Posts Tagged AEDs

[WEB SITE] Medication Adherence Key to Epilepsy Treatment

In assessing the effectiveness of prescribed medication there is a strong emphasis on the ability of the patient to adhere to the regime recommended by the clinician. For individuals with epilepsy, adherence to medication is crucial in preventing or minimizing seizures and their cumulative impact on everyday life. Non-adherence to antiepileptic drugs (AEDs) can result in breakthrough seizures many months or years after a previous episode and can have serious repercussions on an individual’s perceived quality of life. Reasons for non-adherence are complex and multilayered. Patients can accidentally fail to adhere through forgetfulness, misunderstanding, or uncertainty about clinician’s recommendations, or intentionally due to their own expectations of treatment, side-effects, and lifestyle choice.

Adherence in epilepsy

Adherence is acting in accordance with advice, recommendations or instruction. Ways that adherence can be optimized;

  1. Educating individuals and their families and carers in understanding of their condition and the rationale of treatment, reducing the stigma associated with the conditions.
  2. Using simple medication regimes.
  3. Positive relationships between healthcare professionals, the individual with epilepsy and their family and /or carers.
  4. Other measures are; manual telephones follow up, home visits, special reminders, regular appointments/ refill reminders.

While failing to adhere to treatment plans can adversely affect individuals with any general medical condition, Non- adherence to anti-epileptic drugs results to increased risk of status epilepticus (prolonged seizures) resulting into brain damage, SUDEP, risk of injuries, increase rates of admission to hospital due prolonged seizures. The consequences of not taking medication can be more immediate with epilepsy.​

Epilepsy as a chronic condition relies heavily on adherence to medical advice in order to maximize an individual’s quality of life by controlling seizures more effectively while avoiding unwanted side-effects. Treatment of those diagnosed with epilepsy the vast majorities are treated with AEDs and approximately 70% can become seizure-free once the most effective regime is followed.

Monotherapy is viewed as the initial and preferential option for treating epilepsy, the choice of drug depending on seizure type and effectiveness of the drug balanced against possible side-effects. It is difficult to find estimates of how many people are on monotherapy or polytherapy at any one point in time.

However, in one of the cases I encountered that of Sarafina Muthoni from Banana, Kiambu County, she was diagnosed with Epilepsy at a very young age in her primary school days. With no history of such a condition in her family, it got everybody thinking what could have gone wrong with their lovely daughter. After days of trying to figure out, the family had to adapt to reality of their daughter living with Epilepsy. She was lucky to have very supportive parents ready to see her through the long journey of treating the condition. The motivation and support from her loved ones to access medication improved her status by far as she continued to adhere to the prescribed treatment. Unfortunately, the support didn’t last long and the burden of continuing with treatment squarely relied on her. This adversely contributed to the beginning of non-adherence to medication for lack of funds to buy drugs. Not only were finances a challenge but also finding a good hospital to comply was a problem.

Muthoni had to live with the sad reality of pain every time she experienced a seizure. Pain which she clearly knew with access to medication the situation could by far be controlled. At the very worse of her situation she found help. Cheshire Disability Services Kenya (CDSK) a Non-Governmental Organization in Kenya whose objective is to empower an inclusive society of persons with disability and develop their full potential to lead a quality life, in partnership with Kenya Association of People with Epilepsy (KAWE) came for Muthonis’ rescue.

Under CDSK’s program to help Epilepsy patients’ access medication and ensure compliance, Muthoni benefited and today she leads a life full of potential and energy as she explores her skills as a beauty and hair stylist.

As we celebrate International Epilepsy Day on Feb 12th 2018, themed on “Life is beautiful”, Muthoni’s story is a highlight of what beauty is all about. Hers’ is just but one of the many inspiring stories to celebrate during this season of Epilepsy Awareness.

Managing Adherence

Adherence to medication regardless of medical condition remains an important problem in treatment. Factors that have been discussed here – side-effects, drug regime, family support, impact on everyday life, relationship with the clinician – are unlikely to be the only predictors of adherence. While adherence to treatment within the context of epilepsy has been the focus of this review, these factors can equally be applied to various chronic conditions.

Assessment of adherence should be a routine part of management of epilepsy. Further recognition and support should be given to patients who have poor seizure control since they are more likely to be more anxious and have unhelpful illness and treatment beliefs.

Finally, patients may be fully aware of the importance of taking AED medication and the benefits gained by altering their lifestyle choices in order to prevent seizures, but will make a decision about the degree to which they follow advice. Patients only have a small amount of time in contact with the clinician in their “patient role”, after which they return to the practicalities of their everyday routine where their adherence fluctuates based on how they feel their medication affects their quality of life.

Strategies to manage adherence originate from different perspectives. While the medical model may advocate less complex drug regimes, the use of measured pill containers, and minimization of side-effects, the psychosocial model analyzes non-adherence in terms of patient attitudes to medication, stigma, family and peer influences, and ability to manage self care. Neither model can adequately improve adherence independently. Perhaps the best approach is to offer a “menu” of adherence-enhancing strategies. However, what is increasingly clear from both models is that total adherence is an unrealistic goal. The emphasis has shifted away from total adherence towards a compromise with both patient and clinician involved in a joint process of treatment negotiation and decision-making in order to achieve the best outcome for the individual.

 

via Medication Adherence Key to Epilepsy Treatment : Evewoman – The Standard

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[WEB SITE] AEDs: Which Work Best as Monotherapy in Epilepsy? – Neurology Times

Which antiepileptic drugs (AEDs) are best as monotherapy? Before the updated Cochrane review, first-line therapy in adults and children with partial onset seizures was with carbamazepine or lamotrigine. And first-line therapy for generalized seizure onset was with sodium valproate.

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  • 60%-70% of people with epilepsy reach remission from seizures shortly after starting AED treatment. Most are treated with AED monotherapy. The National Institute for Health and Care Excellence (NICE) guidelines in the UK recommend carbamazepine or lamotrigine as first-line-therapy in adults and children with partial onset seizures and sodium valproate as first-line for generalized onset seizures. A 2007 network meta-analysis of AED monotherapy generally agreed with these recommendations.[1]

     

  • The Cochrane Review of AED monotherapy, which updates previous meta-analysis with studies published since 2007, adds levetiracetam and zonisamide.[2]

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  • Individual participant data (IPD) approach were used; considered gold standard for time-to-event pooled network meta-analysis. Combined IPD data from 12,391 people in 36 studies and compared 10 AEDS: carbamazepine, phenytoin, sodium valproate, phenobarbitone, oxcarbazepine, lamotrigine, gabapentin, topiramate, levetiracetam, zonisamide. ooled data from trials that did head-to-head comparisons were analyzed; a second analysis combined all data from trials to compare drugs that had not been previously compared.

  • For partial seizures, levetiracetam was found to be significantly better than carbamazepine and lamotrigine. Lamotrigine was significantly better than all other AEDs (except levetiracetam). And carbamazepine was significantly better than gabapentin and phenobarbitone. For generalized onset seizures, valproate was significantly better than carbamazepine, topiramate and phenobarbitone. For both partial and generalized onset seizures: phenobarbitone, the earliest licensed treatment, performed worse in terms of treatment failure than all other treatments.

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  • There were few notable differences for partial or generalized seizure types, except fpr 12-month remission: Carbamazepine was significantly better than levetiracetam for partial seizures; and 6-month remission: Sodium valproate was significantly better than lamotrigine for generalized seizures. Regarding time to bot partial and generalized seizures: the oldest AEDs (phenytoin and phenobarbitone) were generally better than newer AEDs. The most commonly reported adverse events across all drugs: drowsiness/fatigue, headache/migraine, GI disturbances, dizziness/faintness, rash/skin disorders.

  • IPD data were available for just 69% of total participants from 47% of eligible trials, leaving out 31% of eligible participants. Methodological inadequacies in some trials could have biased results

  • 1. Phenobarbitone and phenytoin are better for seizure control, but at the expense of earlier treatment failure. 2. Carbamazepine and lamotrigine are suitable as first-line monotherapy for partial onset seizures; levetiracetam may be a suitable alternative. 3. Sodium valproate is suitable as first-line monotherapy for generalized seizures; lamotrigine and levetiracetam may be suitable alternatives, especially for women of child-bearing age given the potential teratogenicity of sodium valproate 4. Zonisamide may effective in partial onset seizures: evidence is limited and more research is needed.

1. Tudur Smith C, Marson AG, Chadwick DW, Williamson PR. Multiple treatment comparisons in epilepsy monotherapy trials. Trials. 2007;5(8):34
2. Nevitt SJ, Sudell M, Weston J, Tudur Smith C, Marson AG. Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data. Cochrane Database of Systematic Reviews. 2017, Issue 6. Art. No. CD011412.

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Which AEDs work best as monotherapy?

A new Cochrane review scrutinizes the efficacy and tolerability of various agents.

 

via AEDs: Which Work Best as Monotherapy in Epilepsy? | Neurology Times

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[WEB SITE] Pregnant Women with Epilepsy Who Take Folic Acid Reduce the Risk of Having an Autistic Child.

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BY SARAH OWENS

Pregnant women taking antiepileptic drugs (AEDs) who supplemented their diets with folic acid had a reduced risk of having a child with autistic traits, according to a study published online on December 26 in JAMA Neurology.

Folic Acid’s Importance

Folic acid supplements are generally recommended to all pregnant women to reduce the risk of birth complications, such as spina bifida, as well as neurodevelopmental complications.

Supplementation may be especially important for pregnant women who take AEDs, which treat epilepsy and seizures, since anti-seizure drugs are known to interfere with folate absorption and metabolism.

Additionally, research has shown that children born to mothers who took AEDs during pregnancy have an increased risk of developing autistic traits, including repetitive behaviors and impaired social skills and communication.

Studying Mothers with Epilepsy

To find out if folic supplementation would decrease the risk of having a child with autistic traits for women taking AEDs during pregnancy, researchers at several universities in Norway assessed data on participants in the Norwegian Mother and Child Cohort study, a long-running study of the health of pregnant women and their children in Norway. Participants had an ultrasonographic examination between June 1999 and December 2008 and provided information on their use of AEDs and folic acid supplementation during pregnancy as well as follow-up information on the health of their children.

A total of 104,946 children between the ages of 18 and 36 months who were born between March 2016 and June 2017, were included. As part of the study, the mothers answered questions about their children’s health using a test that measures autistic traits. The mothers were asked questions such as, “Does your child enjoy being bounced on your knee?” and “Does your child take interest in other children?”

The researchers then compared the mothers’ information on AED use and folic acid supplementation with their answers on the test to look for associations.

A Clear Connection

The researchers discovered that women who took AEDs during pregnancy and also took folic acid supplements were significantly less likely to have a child with autistic traits than pregnant women who took AEDs but did not supplement with folic acid. In particular, they found that higher folic acid levels between weeks 17 and 19 of pregnancy were associated with a reduced risk of autistic traits.

The findings, the study authors conclude, suggest that all women of childbearing age who take AEDs should take folic acid supplementation to reduce the risk of autistic traits in their children.

via Neurology Now

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[WEB SITE] Comprehensive List of Epilepsy & Seizure Medications.

Understanding Epilepsy

Epilepsy makes your brain act abnormally and send unusual signals. This can result in seizures. Injury, sickness, and a number of other reasons can cause seizures, but recurring seizures are symptoms of epilepsy.

There are many different types of epileptic seizures. Several of them can be controlled with the right anti-seizure medications. In fact, 70 percent of people with epilepsy can control their seizures with proper medication.

If you are suffering from epilepsy, you’ll be glad to know there are many different anti-seizure drugs. However, the medication prescribed to you will depend on the type of epilepsy you have and several other factors.

Medications used for the treatment of seizures are known as anti-epileptic drugs, anti-seizure medications or AEDs. There are two types of AEDs: narrow-spectrum and broad-spectrum. Let’s have a look at all of the prescription AEDs in each category.

Here’s a comprehensive list of available epilepsy and anti seizure medications along with links to anti seizure medication prices that will help you save up to 90% off U.S. retail prices.

Narrow-Spectrum AEDs

If you regularly experience seizures in a specific part of your brain, narrow-spectrum AEDs will help. There are 17 narrow-spectrum AEDs, including:

Carbamazepine (Epitol, Equetro, Carbatrol ER, Tegretol)

Generic carbamazepine (Epitol, Equetro, Carbatrol ER, Tegretol) helps treat seizures taking place in the temporal lobe. It can also be used to help with refractory, partial, and secondary seizures. Carbamazepine interacts with a variety of other drugs, so it’s important to tell your doctor about any other medications you’re taking to avoid any harmful side effects.

Clobazam (Onfi)

Generic clobazam (Onfi) is used to help prevent secondary, partial, and absence seizures. This narrow-spectrum AED also falls into the benzodiazepine category. Drugs in this category are often used for anxiety and sedation. The Epilepsy Foundation states children as young as two years old can take Clobazam. However, in some rare cases, this drug can result in serious skin reactions.

Diazepam (Valium)

Generic diazepam is known as brand name, Valium to many of its users. This commonly prescribed drug is a benzodiazepine and is used to help treat prolonged or cluster seizures. It is also very effective in the short-term treatment of every type of seizure. This makes it a popular anti-seizure drug in emergency situations.

Tolerance to Diazepam usually occurs in a few weeks, which means doses must be increased over time. The side effects of this widely used drug include nausea, tiredness, depression, loss of appetite, and unsteady walking. Hyperactivity and drooling are also common side effects in children.

Divalproex (Depakote, Depakote ER)

Generic divalproex (Depakote, Depakote ER) is prescribed to treat multiple, absence, partial, and complex partial seizures. It slows down nerve circuits by increasing gamma-aminobutyric acid levels within your body. This slowing down of the nerve circuits helps control seizures.

Eslicarbazepine (Aptiom)

Generic eslicarbazepine, also known as brand name: Aptiom, is used in the treatment of partial-onset seizures. By blocking sodium channels, it’s able to slow down nerve firing sequences and help control certain seizures.

Ethosuximide (Zarontin)

Generic ethosuximide (Zarontin) is an anti-seizure drug is used to treat childhood, juvenile, and atypical absence seizures,

Gabapentin (Gralise, Horizant, Neurontin, Gabarone)

Generic gabapentin (Gralise, Horizant, Neurontin, Gabarone) has milder side effects than many other AEDs and is used in the treatment of partial seizures. Dizziness and fatigue are its most common side effects.

Lacosamide (Vimpat)

Generic lacosamide (Vimpat) is also used to treat partial seizures. This medication can be taken at home as an oral solution or oral tablet. An IV injection can also be received by a healthcare provider.

Methsuximide (Celontin)

Generic methsuximide (Celontin) is used to treat absence seizures when other medications or treatments don’t work. It works by slowing down your motor cortex. This makes it difficult for your brain to fire rapidly enough to start a seizure.

Oxcarbazepine (Oxtellar XR, Trileptal)

Generic oxcarbazepine (Oxtellar XR, Trileptal) is prescribed to help control focal seizures. It can be used to help treat adults and children as young as two years old.

Perampanel (Fycompa)

Generic perampanel (Fycompa) is used to help treat simple, complex,and refractory seizures. Doctors don’t fully understand how this anti-seizure drug works, but many believe it affects your brain’s glutamate receptors. Perampanel is effective, but it can have serious behavioral and psychiatric side effects.

Phenobarbital (Solfoton, Luminal)

Generic phenobarbital (Solfoton, Luminal) is one of the first seizure drugs ever used and is still prescribed for epilepsy to this day. It is used to treat tonic-clonic, partial, and generalized seizures. This drug is long-acting and effective at reducing convulsions related to seizures. It’s also a sedative, so its main side effects are drowsiness and tiredness.

Phenytoin (Dilantin)

Generic phenytoin (Dilantin) is another commonly used anti-seizure drug with a long history of use. The medication is used to treat simple complex, and refractory seizures. It works by stabilizing your neuronal membranes. The result is a calming effect on your brain’s nerve firings.

Pregabalin (Lyrica)

Generic pregabalin (Lyrica) is used alongside other medications for the treatment of partial-onset seizures. This means it’s an additional treatment only.

Rufinamide (Banzel)

Generic rufinamide (Banzel) is also used as additional treatment. It’s taken with other medications to help treat seizures caused by Lennox-Gastaut syndrome. Unfortunately, it can interact with several drugs and cause unusual heart rhythms. For these reasons, it’s seldom used.

Tiagabine (Gabitril)

Generic tiagabine (Gabitril) is also considered an additional treatment. It’s used to help treat simple and complex partial seizures.

Vigabatrin (Sabril)

Generic vigabatrin (Sabril) is sometimes prescribed along with other drugs to help treat complex partial seizures. However, the use of this drug is highly restricted due to its serious side effects. One of these side effects is permanent vision loss. Doctors and pharmacies must have a special registration in order to prescribe and dispense the drug.

Broad-Spectrum AEDs

If you suffer from two or more types of seizures, your doctor may prescribe a broad-spectrum AED for treatment. Unlike narrow-spectrum AEDs, broad-spectrum AEDs are designed to help treat and prevent seizures in several parts of the brain.

There are 11 broad-spectrum AEDs, including:

Clonazepam (Klonopin)

Generic clonazepam (Klonopin) is used to treat akinetic, myoclonic, absence, and several other types of seizures. It’s a long-acting benzodiazepine that’s popular for its ability to treat a diverse range of seizures.

Clorazepate (Tranxene-T)

Generic clorazepate, also known as brand name: Tranxene-T, clorazepate is also a benzodiazepine and used alongside other medications to help treat partial seizures.

Ezogabine (Potiga)

Generic ezogabine (Potiga) is an additional treatment used for complex partial, refractory, and generalized seizures. The secondary drug works by activating potassium channels and stabilizing the ring of your neurons.

This AED can damage your retina and cause long-term harm to your vision. For this reason, it’s only used as a last resort when other medications aren’t working. If you are prescribed Ezogabine, you will be required to have an eye exam twice a year. If the drug doesn’t help treat your seizures, your doctor will cancel the treatment and try another AED to prevent any eye problems.

Felbamate (Felbatol)

Genereic felbamate (Felbatol) is used to help control nearly every type of seizure. However, it can have serious side effects such as liver failure and anemia. Due to this, it’s only prescribed for people who haven’t had success with other treatments. Fellbamate can be used in combination with other medications or by itself as a single therapy.

Lamotrigine (Lamictal)

Generic lamotrigine or Lamotrigine Xr (Lamictal) has shown to help treat a wide variety of epileptic seizures. Unfortunately, use of the drug has been linked to Stevens-Johnson syndrome. This rare skin condition can include several serious symptoms such as the shedding of your skin.

Levetiracetam (Spritam, Keppra)

Generic levetiracetam (Spritam, Keppra) is often the first medication prescribed to treat absence, atypical, generalized, partial, a many other types of seizures. In fact, according to the Pharmacopoeia of Prophylactic Antiepileptic Drugs, it can be used to treat idiopathic, focal, symptomatic, and generalized epilepsy in adults and children of all ages. It’s effective and has fewer side effects than other epilepsy drugs.

Lorazepam (Ativan)

Generic lorazepam (Ativan) is a type of benzodiazepine used to treat critical, prolonged seizures.

Primidone (Mysoline)

Generic primidone (Mysoline) is prescribed to help treat juvenile myoclonic epilepsy. It also treats tonic-clonic, myoclonic, and focal seizures.

Topiramate (Trokendi XR, Qudexy XR, Topamax)

Generic topiramate (Trokendi XR, Qudexy XR, Topamax) is used by itself or alongside other AEDs to help treat a wide-variety of seizures in both children and adults.

Valproic acid (Stavzor, Depakene, Depacon, Depakote)

Generic valproic acid (Stavzor, Depakene, Depacon, Depakote) is a broad-spectrum AED that is commonly used and approved to help treat nearly all types of seizures. Like Topiramate, it can be used by itself as a single treatment or in conjunction with other anti-seizure medications.Valporic acid works by increasing your body’s GABA levels. This helps calm down and suppress random nerve firings.

Zonisamide (Zonegran)

Generic zonisamide (Zonegran) is sometimes prescribed to treat partial seizures and other forms of epilepsy. Unfortunately, its side effects can be serious. Some of these side effects can include weight loss, kidney stones, and cognitive issues.

Discuss AEDs with Your Doctor

Before you take an AED, discuss them with your doctor and learn about the different side effects they can cause. Use this reference as a starting point to learn more about seizure drugs. By doing so, you’ll be better prepared to work with your doctor and help choose the best AED options for you.

 

via Comprehensive List of Epilepsy & Seizure Medications – Alert News Today

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[VIDEO] Anti-Epileptic Drugs – a video explanation

Have you ever wondered how antiepileptic drugs work? Our short video narrated by Epilepsy Research UK Chair of Trustees, Dr Graeme Sills, will give you a clear picture of the type of drugs that are used in epilepsy and how they work.

How do AEDs work? from Rose Thompson on Vimeo.

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[WEB SITE] Epilepsy and natural treatments: Can they help?

 

Epilepsy is a disease that disrupts the electrical activity of the nervous system, causing seizures.

More than 65 million people in the world have epilepsy. The Epilepsy Foundation estimate that 1 in 26 Americans will develop the disease during their lives.

Children are the group most frequently diagnosed with new cases of epilepsy. In the United States, 300,000 children under 14 are affected by the condition. Some may outgrow the disorder, but most will not. The number of senior citizens with epilepsy is also 300,000.

People with epilepsy have a range of treatment options, including alternative therapies.

The illness is a complex condition, however, and all alternative treatment options must be looked at carefully, to ensure they are effective.

It is essential to work with a doctor when making changes in treatment, as every epileptic seizure can cause brain damage, and the effects build up. So, any treatment must work to avoid seizures.

Causes of epilepsy

electrical activity in the brain diagram

Epilepsy is a complex disease that can disrupt the electrical activity of the nervous system.

Infections, which can cause scarring on the brain that leads to seizures, are among the more common causes of epilepsy.

Possible links between autism and epilepsy are also under investigation, as a third of children on the autism spectrum are also likely to have seizures.

In the over 65s, strokes are the most common cause of new seizures. Family history and brain injuries account for other cases.

However, the Epilepsy Foundation say the cause is unknown in 60 percent of people.

Eight natural remedies for epilepsy

People with epilepsy and their doctors are expressing growing interest in alternative therapies.

Although antiepileptic drugs (AEDs) help most people control their symptoms, these do not work for everyone. Furthermore, some people are concerned about the long-term safety of these drugs.

Complementary health practices for epilepsy, such as the eight natural remedies discussed here, are designed for use in combination with AEDs.

After talking to a doctor, and before beginning natural treatments, people with epilepsy should ensure they are working with a well-qualified and informed therapist.

Common complementary treatments for epilepsy include the following:

Medical marijuana

Cannabis sativa, or marijuana, as it is commonly known, has been used to treat convulsions for centuries. Today, it is attracting increasing attention from people with epilepsy, clinicians, and researchers.

Interest in the use of medical marijuana is particularly strong for the roughly 1 million U.S. residents whose seizures are not controlled by AEDs. Some families with young children, suffering from severe seizures, have moved to one of the 22 states where medical marijuana use is legal.

Charlotte’s Web is a strain of cannabis bred to contain high levels of CBD, a part of the plant showing promise against seizures. It is named after a child whose convulsions dropped from more than 300 a week to 2-3 a month with this treatment.

However, since broad-based, well-designed scientific studies have yet to prove the effectiveness of marijuana in treating epilepsy, doctors do not generally recommend its use.

Diet

The ketogenic diet

The ketogenic diet is a low-carbohydrate, high-fat diet that may help to reduce seizures.

Diet is one of the earliest forms of treatment for epilepsy and is used with contemporary variations to make it easier for children and adults to adopt.

The ketogenic diet is a high-fat, low-carbohydrate diet that has had some success in reducing seizures in children who cannot tolerate or benefit from AEDs. It requires extensive commitment and monitoring.

The Atkins diet is a high-protein, low-carbohydrate diet that is less restrictive and has shown positive effects.

Low glycemic index treatment (LGIT) is similar but allows for a targeted level of carbohydrate consumption.

Herbal treatments

Herbs are used for many illnesses by 80 percent of the world’s population. Remedies drawing on Chinese traditions have shown promise in treating epilepsy.

Some herbs, such as chamomile, passionflower, and valerian, may make AEDs more effective and calming.

However, ginkgo, ginseng, and stimulating herbs containing caffeine and ephedrine can make seizures worse.

St. John’s wort can interfere with medications and make seizures more likely, similarly to evening primrose and borage.

Caution is advised when working with all these herbs.

It is important to remember that herbs are not monitored by the U.S. Food and Drug Administration (FDA). If any herbs are used, they should be researched and bought from reputable sources.

Vitamins

Low levels of the B6 vitamin have been known to trigger seizures.

Magnesium, vitamin E, and other vitamins and nutritional supplements, have been identified as either promising or problematic for treating epilepsy.

People taking AEDs are often advised to take vitamin D supplements to keep their systems in balance.

Along with vitamin B6, magnesium, and vitamin E, which have been found to be helpful in treating epilepsy, doctors have found treatment with manganese and taurine reduced seizures, as well.

Thiamine may help improve the ability to think in people with epilepsy.

Biofeedback

When AEDs do not work, some people have successfully used biofeedback to reduce seizures.

With the use of extensive training and a machine that detects electrical activity in the brain, the technique teaches individuals to recognize the warning signs of seizures, and train their brains to prevent a full-blown attack.

Relaxation

Stress and anxiety are both linked to seizures.

There are many different practices that people with epilepsy can follow on their own to help them feel calmer, relax their muscles, get better sleep, and enjoy a better state of mind.

All these actions taken together can help reduce seizures and make it easier for people to manage their epilepsy.

People should be cautious if trying meditation, as this can change the electrical signals in the brain.

Some essential oils used in aromatherapy, such as lavender, chamomile, jasmine, and ylang-ylang, have been found to be effective in preventing seizures when used with relaxation techniques.

However, the Epilepsy Society report that others may provoke seizures. These include spike lavender, eucalyptus, camphor, sage, rosemary, hyssop, and fennel.

Acupuncture and chiropractic

acupuncture

Acupuncture may help to reduce the stress of living with epilepsy.

While acupuncture does not seem to be helpful in preventing seizures, people with epilepsy find it can reduce the stress of living with the condition.

There is little evidence on chiropractic care, but it also may be among the natural treatments people with epilepsy find useful.

Education and avoiding triggers

Education and avoidance can have a big impact on quality of life for people with this condition.

Many of those with epilepsy find that their seizures develop in response to specific triggers. This is the case for people with photosensitive epilepsy.

Learning how to avoid situations and stimuli that could spark a seizure can be very helpful. Some children may learn to avoid using video games in dark rooms, for example, or to cover one eye when exposed to flashing lights.

Do natural treatments for epilepsy work?

For many practices, there has not been enough study to give a definite answer to this question, one way or the other.

The following overview of the top natural treatments for epilepsy offers a quick summary of their reported effectiveness:

  • Diet: The ketogenic diet, usually prescribed for children whose epilepsy does not respond to AEDs, has been shown to cut their seizures by half and eliminate seizures completely for 10-15 percent of those studied.
  • Herbal treatments: Two studies of Chinese herbal compounds found them effective at reducing seizures in children and adults. But some herbs, such as St. John’s wort, can make seizures worse.
  • Vitamins: Many studies have linked low levels of vitamin B6, magnesium, and vitamin E to seizures. Treating people with supplemental doses helped reduce the frequency of seizures.
  • Biofeedback: Researchers in 10 different studies showed that 74 percent of people whose epilepsy could not be treated with medication, reported fewer seizures after they learned this technique.
  • Relaxation: Fewer seizures and a better quality of life were reported by children who took part in trials, according to research.
  • Acupuncture and chiropractic: Scientific studies have not found acupuncture to be effective for people with epilepsy. However, positive outcomes were reported for some children with drug-resistant epilepsy who tried chiropractic therapy.
  • Education: After learning more about epilepsy, coping strategies for it, and how to take medication, improved quality of life was observed for people of all ages with epilepsy.

Conclusion

Many reports on the effectiveness of complementary treatments for epilepsy come from personal experience, and from studies that are not considered conclusive.

Most importantly, people should always talk to their doctor before trying natural treatments to help ease their symptoms.

Source: Epilepsy and natural treatments: Can they help? – Medical News Today

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[ARTICLE] The relationship between sleep and epilepsy – Full Text HTML

Abstract
Epilepsy and sleep have a close association and a two way interaction. Recognising this allows for a greater awareness of the importance of good quality sleep in epilepsy patients with potential benefits on seizure control and quality of life. This article reviews this complicated but fascinating area addressing diagnostic issues, the effects of epilepsy and its treatments on sleep, the effects of sleep disorders on epilepsy concluding with some practical advice on assessment.


Introduction

Sleep and epilepsy are intimate bedfellows, having an impact on each other and adversely affecting quality of life and daytime performance.1 Sleep has an important role in memory consolidation.2 Sleep deprivation impairs this process3 and epilepsy can upset this delicate balance.4 Sleep disorders are up to three times as common in epilepsy5 and can be a major contributor to refractory seizures,6 poorer quality of life7 and possibly SUDEP.8 Recognition of the comorbid sleep disorder and successful treatment can lead to significant improvements in seizure control.9 Many patients with epilepsy have seizures in sleep, some exclusively so. Often diagnosis is difficult due to incomplete histories from sleep partners. Even when telemetry facilities are available, data can be difficult to interpret and EEG is not always diagnostic.10 To add to this complexity, epilepsy treatments often have impact on sleep. Understanding this complex relationship can lead to better treatment outcomes for patients. This review will begin with diagnostic issues, moving on to the effects of epilepsy and its treatments on sleep, the effects of sleep disorders on epilepsy and concludes with practical advice on assessment.

Continue —> The relationship between sleep and epilepsy | ACNR | Online Neurology Journal

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Figure 1: A video EEG image of a nocturnal seizure showing short lived dystonic posturing of the right hand seen immediately on waking. 30 stereotyped attacks were recorded over 2 nights. The EEG was normal throughout. Awareness was reported for most attacks although the hand posturing was not recalled by the patient.

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[ARTICLE] The relationship between sleep and epilepsy | ACNR | – Full Text

Abstract
Epilepsy and sleep have a close association and a two way interaction. Recognising this allows for a greater awareness of the importance of good quality sleep in epilepsy patients with potential benefits on seizure control and quality of life. This article reviews this complicated but fascinating area addressing diagnostic issues, the effects of epilepsy and its treatments on sleep, the effects of sleep disorders on epilepsy concluding with some practical advice on assessment.


Introduction

Sleep and epilepsy are intimate bedfellows, having an impact on each other and adversely affecting quality of life and daytime performance.1 Sleep has an important role in memory consolidation.2 Sleep deprivation impairs this process3 and epilepsy can upset this delicate balance.4 Sleep disorders are up to three times as common in epilepsy5 and can be a major contributor to refractory seizures,6 poorer quality of life7 and possibly SUDEP.8 Recognition of the comorbid sleep disorder and successful treatment can lead to significant improvements in seizure control.9 Many patients with epilepsy have seizures in sleep, some exclusively so. Often diagnosis is difficult due to incomplete histories from sleep partners. Even when telemetry facilities are available, data can be difficult to interpret and EEG is not always diagnostic.10 To add to this complexity, epilepsy treatments often have impact on sleep. Understanding this complex relationship can lead to better treatment outcomes for patients. This review will begin with diagnostic issues, moving on to the effects of epilepsy and its treatments on sleep, the effects of sleep disorders on epilepsy and concludes with practical advice on assessment.

Epilepsy Syndromes Closely Associated with Sleep

There are a small number of epilepsy syndromes which are predominantly or exclusively associated with sleep (Table 1). Seizures arising from sleep are almost always of focal onset. These include the childhood onset syndromes of benign childhood epilepsy with centrotemporal spikes (BCECTS, Rolandic epilepsy), benign childhood epilepsy with occipital paroxsysms (Panayiotopoulos syndrome) and the frontal lobe epilepsy syndromes (including autosomal dominant nocturnal frontal lobe epilepsy ADNFLE). Idiopathic generalised epilepsy syndromes (IGE) such as juvenile myoclonic epilepsy (JME) and generalised tonic clonic seizures on waking arise shortly before or after sleep onset but not from a sleep state.

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Continue —> The relationship between sleep and epilepsy | ACNR | Online Neurology Journal

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[WEB SITE] List of 31 Common Epilepsy and Seizure Medications – Healthy resources

LIST OF 31 COMMON EPILEPSY AND SEIZURE MEDICATIONS

Get a Complete Understanding

Epilepsy is a disorder in which the brain sends abnormal signals, which can lead to seizures. Although seizures can occur for a variety of reasons, such as injury or sickness, epilepsy causes recurrent seizures. There are many types of epileptic seizures. Many of them can be treated with anti-seizure medications.

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Anti-seizure medications are also known as antiepileptic drugs (AEDs). According to the National Institute of Neurological Disorders and Stroke (NINDS), there are more than 20 AEDs available through prescription. While there are many options in epilepsy treatment, your therapy choices will depend on your:

  • age
  • type of seizures
  • frequency of seizures
  • lifestyle
  • chances of pregnancy (in women)

Seizure medications are available in two types: narrow- and broad-spectrum AEDs. Some patients may need more than one medication to prevent epileptic seizures more effectively. It’s important to discuss the possibility of side effects, and even worsening seizures, with your doctor before starting any of these medications.

See average costs for the most common epilepsy medications »

Part 2 of 3: Narrow-Spectrum AEDs

Narrow-Spectrum AEDs

Narrow-spectrum AEDs are designed for specific types of seizures. These are the most appropriate medications if seizures occur in one specific part of the brain on a regular basis.

Carbamazepine (Carbatrol, Tegretol, Epitol, Equetro)

Carbamazepine is used to treat seizures that occur in the temporal lobe. It may also be helpful in treating secondary, partial, and refractory seizures. It is used for many other purposes, including pain and mood treatment. Carbamazepine interacts with many other drugs.

Clobazam (Frisium, Onfri)

Clobazam helps prevent absence, secondary, and partial seizures. It is a benzodiazepine, a drug class that is often used for sedation, sleep, and anxiety. According to the Epilepsy Foundation, this medication may be used in patients as young as 2 years old. It has recently been linked to a rare but potentially serious skin reaction.

Diazepam (Valium, Diastat)

Used to treat cluster seizures, diazepam can also be used to treat prolonged seizures. Diazepam is a benzodiazepine. It’s also used to treat anxiety, alcohol withdrawal, and more. The product Diastat is used rectally for life threatening seizures.

Divalproex (Depakote)

This medication is approved to help treat complex partial, absence, partial, and multiple seizure types. Divalproex increases availability of gamma-aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter. It may also be helpful for bipolar mania and migraines.

Eslicarbazepine Acetate (Aptiom)

This seizure drug is approved as additional (adjunctive) treatment for partial-onset seizures. Its action is thought to involve blockade of sodium channels.

Ethosuximide (Zarontin)

This AED is used to treat all forms of absence seizures. These also include atypical, childhood, and juvenile absence seizures. Ethosuxemide reduces the likelihood of seizures.

Gabapentin (Neurontin, Gralise, Gabarone)

Glabapentin is used to treat partial seizures. It may be preferable over other AEDs because the potential side effects are mild. The most common are dizziness and fatigue. Gabapentin is also widely used for several pain syndromes.

Lacosamide (Vimpat)

This medication is used for partial seizures. According to the Epilepsy Foundation, it is approved for patients ages 17 and older. Lacosamide may be prescribed orally or intravenously.

Perampanel (Fycompa)

Perampanel is used to treat complex, simple, and refractory seizures. The way it works is not fully understood. The medication is thought to affect glutamate receptors in the brain. Perampanel can cause serious of life-threatening psychiatric or behavioral adverse reactions.

Phenobarbital

This is one of the first and oldest seizure medications still used in the treatment of epilepsy. It can treat generalized seizures, partial seizures, and tonic-clonic seizures. Phenobarbital is a long-acting sedative drug with anticonvulsant action.

Phenytoin (Dilantin, Phenytek, and others)

Phenytoin is another old and prominent anti-epileptic drug on the market. It stabilizes neuronal membranes. It’s used in the treatment of complex, simple, and refractory seizures. Phenytoin is available in both capsule and liquid form.

Pregabalin (Lyrica)

This medication is used as additional (adjunctive) treatment for partial-onset seizures. Pregabalin is used more often to treat diabetic neuropathy or fibromyalgia.

Rufinamide (Banzel)

This medication is used as additional (adjunctive) treatment of seizures associated with Lennox-Gastaut syndrome. It can cause adverse effects like high rate of heart rhythm changes and drug interactions. These effects limit the use of this drug.

Tiagabine Hydrochloride (Gabitril)

This medication is used as additional (adjunctive) treatment for complex and simple partial seizures.

Oxcarbazepine (Trileptal)

Oxcarbasepine is used to treat call types of focal seizures. According to Panayiotopoulos, it can be used in adults and children as young as 2 years old.

Vigabatrin (Sabril)

This medication is used as additional (adjunctive) treatment for complex partial seizures. This medication is restricted in use. It must be prescribed and dispensed by prescribers and pharmacies registered with the program. It comes with possible serious adverse effects, including permanent vision loss.

Part 3 of 3: Broad-Spectrum AEDs

Broad-Spectrum AEDs

If you have more than one type of seizure, a broad-spectrum AED may be your best choice of treatment. These medications are designed to prevent seizures in more than one part of the brain, as opposed to the focalized effects of narrow-spectrum AEDs.

Clonazepam (Epitril, Klonopin, Rivotril)

Clonazepam is a long-acting benzodiazepine. It’s used to treat multiple types of seizures. This includes myoclonic, akinetic, and absence seizures. Klonopin is the most common brand name. Clonazepam is also used to treat several other non-epileptic disorders.

Ezogabine (Potiga)

This AED is used as an additional (adjunctive) treatment. It’s used for generalized seizures, refractory, and complex partial seizures. Ezogabine can cause vision abnormalities that can become vision loss over time. It’s reserved for patients who do not respond to other drugs.

Felbamate (Felbatol)

Felbamate is used to treat nearly all types of seizures in people who don’t respond to other therapy. It can be used as single therapy or in combination with other drugs. It is used when other therapies have failed.

Lamotrigine (Lamictal)

This medication may treat a wide range of epileptic seizures. It’s also sometimes used in the treatment of Lennox-Gastaut Syndrome. When you start lamotrigine, your dose is gradually increased. People on this drug must watch for rare skin reactions, which can be serious.

Lorazepam (Ativan)

Lorazepam is approved for use in status epilepticus (prolonged, critical seizure). Lorazepam is a benzodiazepine. It’s often used for anxiety and mild sedation, with a rapid onset of action. It’s available in oral tablets, liquid, and injectable forms.

Primidone (Mysoline)

Primidone is used to treat myoclonic, tonic-clonic, and focal seizures. This medication is also approved for the use in juvenile myoclonic epilepsy.

Topiramate (Topamax)

Used as single or in combination treatment for a variety of seizures, topiramate is only available in its brand-name form Topamax. It has several actions. Topiramate is also used to treat migraine. It may also cause headache in some patients.

Levetiracetam (Keppra)

Levetiracetam is considered first line therapy for generalized and partial seizures, atypical, absence and other types of seizures. According to Panayiotopoulos, this promising drug can be used to treat all focal or generalized, idiopathic, or symptomatic epilepsy in people of all ages. It is also considered one of the drugs most free from adverse reactions.

Zonisamide (Zonegran)

Zonisamide is used as additional (adjuctive) treatment in partial seizures and other types of epilepsy. This drug has been shown to be effective in treating a range of epilepsy and seizure types. However, it comes with many potentially serious adverse reactions.

Valproic Acid

Valproic acid is a common AED. It’s approved to treat most seizures on its own or in combination treatment. Valproic acid increases the availability of gamma-aminobutryic acid (GABA). GABA is an inhibitory neurotransmitter to brain neurons. Valproic acid is also used to treat mood disorders or migraine. It is available in the following brands:

  • Depacon
  • Depakene
  • Depakine
  • Depakote
  • Depakote Sprinkles
  • Stavzor

Source: List of 31 Common Epilepsy and Seizure Medications – Healthy resources

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[WEB SITE] Seizure Decisions: After an unprovoked seizure, patients are often left wondering what’s next. A new guideline from a panel of epilepsy experts tries to answer that question.

Dolan, Darrach

Last September, Anthony Bonadio, 26, flew from New York to San Diego for a friend’s wedding. The morning after the wedding, he turned on the water for a shower—and the next thing he remembers is waking up in an ambulance. His friend, who was sharing the hotel room, says he heard a heavy thump followed by several more. He rushed to the bathroom and found Bonadio convulsing on the floor.

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In October, after a long, stressful day playing piano in auditions for a Broadway musical, Nick Day, 23, went to bed and fell asleep. When he woke up, his girlfriend told him he’d had a seizure and an ambulance was on the way.Both young men were examined by emergency department doctors, observed for a few hours, and sent home with orders to take it easy. Both were told that unprovoked seizures were quite common and that theirs may have been brought on by exhaustion.

AN UNCERTAIN FUTURE

Each year, an estimated 150,000 Americans experience unprovoked seizures—seizures without an obvious trigger like a blow to the head, a high fever, low blood sugar, or alcohol withdrawal. More than 50 percent of the time, patients will never have a second seizure, even though the cause of the first remains a mystery.Neither Bonadio nor Day knew whether the seizure was an isolated incident or signaled the onset of epilepsy. Should they take antiepileptic drugs (AEDs) to reduce the risk of having a second seizure, or do nothing and hope they were among the percentage of patients who never have another seizure?With such uncertainty common in medical practice, the American Academy of Neurology (AAN) and the American Epilepsy Society convened a panel of experts to review the available evidence and draft a guideline, published in the journal Neurology, to help patients and doctors decide what to do in the case of a first unprovoked seizure. The experts set out to answer three questions: If you have an unprovoked seizure, what is your risk of a second one? If you take an AED immediately after your first seizure, will this help you remain free of seizures in the long term? And are there any adverse side effects of AEDs that patients need to know about?

Continue —> Seizure Decisions: After an unprovoked seizure, patients are… : Neurology Now.

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