keep them safe: Ease them to the ground if they appear to be falling. […] Time the seizure to track if it lasts more than 5 minutes. If it does, seek immediate medical attention or call 911. […] Seizures don’t usually require emergency medical attention. […] But you should call 911 if one or more of these things happen: The seizure lasts longer than 5 minutes. […] It is also important to call 911 if the person having the seizure: Has never had a seizure before. […] Get Seizure First Aid Training. […] Free, online on-demand training is available through the Epilepsy Foundation. […] Epilepsy is a broad term used for a brain disorder that causes seizures.

• #40 Seizures – treatments, symptoms, causes and prevention | healthdirect

  https://www.healthdirect.gov.au/seizures

  If someone is having a seizure, prevent them from injuring themselves and stay with them until the seizure has finished. Call an ambulance if the seizure lasts for more than 5 minutes, if the person is unresponsive for more than 5 minutes afterwards, or a second seizure quickly follows the first. […] For most people, medicines are effective in managing seizures. […] Medicines are the usual treatment for epilepsy, however there are other options that your doctor may recommend. […] If your doctor diagnoses epilepsy, they will usually prescribe you medicines to control your seizures. These medicines are called antiepileptic drugs, and around 2 in every 3 people with epilepsy will be able to manage their seizures with medicines. […] Some adults and children whose seizures do not respond to medicines can try a special diet called the ketogenic diet to help with some types of seizures.

• #41 Epilepsy – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/drc-20350098

  Some children and adults with epilepsy reduce their seizures by following a diet high in fats and low in carbohydrates. This may be an option when medicines aren’t helping to control epilepsy. […] Researchers are studying many potential new treatments for epilepsy, including: Continuous stimulation of the seizure onset zone, known as subthreshold stimulation.

• #42 10 epilepsy treatments – from lowest to highest risk | Brain | UT Southwestern Medical Center

  https://utswmed.org/medblog/epilepsy-treatments/

  Medications that have been tested in rigorous scientific trials and gotten approval from the U.S. Food and Drug Administration (FDA) are the mainstay of epilepsy treatment. […] The first medication might not be effective or might cause intolerable side effects. We usually will try a second medication by itself, but sometimes two or more are needed. Unfortunately, about 30 percent to 40 percent of patients do not respond to medications at all, and we must consider other therapies. […] Medical marijuana is a term that now refers to one of more than 80 chemical compounds found in the cannabis plant cannabidiol oil or CBD oil. […] The goal of medication clinical trials is to make sure the drugs are safe and effective. […] Neurostimulators deliver electrical stimulation to the brain. […] Occasionally, epilepsy is caused by the patient’s immune system attacking the brain.

• #43 A New Hope for Patients With Epilepsy > News > Yale Medicine

  https://www.yalemedicine.org/news/epilepsy-deep-brain-stimulation

  Yale physicians are using an implantable device to personalize therapy for those with certain types of epilepsy. […] But about one-third of patients aren’t so lucky. They experience no relief from anti-seizure drugs and are looking for additional treatment options. […] In some cases, however, neurostimulation is the only option that is effective, says Dr. Quraishi. […] The 2018-approved DBS device uses electrical pulses to regulate the brain’s electrical activity. […] The device has two components: a neurostimulator, which is surgically implanted in a patient’s chest, and electrodes that are inserted into the brain. […] The Percept PC approved last June is Medtronic’s same DBS device, but with one significant difference—it records a patient’s brain signals. […] Using information collected by the Percept PC, Dr. Hirsch explains, neurologists can more precisely adjust the device’s programming.

• #44 Treatment Options | Trinity Health System

  https://www.holycrosshealth.org/services/neurosciences/neurosurgery/epilepsy/treatment-options

  The epilepsy care team provides a variety of treatment options for patients with seizure disorders. The aim of all therapy is to control seizures and improve each patient’s quality of life. […] No one treatment works for all patients. Often, the team will offer patients a number of different options. Then together, physicians and patients decide which therapy offers the best chance for a successful outcome. […] Medications can’t cure seizure activity, but they can help control it. A single medication or a combination of drugs that are prescribed at the correct dosage will often produce a positive effect. The team works closely with patients to modify medications they may already be taking, or to offer a new drug therapy regimen. […] Patients who don’t respond to medication may be candidates for surgery. Epileptologists work closely with neurosurgeons to determine if surgery is an appropriate treatment alternative.

• #45 Epilepsy: Treatment Options | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0715/p87.html

  Early initiation of AED therapy may reduce the risk of sudden unexpected death in epilepsy (SUDEP), which is death in a person with epilepsy in whom no other cause of death is found. […] Choice of AED should be individualized in consultation with a neurologist, and based on factors such as seizure type, presence of an epilepsy syndrome, other medications, comorbidities, lifestyle, and patient preference. […] Monotherapy with all indicated AEDs should be attempted before initiating combination therapy. […] Routine monitoring of AED levels does not reduce adverse effects or improve effectiveness and is not recommended. […] Treatment goals, medication adherence, and adverse effects of AEDs should be reviewed at least annually with attention to seizure frequency, medication effects, preconception counseling, if indicated, and the need for referral to specialized centers for persistent symptoms.

• #46 Treatment of Functional Seizures

  https://practicalneurology.com/articles/2022-mar-apr/treatment-of-functional-seizures

  Treatment for functional seizures, also termed psychogenic nonepileptic seizures, is multidisciplinary and begins as soon as the diagnosis is suspected. Psychotherapy remains the primary treatment modality for FS and should be multidisciplinary with a team-based approach, including a neurologist, a mental health professional, and other clinicians, along with family and other social supports when possible. […] Many persons with FS have a difficult time adhering to treatment recommendations. The diagnosing neurologist should remain available after the diagnosis is established, especially to facilitate engagement in treatment. Motivational interviewing (MI) is a communication strategy designed to engage a person’s intrinsic motivation to generate change and has been shown to improve adherence to psychotherapy after the diagnosis of FS is presented.

• #47

  https://www.healthychildren.org/English/health-issues/conditions/seizures/Pages/Epilepsy-in-Children-Diagnosis-and-Treatment.aspx

  If epilepsy medication does not work, other options include: Brain surgery, Medical devices to prevent and control seizures (for example a vagal nerve stimulator (VNS), a responsive neurostimulator (RNS), or a deep brain stimulator (DBS)), Dietary therapies (e.g. ketogenic diet, modified Atkins diet, low glycemic index treatment). […] It’s best to work together with your child’s doctor to make decisions and choose tests and treatments. You can take into account the potential risks and benefits of each option as well as your family’s preferences and values. Shared decision-making is particularly important in epilepsy. This is because there is often no one right treatment; possible risks and benefits of each option may affect each child differently.

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