After collecting information from your medical history and physical evaluation, diagnostic testing and/or monitoring, your physician will discuss the findings with you and your family. If epilepsy or other brain or nerve disorder has been diagnosed, the neurologist will chart a course of treatment. In many cases anti-convulsant (more commonly called anti-epileptic) medications can control your seizures.
The type of brain or nerve disorder and your personal medical history determine the right medication. As with any medication, the most important guideline is to take it as prescribed and never change it or stop taking it without consulting with your physician. Some medications may cause side effects, which are often temporary. If the side effects are serious, it is important to contact your physician immediately.
Depending on the medication therapy, you may need to have frequent blood tests to monitor your blood levels. As with all medications, adjustments may be necessary. It is also important to manage other medications you’re taking—including over-the-counter products—to watch for possible side effects or complications with anti-convulsion medications.
If drug therapy does not achieve satisfactory results, you may be a candidate for surgical treatment. Extensive neurological testing is required to determine if your condition qualifies. The latest tests include video EEG monitoring, magnetic resonance imaging (MRI), positron emission tomography (PET) and implantable electrodes. These sophisticated tests help your physicians locate the source of seizures.
You may be admitted to the hospital for a two- to five-day inpatient video EEG monitoring stay. Nurses and EEG technicians observe and provide constant care, and clinicians record and document your neurological activity before, during and after seizures. Once it is determined that you are eligible for surgery, the surgeon will meet with you and your family to review the risks and benefits.
If you’re not a candidate for surgery or you choose not to proceed, your physician may try new medication therapy or a less invasive surgical option such as the vagus nerve stimulator (VNS). This minor surgery implants a pacemaker to stimulate the vagus nerve in your neck. New epileptic medications and advances in surgical procedures are constantly being introduced.
Even though you may not be eligible now or you choose not to have a surgery at this time, your physician will keep you informed of new treatments to consider as they evolve and become available.
Neuropsychological evaluation and testing
Neuro-counseling is available for pre- and post-diagnostic testing through a Community neuropsychologist. The evaluation may indicate where the seizures may originate in your brain. These conditions can affect your memory, concentration and problem-solving skills, which often leads to depression and anxiety.
This assessment provides the physician important information in planning treatment and helping you and your family to better understand what you’re experiencing, and it provides a baseline for future assessment to measure improvement and manage medications. The evaluation is an interview that may last from 30 minutes to an hour. The testing may take from three to five hours depending on your individualized testing plan.
Maintaining regular visits with the physician is an important commitment in controlling epilepsy and other brain or nerve disorders. Periodic exams to manage medication therapy, monitor side effects or other condition changes help the physician in planning the patient’s treatment plan. Your physician may find it necessary to schedule regular blood tests or other tests, such as imaging studies, to keep you free of seizures or limit seizures so you can stay active doing the things important in your life.