Epilepsy

Epilepsy1A Brief HistoryEarliest record dates back as early as 2000 B.CHippocrates: epilepsy is a process in the brain. Ancient writers: epilepsy is a work of supernatural forces:Epilepsy - to be seized by forces from without.John Hughlings Jackson : has formulated the modern definition of epilepsy An occasional, excessive , and disorderly discharge of nerve tissue1) ---2) Interestingly, the Greek philosopher , Hippocrates has identified epilepsy as a process in the brain. 3) However many ancient writers have considered epilepsy to be the work of supernatural forces. Hence, the term epilepsy is based on a Greek word which means to be seized by forces from without. This implies that the seizures are caused by spirits.4) It was only when a 19th century neurologist John Hughlings Jackson through research has been able to formulate the modern definition of epilepsy:An occasional, excessive , and disorderly discharge of nerve tissue

2Defining EpilepsyBrain disorderEpileptics have an abnormal brain electrical activityA condition in which there are repeated episodes of seizures

Seizures and epilepsy.A single seizure alone due to high fever or brain damage does not equate to having epilepsyBrain disorderEpileptics have an abnormal brain electrical activityThis then leads to seizuresNot all seizures are epileptic.A single seizure alone due to high fever or brain damage does not necessarily translate to epilepsy.If the patient has repeated episodes of seizures then he/she is an epileptic.

3What is a Seizure?A seizure is a sudden surge of electrical activity in our brain Normally, neurons follow a balance between excitatory and resting states.When chemical balances responsible for these states go into a state of disarray leading to little or too much activity, this then results into electrical surges in our brain and causes the seizure to occur.Three Stages: AuraIctusPostictalNOTE: Seizure by itself, is NOT a disease.

A seizure is a sudden surge of electrical activity in our brain The brain is the main control center for our body. It is composed of neurons. Normally these neurons follow a balance between excitatory and resting states.However during a seizure the chemical balances responsible for these states go into a state of disarray leading to little or too much activity. This then results to electrical surges in our brainNOTE: SEIZURE is not a disease but merely a symptom of a disease that is not exclusive only to epilepsy

Three Stages: >BEGGININGAura- The start of a partial seizure. An aura or warning is the first symptom of a seizure and is considered part of the seizure. Often the aura is an indescribable feeling. Other times its easy to recognize and may be a change in feeling, sensation, thought, or behavior that is similar each time a seizure occurs.>MIDDLEIctus- Meaningstrokeorattack, ictus is another word for the physical seizure. The middle of a seizure is often called theictal phase. Its the period of time from the first symptoms (including an aura)to the end of the seizure activity, This correlates withthe electrical seizure activity in the brain. Sometimes the visible symptoms last longer than the seizure activity on an EEG. This is because some of the visible symptoms may be aftereffects of a seizure or not related to seizure activity at all.>ENDINGPostictal- Meaningafter the attack, postictal refers to the aftereffects of the seizure, e.g., arm numbness, loss of consciousness, partial paralysis, etc. As the seizure ends, the postictal phase occurs - this is the recovery period after the seizure. Some people recover immediately while others may take minutes to hours to feel like their usual self. The type of seizure, as well as what part of the brain the seizure impacts, affects the recovery period how long it may last and what may occurduring it.

4other conditions that can cause seizures:head traumafeverbrain infection brain tumorstrokeabnormal levels of glucose/sodium in blood and many more5Seizure EEGEEG testing shows a 3 Hz generalized spike and waves.

The EEG shows sudden bursts of electrical activity (spikes) or sudden slowing of brain waves in the brain.This changed is caused by the seizure (absence seizure in this case). When a person has epilepsy, the location and exact pattern of the abnormal brain waves may help show what type of epilepsy or seizures the person has. Keep in mind that in many people with epilepsy, the EEG may appear completely normal between seizures. An EEG by itself does not diagnose or rule out epilepsy or a seizure problem.

Whats in a wave?The EEG recording shows different types of brain waves. A wave is any type of brain activity, which appears as a wave shape on the EEG recording. There are different names for the brain waves which are put into bands according to their frequency or number of waves per second (see below), and each type of wave looks different on the EEG. Some brain waves happen at particular times or in different areas of the brain.

Alpha waves are at a frequency of 8-13 waves per second, and are the typical waves seen in adults who are relaxed with their eyes closed. These waves are clearest in the occipital lobes (the part of the brain responsible for our sight and seeing).

Beta waves are at frequencies greater than 13 per second. These are often seen in people who are awake, with their eyes open or closed. They are often seen in the frontal lobes (responsible for conscious thought and movement) and in central areas of the brain.

Theta waves happen between the frequencies of 4-7 waves per second, and are also called slow activity. Theta waves occur during sleep and in young children. They are not obvious in adults who are awake.

Delta waves are at frequencies up to 4 waves per second. These are the slowest type of wave but have the highest amplitude (strongest signal). Delta waves are common in children under one year. They also happen during some parts of sleep.

Gamma waves are at frequencies of 26-100 waves per second.Spikes are very fast waves and are called spikes because of their shape on the EEG. Each lasts less than 80 milliseconds (less than 1/12th of a second) and may be followed by slow delta waves. Spikes clearly stand out from other brain activity on the EEG.

Polyspikes are a series of spikes that happen quickly.

Spike waves happen when one or more brief spikes are followed by a slow wave, and this happens three times per second.

Sharp waves happen over 80-200 milliseconds.

6Types of SeizuresOne of the main concern by people affected by epilepsy will probably be, how can this epilepsy be treated?

There is no single answer to this question since different epilepsy syndromes will involve many different types of seizures.

What then, are the various types of seizures ?

7Major GroupsGeneralized seizures

Absence (petit mal) seizuresMyoclonic seizuresClonic seizuresTonic seizuresTonic-clonic (grand mal)seizuresAtonic seizures (drop attacks)

Partial or Focal seizures

Simple Partial SeizureComplex Partial SeizurePartial seizure that secondarily generalizeSeizures are divided into 2 major groups

Generalized seizures- EEG spikes are found at multiple regions of the brainPartial or Focal seizures- EEG spikes start at one area of the brain

8Generalized SeizuresViewer discretion is advised: videos shown are purely for educational purposes9Lapses of awareness for a few secondsCommonly found in childrenUsually returns to being alert after the seizure

Absence Seizure (Petit mal)

Video source: https://www.youtube.com/watch?v=H3iLQi6wt94Absence seizures cause a short loss of consciousness (just a few seconds) with few or no symptoms. The patient, most often a child, typically interrupts an activity and stares blankly. These seizures begin and end abruptly and may occur several times a day. Patients are usually not aware that they are having a seizure, except that they may be aware of "losing time.

It is often mistaken for children to be daydreaming10myo muscle, clonic- jerkSudden increase in muscle tone

Myoclonic Seizure

Video source: https://www.youtube.com/watch?v=zPNVYFRhthgMyoclonic seizures consist of sporadic jerks, usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent, these seizures may result in dropping or involuntarily throwing objects.11Tonic Seizure/Phase- Tonic seizures are characterized by stiffening of the muscles, loss of consciousness.Clonic Seizure/Pahse- Clonic seizures are repetitive, rhythmic jerks that involve both sides of the body at the same time

Usually a Tonic seizure is always followed by a Clonic seizure it rarely happens when only one type is experiencedTonic and clonic/ tonic-clonic seizures (Grand Mal)Video source: https://www.youtube.com/watch?v=BvqA3vbNYPc

Tonic-clonic seizures(formerly known asgrand mal seizures) can be one of the most frightening seizures to observe. There are two parts to a tonic-clonic seizure:Tonic phase The person initially stiffens and loses consciousness, causing them to fall to the ground. The persons eyes roll back into their head as the muscles (including those in the chest, arms and legs) contract and the back arches. As the chest muscles tighten, it becomes harder for the person to breathe the lips and face may take on a bluish hue, and the person may begin to make gargling noises.

Many observers have the misconception that the person is in danger of swallowing their tongue, so they attempt to put something in the persons mouth.Swallowing your tongue is actually impossible, and any attempt to open the now tightly clenched jaw may cause more harm than good.The tonic phase will typically last no longer than a minute.

Clonic phase Typically following the tonic phase, the clonic phase will start as the muscles begin to spasm and jerk. The elbows, legs and head will flex then relax rapidly at first, but the frequency of the spasms will gradually subside until they cease altogether. As the jerking stops, it is common for the person to let out a deep sigh, after which normal breathing resumes. The clonic phase will rarely last longer than a few minutes.As the person transitions from the clonic phase to the post-seizure period, theyll likely remain unconscious for a few minutes or more, depending on the severity of the seizure. During this time (known as thepostictal period), the brain is extremely active trying to stop the cells from firing to bring the seizure under control. When the person wakes up, they may have sore muscles and be tired or confused. The observers best course of action is to be assuring and supportive.Occasionally, it is possible to experience the tonic phase without the clonic phase and vice versa.

12Its the opposite of the tonic/clonic seizure. Consists of the sudden loss of muscle toneAtonic Seizure (drop attack)

Video source: https://www.youtube.com/watch?v=EEusUYl5uQ4Unlikemyoclonic seizures(which cause muscles to tense),atonic seizurescause the muscles to go limp. The patients body may slump or crumple to the ground, possibly causing injury.The areas of the brain stem responsible for increasing and decreasing muscle tone are close together, which means atonic and myoclonic seizures probably begin in the same place. Patients experiencing sudden dramatic changes in muscle tone will often suffer from either or both types of seizures.

13Partial (focal) Seizuresanomaly starts at one area and may move or spread out to other areas of the brainDoes not impede awarenessDivided into further sub categories

AutonomicRacing heartbeat, loss of bladder control, and other autonomic functionsMotorJerking, muscle rigidity, spasms, head turningSensoryUnusual sensations affecting the sensesPsychologicalMemory or emotional disturbanceSimple partial Seizure

Video source: https://www.youtube.com/watch?v=gbryS0aIqOcSimple partial seizures are divided into four main categories: Autonomic---- affects the autonomic nervous system which are the group of nerves that control our organs. So things like a racing heartbeat, stomach upset, diarrhea, loss of bladder control. The only common autonomic symptom is a peculiar sensation in the stomach that is experienced by some patients with a type ofepilepsycalled temporal lobe epilepsy.

Simple Motor repetitive jerking movements and stiffening.

Simple Sensory- involves experiencing unusual sensations affecting the five senses (taste, smell, touch, vision, or hearing)

Simple Psychological- involved are various memory experiences such dejavu, emotions (fear/pleasure) or other complex psychological phenomena

15Impairs patient awarenessMay include Automatisms which are involuntary coordinated movements that are purposeless and repetitive such as: lip smacking, picking at clothesComplex Partial Seizure

Video source: https://www.youtube.com/watch?v=uQWk5Ur5kD8A partial seizure occurs when the seizures begins at one area of the brain. If this partial seizure spreads to the other side of the brain then it is known to secondarily generalize.Focal seizure to grand mal seizure. Partial seizure that secondarily generalizeVideo source: https://www.youtube.com/watch?v=Ghv5odRakL8

Types of Epilepsy

Temporal Lobe Epilepsy

Arises from the temporal lobe; most experience a complex partial seizure or rarely only a simple partial seizure

Frontal Lobe EpilepsyBegins at frontal lobe; most experience tonic-clonic seizures or short complex partial seizures

Parietal Lobe EpilepsyAt the parietal lobe; seizures involving sensory functions and may slightly impair language and simple math skillOccipital Lobe EpilepsyStarts at the occipital lobe; can be genetic or due to a lesion; seizures are hallucinations and other symptoms related to vision

There are several types of epilepsy, each with different causes, symptoms, and treatments.Temporal Lobe EpilepsyMost auras and automatisms last a very short period - seconds or 1 to 2 minutes.Olfactory, auditory and gustatory illusions and hallucinations may occur.Patients may report distortions of shape, size, and distance of objects.These visual illusions differ from the visual hallucinations associated with occipital lobe seizure in that there is no formed visual image.Objects may appear smaller or larger than usual.Vertigo may occur with seizures in the posterior superior temporal gyrus.3. Frontal Lobe Epilepsythe next most common form of epilepsy after temporal lobe epilepsy (TLE)and involves the frontal lobes of the brain. As in temporal lobe epilepsy, seizures in frontal lobe epilepsy are partial, though seizure symptoms differ depending on the frontal lobe area involved. Since the frontal lobes are responsible for a wide array of functions including motor function, language, impulse control, memory, judgment, problem solving, and social behavior, to name a few, seizure symptoms in the frontal lobes vary widely. Also, the frontal lobes are large and include many areas that do not have a precisely known function. Therefore, when a seizure begins in these areas, there may be no symptoms until it spreads to other areas or to most of the brain, causing a tonic-clonic seizure. When motor areas (areas that control movement) are affected, abnormal movements occur on the opposite side of the body. Seizures beginning in frontal lobe motor areas can result in weakness or the inability to use certain muscles, such as the muscles that allow someone to speak. - See more at: http://epilepsy.med.nyu.edu/epilepsy/types-epilepsy/frontal-lobe-epilepsy#sthash.ruMfyqvL.dpuf*( http://epilepsy.med.nyu.edu/epilepsy/types-epilepsy/frontal-lobe-epilepsy#sthash.ruMfyqvL.dpuf)

4. Parietal Lobe EpilepsyParietal lobe epilepsy is a relatively rare form of epilepsy, comprising about 5% of all epilepsy, in which seizures arise from the parietal lobe of the brain. Parietal lobe epilepsy can start at any age and occurs in both males and females equally. It may be a result of head trauma, birth difficulties, stroke, or tumor, though the cause is unknown in 20% of patients.

What are Parietal Lobe Seizures Like?Since the parietal lobe involves the processing and integration of sensory and visual perception, seizures originating from the parietal lobe can involve both sensory and visual sensations. Seizure duration varies, from a few seconds in some patients to a few minutes in others. The following are the different types of symptoms associated with parietal lobe seizures:Somatosensory Seizures: These are the most common type of seizure in parietal epilepsies. Patients with these types of seizures describe feeling physical sensations of numbness and tingling, heat, pressure, electricity and/or pain. Pain, though a rare symptom in seizures overall, is quite common in parietal seizures, occurring in up to one quarter of patients. Some patients describe a typical Jacksonian march, in which the sensation marches in a predictable pattern from the face to the hand up the arm and down the leg. Rarely, a patient will describe a sensation in the genitalia, occasionally leading to orgasm.Somatic Illusions: During a somatic illusion, another common symptom of parietal seizures, patients may experience a feeling like their posture is distorted, that their arms or legs are in a weird position or are in motion when they are not, or that a part of their body is missing or feels like it does not belong.Vertigo: Patients with parietal seizures may experience a sensation of movement or spinning of the environment, or of their body within the environment.Visual Illusions and Hallucinations: Patients with visual illusions report a distortion of visual perception: objects seem too close, too far, too large, too small, slanted, moving or otherwise not right. A patient with hallucinations describes seeing objects that seem very real, though in fact they do not exist.Language Disturbances: Rarely, a patient with a parietal seizure will report difficulty understanding spoken words or language, difficulty reading or performing simple math.

How are Parietal Lobe Epilepsies Treated?Treatment with antiepileptic medication is usually effective in controlling seizures in parietal lobe epilepsy. In severe cases,surgerymay be an option.

5. Occipital Lobe EpilepsyThe occipital lobe is the main center of the visual system. Occipital lobe epilepsy accounts for about 5-10% of all epilepsy syndromes. This kind of epilepsy can be either idiopathic (of unknown, presumed genetic, cause) or symptomatic (associated with a known or suspected underlying lesion). Benign occipital epilepsies usually begin in childhoodOccipital seizures usually begin with visual hallucinations like flickering or colored lights, rapid blinking, or other symptoms related to the eyes and vision. They may occur spontaneously but can often be triggered by particular visual stimuli, such as seeing flashing lights or a repeating pattern. Occipital seizures are often mistaken for migraine headache because they share similar symptoms including visual disturbances, partial blindness, nausea and vomiting, and headache18

Types of Epilepsy

Primary/ Ideopathic Generalized Epilepsy

there is often, but not always, a family history of epilepsy; genetic causes

Iodiopathic Partial Epilepsypartial epilepsy syndromes of unknown or idiopathic cause . There are a few idiopathic partial epilepsy syndromes. Each individual syndrome generally has its own characteristic seizure type(s), typical age of onset, and specific EEG patterns. Symptomatic Generalized EpilepsyProgressive myoclonic EpilepsyRare and are the result of hereditary metabolic disorder; combination of tonic-clonic and myoclonic

Reflex Epilepsy

Triggered by the environment (ex. flashing lights, specific sounds, arithmetic, reading, writing or specific topics); involves absence, tonic-clonic or myoclonic seizures;

2. Primary/ Ideopathic Generalized EpilepsyIdiopathic means there is no apparent cause.Idiopathic generalized epilepsy tends to appear during childhood or adolescence, although it may not be diagnosed until adulthood. In this type of epilepsy, no nervous system (brain or spinal cord) abnormalities, other than the seizures, can be identified on either an EEG or imaging studies ( MRI). The brain is structurally normal on a brainmagnetic resonance imaging(MRI) scan, although special studies may show a scar or subtle change in the brain that may have been present since birth.People with idiopathic generalized epilepsy have normal intelligence and the results of the neurological exam and MRI are usually normal. The results of theelectroencephalogram(EEG -- a test which measures electrical impulses in the brain) may show epileptic discharges affecting a single area or multiple areas in the brain (so called generalized discharges).The types of seizures affecting patients with idiopathic generalized epilepsy may include:Myoclonic seizures (sudden and very short duration jerking of the extremities)Absence seizures (staring spells)Generalized tonic-clonic seizures (grand mal seizures)Idiopathic generalized epilepsy is usually treated withmedications. Some people outgrow this condition and stop having seizures, as is the case with childhood absence epilepsy and a large number of patients with juvenile myoclonic epilepsy.*(http://www.webmd.com/epilepsy/guide/types-epilepsy)

3. Iodiopathic Partial EpilepsySome of these syndromes are:Benign rolandic epilepsy, also known as benign epilepsy of childhood with centrotemporal spikesEarly onset benign childhood occipital epilepsyLate onset benign childhood occipital epilepsy

Treatment: The seizures in idiopathic partial epilepsy typically respond well to medications used for other partial epilepsy syndromes. However, depending on the seizure type, time of day, and frequency, some doctors and parents choose not to treat the child with medication at all. For example, a patient with benign rolandic epilepsy who experiences rare nocturnal seizures consisting of only brief face and arm twitching may do well without any medication treatment.

Prognosis: Though the prognosis of these syndromes varies by syndrome type, it is usually quite good. Most patients with these syndromes outgrow their seizures by teenage years or young adulthood, and also have normal intelligence and motor skills. - See more at: http://epilepsy.med.nyu.edu/epilepsy/types-epilepsy/idiopathic-partial-epilepsy#sthash.jofsBJe9.dpuf*(See more at: http://epilepsy.med.nyu.edu/epilepsy/types-epilepsy/idiopathic-partial-epilepsy#sthash.jofsBJe9.dpuf)

5. Progressive myoclonic EpilepsyProgressive myoclonic epilepsies feature a combination of myoclonic and tonic-clonic seizures. Unsteadiness, muscle rigidity, and mental deterioration are often also present.Hereditary metabolic disorders are often responsible, but sometimes metabolic test results are normal and the cause remains unknown.The disorders affect both sexes. The age of onset can vary from infancy to adulthoodProgressive myoclonic epilepsy is not a single disorder but includes a group of syndromes with various namesSevere myoclonic epilepsy of infancy (Dravet syndrome)Unverricht-Lundborg disease (also called Baltic myoclonus)Lafora diseaseMitochondrial encephalopathies

Treatment: The medical treatment of progressive myoclonic epilepsy is often successful only for a few months or years. These patients may require more than one seizure medicine. As the disorder progresses, the medications become less effective, and side effects may be more severe as more of them are used at higher doses. In such cases, it is often worthwhile to try lower doses.The outlook is generally unfavorable. Seizures are difficult to control and patients often lose abilities involving thinking and movement. However, the course of the various syndromes varies considerably from individual to individual.

*(http://www.epilepsy.com/learn/types-epilepsy-syndromes/progressive-myoclonic-epilepsies)19Types of Epilepsy (common in Children)Febrile Seizureshereditary; tonic-clonic seizures may occur at children ages 6 months to 6 years during high fever; Benign Rolandic EpilepsyHerdiatry; 2-13 years old; simple partial(motor) seizure, sensory seizure or tonic-clonic seizureJuvenile Myoclonic EpilepsyBegins shortly before or after puberty, or sometimes at early adulthood; myoclonic seizures with or without tonic-clonic seiuzres or absence seizresInfantile Spasms60% of cases are due to brain injury or O2 deprivation, 40% of cases are idiopathic; Rare but mostly found in infants 3-12 months; seizures consist of a sudden jerk followed by stiffeningLennox-Gastaut Syndrome1-6 years; patients with mental handicap; difficult to control generalized seizures; combination of tonic, atonic, absence, myoclonic, and tonic-clonic seizuresChildhood Absence EpilepsyAges 5-9 years; can be inherited are sporadically acquired; seizures involve sudden cessation of movement, staring, sometimes blinking, and slightloss of muscle tone (rarely); occurs without an aura or warningBenign Occipital EpilepsyAges 5-7 years; occipital lobe origin; seizures are visual hallucinations, vomit, loss of vision or forced deviation of eyes; children may complain of intense headaches; may be mistakenly diagnosed as migraine Mitochondrial DisordersAbnormal mitochondrial DNA resulting in metabolic disorders affecting the brains and muscle; two disorders are associated: mitochondrial encephalopathy, lactic acidosis and stroke like episodes (MELAS), and myoclonic epilepsy with ragged red muscle fiber (MERFF)Types of Epilepsy (common in Children)Landau-Kleffner Syndrome (acquired epileptic aphasia)

Rare; ages 3-7 years; child will experience progressive language problems with or without seizure; mostly auditory impairment but it may affect speaking; simple partial motor seizures are most common but tonic-clonic can also occurRasmussen Syndrome

Age 14 months-14 years; slow progressive neurologic deterioration; commonly simple partial motor seizures but 20% in most cases experience tonic-clonic seizures. Hypothalamic Hamartoma & Epilepsy

Small tumors in the brain affecting the hypothalamus; abnormal early puberty, partial seizures with laughing as a frequent nature; simple or complex and may secondarily generalize into tonic-clonic seizures; affected individuals have dysmorphismsCause of epilepsyIn todays current knowledge , still no one really knows what causes it.

GeneticsHead TraumaMedical ConditionsProblems during the patients embryonic development.In todays current knowledge , still no one really knows what causes it.

However several factors have been taken into account that may contribute to increased risk among several patients.

GeneticsHead TraumaMedical ConditionsProblems during the patients embryonic development.

22TreatmentMostly through drug therapySide effects of these drugs may include: blurry or double vision, fatigue, sleepiness, unsteadiness, stomach upset, skin rashes, low blood cell count, and liver problemsAppropriate treatment depends on age, severity and frequency of seizure, overall health, medical history and most importantly the type of epilepsy diagnosed Treatment may last to a few years to a lifetime. Discontinuation of seizure drugs will be considered in patients who are seizure-free for 10 yearsSurgery is also a common option if patients seizure is still not controlled after a trial of 2-3 medications to treat partial epilepsies Ketogenic diet- high fat, low carbohydrate plan

1. Mostly through drug therapy: (anticonvulsant) such as Dilantin, Phenobarbital, Tegretol, Mysoline, and many more.

2. Side effects of these drugs may include: blurry or double vision, fatigue, sleepiness, unsteadiness, stomach upset, skin rashes, low blood cell count, and liver problemsSpecific side effects of Dilantin and Phenytek can cause gum swelling; Depakene may cause hair loss and weight gain.

Appropriate treatment depends on age, severity and frequency of seizure, overall health, medical history and most importantly the type of epilepsy diagnosed

Treatment may last to a few years to a lifetime. Discontinuation of seizure drugs will be considered in patients who are seizure-free for 10 years

Surgery is also a common option if patients seizure is still not controlled after a trial of 2-3 medications to treat partial epilepsies (by removing the brain region triggering epilepsy), other surgical procedures reserved for specific types of epilepsies and lastly implantation of devices to control epilepsy.

Ketogenic diet- high fat, low carbohydrate plan The diet is high in fat, supplies adequate protein and is low in carbohydrates. This combinationchanges the way energy is used in the body. Fat is converted in the liver into fatty acids and ketone bodies. Another effect of the diet is that it lowers glucose levels and improves insulin resistance. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the occurrence of epileptic seizures. *http://www.charliefoundation.org/explore-ketogenic-diet/explore-1/introducing-the-diet)

NOTE FOR TREATMENT AND MEDICATIONS: AEDs do not cure epilepsy or treat the reason why epilepsy has started. They are taken to try and stop the symptoms of epilepsy the seizures. They aim to stop seizures from happening. They do not stop a seizure once it has started. They are prophylactic (preventative) and are usually taken either once or twice a day.

There are various ways medications are taken, by mouth, by injection (into the vein, muscle, or just under the skin) or by suppository (into the bottom). AEDs are usually taken orally (by mouth), and are tablets, capsules, liquids and syrups.

23Classic medications used to treat epilepsy include:Dilantinor PhenytekPhenobarbitalTegretol or CarbatrolMysolineZarontinDepakeneDepakote, Depakote ERValium and similar tranquilizers, such as Tranxene and Klonopin

Newer drugs to treat epilepsy include:AptiomFelbatolFycompaGabitrilKeppraLamictalLyricaNeurontinOxteller XRTopamaxTrileptalVimpatZonegran

There are more drugs available today to control seizures than ever before. In fact, there are more than 20 different medications now on the market to treat epilepsy.

Older medications are still used to treat epilepsy

"Each of these drugs is slightly different. Some work well for some kinds of epilepsy and not for others. Each one also has its own side effects, like all drugs do. Besides the type of epilepsy, here are some other factors that can influence which drug might be right for the patient. These factors should be discussed and taken into consideration:age, gender, and other health issuesHow the drugs work and possible side effectsOther drugs being takenWhat kind of side effects the patient can live withWhat are the expectations regarding the medication; for example, you might want a medication that makes you more alert and better able to concentrate at work.There are also specific questions that women with epilepsy should ask. For example:Is it safe to get pregnant while taking this drug?Could this drug interfere with my birth control?My seizures seem to be affected by my menstrual cycle. Will this drug help manage that?Could this drug increase my risk for osteoporosis?

*http://www.webmd.com/epilepsy/working-partnership-your-doctor-best-treatment24ReferencesJuvenile Absence Epilepsy. (n.d.). Retrieved February 6, 2015, from http://www.chp.edu/CHP/juvenile absence epilepsyThe Charlie Foundation - WHAT IS THE KETOGENIC DIET? (n.d.). Retrieved February 6, 2015, from http://www.charliefoundation.org/explore-ketogenic-diet/explore-1/introducing-the-dietTypes of Epilepsy. (n.d.). Retrieved February 6, 2015, from http://epilepsy.med.nyu.edu/epilepsy/types-epilepsy#sthash.bkSW3YLA.dpbsSeizures: Read About Symptoms and Types. (n.d.). Retrieved February 6, 2015, from http://www.medicinenet.com/seizures_symptoms_and_types/article.htmSeizures. (n.d.). Retrieved February 6, 2015, from http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/epilepsy/seizures/WebMD Epilepsy Guide - Better Information for Better Health. (n.d.). Retrieved February 6, 2015, from http://www.webmd.com/epilepsy/guide/default.htm25