Can seizures be controlled?

Treatment of epileptic seizures is usually accomplished through medication management. Antiepileptic medications work by circulating in the blood stream at an optimal and steady therapeutic level to provide maximum seizure control. This therapeutic level is called the plasma drug level, and this level is routinely measured from an assay of the patient’s blood. Steady plasma drug levels are best achieved by taking the antiepileptic medication as prescribed. This can be enhanced by taking the medication after meals, which will not only decrease the medication’s absorption rate into the blood stream (and ensuring a steady level) but also will reduce any gastric discomfort caused by taking it on an empty stomach.

There are many antiepileptic medications currently on the market: Luminal, Dilantin, Tegretol, Mysoline, Zarontin, Celontin, Valium, Ativan, Depakote, Klonopin, and Neurontin, to name a few. The current therapeutic approach to treating epileptic seizures involves using one drug as a method of control, and, if this drug proves ineffective, changing to another drug. This approach, referred to as monotherapy, replaces previous combined medication approaches. Monotherapy is believed to be safer because there are fewer cognitive and physical side effects.

The term ‘toxicity’ refers to cognitive, neuronal, and other physical side effects caused by taking antiepileptic medications. Some of these side effects include: sedation, GI distress, dizziness, drowsiness, ataxia, nausea, agitation, and slurred speech. It is important for patients and their families become familiar with the different side effects of antiepileptic medication toxicity.

How Long will he / she be on seizure medication:

Usually seizure medications are tapered after 1 week of therapy except in the following:

1. Penetrating brain injury
2. Development of posttraumatic seizure.
3. Prior seizure history.
4. Patients undergoing craniotomy.

For patients in whom seizure medications are continued for any of the reasons above maintain 6-12 months of therapeutic levels.