Nearly two-and-one-half million Americans suffer from Epilepsy.
It’s caused by abnormal electrical activity in the brain.
A person having an epileptic seizure may cry out, fall to the floor unconscious, twitch, or move uncontrollably, drool, or even lose bladder control. When the attack is over the person regains consciousness but may be exhausted, dazed, and sore.
The strange behavior caused by some seizures has contributed through the ages to many superstitions and prejudices about epilepsy.
The word “epilepsy” is derived from the Greek word for “attack.” People apparently once imagined that demons or gods were visiting those with epilepsy.
However, in 400 B.C., the early physician Hippocrates suggested that epilepsy was a disorder of the brain, and we now know that he was right.
Today, there are many ways to treat epilepsy. But an early and accurate diagnosis is crucial for finding an effective treatment.
Available treatments currently used by physicians can control seizures at least some of the time in about 80 percent of people with epilepsy. However, 20 percent (about 600,000 people with epilepsy in the United States) have intractable seizures, and another 400,000 feel they get inadequate relief from current medications.
Doctors who treat epilepsy come from different fields of medicine. They include neurologists, pediatricians, pediatric neurologists, internists, and family physicians, as well as neurosurgeons and doctors called epileptologists who specialize in treating epilepsy.
Patients who require specialized or intensive care for epilepsy may be treated at large medical centers and neurology clinics and hospitals or by neurologists in private practice.
Many epilepsy treatment centers are associated with university hospitals that perform research in addition to providing medical care.
Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. Research suggests that medication and other treatments may be less successful in treating epilepsy once seizures and their consequences become established.
When seizures cannot be adequately controlled by medications, doctors may recommend that the person be evaluated for surgery. Teams of doctors at medical centers perform surgery for epilepsy.
To determine if a person may benefit from surgery, doctors consider the kind of seizures the patient has.
They also consider the brain region involved and how important that region is for everyday behavior.
Surgeons usually avoid operating in areas of the brain that are necessary for speech, language, hearing, or other important abilities. They often monitor the patient intensively prior to surgery in order to pinpoint the exact location in the brain where seizures begin. (Doctors use standard Magnetic Resonance Imaging (MRI) to locate the area of that abnormality.)
Physicians also may use implanted electrodes to record brain activity from the surface of the brain.
According to a study published in 2000, 64 percent of patients receiving surgery became seizure-free, compared to 8 percent of those patients who continued with medication only.
Because of this study and other evidence, the American Academy of Neurology (ANN) now recommends surgery for temporal lobe epilepsy (TLE) in patients when anti-epileptic drugs are not effective.
A nationwide study now is underway to determine how soon surgery for TLE should be performed on patients. Decisions are based on length of duration and severity of the seizures in patients, but only after medications have been tried unsuccessfully.
According to some medical studies, it can be difficult for persons who have experienced years of seizures to fully re-adapt to a seizure-free lifestyle if the surgery is successful.
Therefore, health officials agree that surgery should always be performed with support from rehabilitation specialists and counselors who can help the patient deal with the psychological, social, and employment issues he/she may face.
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