Severe and Uncontrolled Epilepsy
Seizures happen because of abnormal brain activity. For many people, it is not known why this happens. Some known causes are:
- Head trauma
- Alcohol use disorder
- Degenerative diseases, such as Alzheimer disease
- Brain damage
- Brain tumors
- Infections, such as bacterial meningitis
- Genetic problems
- Problems with the immune system
Symptoms depend on the type of seizures that a person has.
Generalized seizures may cause:
- Eye blinking or staring into space
- Crying out
- Loss of consciousness
- Falling to the ground
- Muscle jerking or spasms
- Feelings of tiredness after the seizure has ended
Partial seizures may cause:
- Muscle twitching
- Sensing a strange taste or smell
- Confusion or a dazed feeling
- Inability to respond to questions or directions
The doctor will ask about symptoms and past health. A physical exam will be done. An appointment with a doctor who treats the nervous system and brain may be needed.
Brain activity may be tested. This can be done with an electroencephalogram (EEG). Images of the brain may be taken with:
- MRI scan
- CT scan
- Positron emission tomography (PET)
- Single photon emission computed tomography (SPECT)
The goals of treatment are prevent further seizures with fewest side effects. This may mean treating an underlying cause or avoiding triggers.
Anti-seizure medicines may be given. More than one may be needed. It may take some time to find the right medicine and dosage.
Devices can help to interrupt signals that cause seizures. They are placed just under the skin and attached to brain or large nerve. The devices may be used alone or with medicine. Implanted devices include:
- Vagus nerve stimulation (VNS)—implanted in the chest to stimulate the vagus nerve to decrease seizures
- Responsive nerve stimulator (RNS)—implanted in the brain to detect and stop seizures
- Deep brain stimulation (DBS)—implanted in the brain and attached to a device implanted in the chest to stop signals that trigger a seizure
A ketogenic diet is a strict diet that is low in carbohydrates and rich in fats. For some people, this diet may reduce seizures. It is not known why it helps.
This diet is very strict and may be hard to stick to. Other low carbohydrate diets like Atkins or low glycemic diet may have some benefit.
Learning and avoiding triggers can help some. Triggers can differ from person to person. Some common triggers are:
- Lack of sleep
- Flashing bright lights
- Excessive alcohol use
- Drug use
Surgery may be done for seizures that are not helped by medicine. The area that is causing the seizures will be removed or destroyed. It is only an option if the seizures start in one specific spot in the brain.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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