Natural treatments for epilepsy, such as herbs, biofeedback, and acupuncture, may complement traditional treatment options. Learn more. Jun 13, Learn about seizure types, what causes seizures, what happens during a seizure and what you can do if you see someone having a seizure. Feb 20, WebMD takes you through first aid steps for helping someone who is having a seizure.
from seizures Relief
There is also no good scientific evidence to support suggestions that the addition of THC in combination with CBD increases the efficacy of cannabis-based medicinal products for children. We welcome the rescheduling of these products from Schedule 1 to Schedule 2 that will enable their investigation in clinical trials.
The BPNA also recommends that where children are already taking other cannabis-based products that contain higher proportions of THC, they should be transitioned on to CBD until strong evidence for these products can be produced through clinical trials. The Government has no plans to legalise the use of cannabis for recreational purposes. Possession of cannabis is illegal. This includes cannabis for medical use unless it has been prescribed for you.
Cannabis-based medicinal products can only be prescribed by a specialist. A GP cannot prescribe the medication but could refer you to a specialist. The specialist will discuss all other treatment options with you first before considering a cannabis-based product. A prescription for medicinal cannabis would only be given when all other treatment options have been tried or are considered unsuitable, and would only be given if the doctor considers it to be in your best interests. MHRA is working with individual companies to ensure that CBD-based products that make medicinal claims should be licensed and meet safety, quality and efficacy standards to protect public health.
To date, the MHRA has licensed no other cannabis based medicinal products as medicines. Skip to main content. In this section What is epilepsy? Diagnosing epilepsy Epileptic seizures Treatment Medication for epilepsy Ketogenic diet Vagus nerve stimulation therapy Epilepsy surgery Deep brain stimulation Care and treatment: Cannabis oil for epilepsy. What is medicinal cannabis?
The Government has defined a cannabis-based product for medicinal use in humans as one that: What does the guidance say? The guidance states that non-licensed medicinal cannabis should only be considered for children who: What is the evidence? What is the evidence around THC? It may take time for the dosage to achieve optimal seizure control while minimizing side effects.
The latter are usually worse when first starting a new medicine. Most side effects of antiseizure drugs are relatively minor, such as fatigue, dizziness, or weight gain. Antiseizure medications have differing effects on mood: However, severe and life-threatening reactions such as allergic reactions or damage to the liver or bone marrow can occur. Antiseizure medications can interact with many other drugs in potentially harmful ways.
Some antiseizure drugs can cause the liver to speed the metabolism of other drugs and make the other drugs less effective, as may be the case with oral contraceptives. Since people can become more sensitive to medications as they age, blood levels of medication may need to be checked occasionally to see if dosage adjustments are necessary.
The effectiveness of a medication can diminish over time, which can increase the risk of seizures. Some citrus fruit and products, in particular grapefruit juice, may interfere with the breakdown of many drugs, including antiseizure medications — causing them to build up in the body, which can worsen side effects.
Some people with epilepsy may be advised to discontinue their antiseizure drugs after years have passed without a seizure. Others may be advised to wait for 4 to 5 years. Discontinuing medication should always be done with supervision of a health care professional. It is very important to continue taking antiseizure medication for as long as it is prescribed. Discontinuing medication too early is one of the major reasons people who have been seizure-free start having new seizures and can lead to status epilepticus.
Some evidence also suggests that uncontrolled seizures may trigger changes in the brain that will make it more difficult to treat the seizures in the future. The chance that a person will eventually be able to discontinue medication varies depending on the person's age and his or her type of epilepsy. More than half of children who go into remission with medication can eventually stop their medication without having new seizures.
One study showed that 68 percent of adults who had been seizure-free for 2 years before stopping medication were able to do so without having more seizures and 75 percent could successfully discontinue medication if they had been seizure-free for 3 years.
However, the odds of successfully stopping medication are not as good for people with a family history of epilepsy, those who need multiple medications, those with focal seizures, and those who continue to have abnormal EEG results while on medication.
There are specific syndromes in which certain antiseizure medications should not be used because they may make the seizures worse. For example, carbamazepine can worsen epilepsy in children diagnosed with Dravet syndrome. Dietary approaches and other treatments may be more appropriate depending on the age of the individual and the type of epilepsy.
A high-fat, very low carbohydrate ketogenic diet is often used to treat medication-resistant epilepsies. The diet induces a state known as ketosis, which means that the body shifts to breaking down fats instead of carbohydrates to survive. A ketogenic diet effectively reduces seizures for some people, especially children with certain forms of epilepsy. Studies have shown that more than 50 percent of people who try the ketogenic diet have a greater than 50 percent improvement in seizure control and 10 percent experience seizure freedom.
Some children are able to discontinue the ketogenic diet after several years and remain seizure-free, but this is done with strict supervision and monitoring by a physician. The ketogenic diet is not easy to maintain, as it requires strict adherence to a limited range of foods.
Possible side effects include impaired growth due to nutritional deficiency and a buildup of uric acid in the blood, which can lead to kidney stones. Researchers are looking at modified versions of and alternatives to the ketogenic diet. For example, studies show promising results for a modified Atkins diet and for a low-glycemic-index treatment, both of which are less restrictive and easier to follow than the ketogenic diet, but well-controlled randomized controlled trials have yet to assess these approaches.
When someone is considered to be a good candidate for surgery experts generally agree that it should be performed as early as possible. Surgical evaluation takes into account the seizure type, the brain region involved, and the importance of the area of the brain where seizures originate called the focus for everyday behavior.
Prior to surgery, individuals with epilepsy are monitored intensively in order to pinpoint the exact location in the brain where seizures begin. Implanted electrodes may be used to record activity from the surface of the brain, which yields more detailed information than an external scalp EEG.
Surgeons usually avoid operating in areas of the brain that are necessary for speech, movement, sensation, memory and thinking, or other important abilities.
While surgery can significantly reduce or even halt seizures for many people, any kind of surgery involves some level of risk. Surgery for epilepsy does not always successfully reduce seizures and it can result in cognitive or personality changes as well as physical disability, even in people who are excellent candidates for it. Nonetheless, when medications fail, several studies have shown that surgery is much more likely to make someone seizure-free compared to attempts to use other medications.
Anyone thinking about surgery for epilepsy should be assessed at an epilepsy center experienced in surgical techniques and should discuss with the epilepsy specialists the balance between the risks of surgery and desire to become seizure-free. Even when surgery completely ends a person's seizures, it is important to continue taking antiseizure medication for some time. Doctors generally recommend continuing medication for at least two years after a successful operation to avoid recurrence of seizures.
Electrical stimulation of the brain remains a therapeutic strategy of interest for people with medication-resistant forms of epilepsy who are not candidates for surgery. The vagus nerve stimulation device for the treatment of epilepsy was approved by the U.
The device delivers short bursts of electrical energy to the brain via the vagus nerve. On average, this stimulation reduces seizures by about 20 - 40 percent. Individuals usually cannot stop taking epilepsy medication because of the stimulator, but they often experience fewer seizures and they may be able to reduce the dosage of their medication. Once detected, the device administers an intervention, such as electrical stimulation or a fast-acting drug to prevent the seizure from occurring.
These devices also are known as closed-loop systems. NeuroPace, one of the first responsive stimulation, closed-loop devices, received premarket approval by the FDA in late and is available for adults with refractory epilepsy hard to treat epilepsy that does not respond well to trials of at least two medicines.
The majority of people with epilepsy can do the same things as people without the disorder and have successful and productive lives. In most cases it does not affect job choice or performance.
One-third or more of people with epilepsy, however, may have cognitive or neuropsychiatric co-concurring symptoms that can negatively impact their quality of life. Many people with epilepsy are significantly helped by available therapies, and some may go months or years without having a seizure. However, people with treatment-resistant epilepsy can have as many as hundreds of seizures a day or they can have one seizure a year with sometimes disabling consequences.
On average, having treatment-resistant epilepsy is associated with an increased risk of cognitive impairment, particularly if the seizures developed in early childhood. These impairments may be related to the underlying conditions associated with the epilepsy rather than to the epilepsy itself. Depression is common among people with epilepsy. It is estimated that one of every three persons with epilepsy will have depression in the course of his or her lifetime, often with accompanying symptoms of anxiety disorder.
In adults, depression and anxiety are the two most frequent mental health-related diagnoses. In adults, a depression screening questionnaire specifically designed for epilepsy helps health care professions identify people who need treatment. People with epilepsy should not simply accept that depression is part of having epilepsy and should discuss symptoms and feelings with health care professionals.
Behavioral problems may precede the onset of seizures in some children. Children are especially vulnerable to the emotional problems caused by ignorance or the lack of knowledge among others about epilepsy.
This often results in stigmatization, bullying, or teasing of a child who has epilepsy. Such experiences can lead to behaviors of avoidance in school and other social settings. Counseling services and support groups can help families cope with epilepsy in a positive manner. Some states make exceptions for this policy when seizures don't impair consciousness, occur only during sleep, or have long auras or other warning signs that allow the person to avoid driving when a seizure is likely to occur.
Studies show that the risk of having a seizure-related accident decreases as the length of time since the last seizure increases. In addition, people with epilepsy should take extra care if a job involves operation of machinery or vehicles. The risk of seizures also limits people's recreational choices. Individuals may need to take precautions with activities such as climbing, sailing, swimming, or working on ladders.
Studies have not shown any increase in seizures due to sports, although these studies have not focused on any activity in particular. The benefits of sports participation may outweigh the risks and coaches or other leaders can take appropriate safety precautions.
Steps should be taken to avoid dehydration, overexertion, and hypoglycemia, as these problems can increase the risk of seizures. By law, people with epilepsy or disabilities in the United States cannot be denied employment or access to any educational, recreational, or other activity because of their epilepsy. However, significant barriers still exist for people with epilepsy in school and work.
Antiseizure drugs may cause side effects that interfere with concentration and memory. Children with epilepsy may need extra time to complete schoolwork, and they sometimes may need to have instructions or other information repeated for them. Teachers should be told what to do if a child in their classroom has a seizure, and parents should work with the school system to find reasonable ways to accommodate any special needs their child may have.
Women with epilepsy are often concerned about whether they can become pregnant and have a healthy child. Epilepsy itself does not interfere with the ability to become pregnant. With the right planning, supplemental vitamin use, and medication adjustments prior to pregnancy, the odds of a woman with epilepsy having a healthy pregnancy and a healthy child are similar to a woman without a chronic medical condition. Children of parents with epilepsy have about 5 percent risk of developing the condition at some point during life, in comparison to about a 1 percent risk in a child in the general population.
However, the risk of developing epilepsy increases if a parent has a clearly hereditary form of the disorder. Parents who are worried that their epilepsy may be hereditary may wish to consult a genetic counselor to determine their risk of passing on the disorder. Other potential risks to the developing child of a woman with epilepsy or on antiseizure medication include increased risk for major congenital malformations also known as birth defects and adverse effects on the developing brain.
The types of birth defects that have been most commonly reported with antiseizure medications include cleft lip or cleft palate, heart problems, abnormal spinal cord development spina bifida , urogenital defects, and limb-skeletal defects. It is important that a woman work with a team of providers that includes her neurologist and her obstetrician to learn about any special risks associated with her epilepsy and the medications she may be taking.
Although planned pregnancies are essential to ensuring a healthy pregnancy, effective birth control is also essential. Women who are on these enzyme-inducing antiseizure medications and using hormonal contraceptives may need to switch to a different kind of birth control that is more effective such as different intrauterine devices, progestin implants, or long-lasting injections.
Prior to a planned pregnancy, a woman with epilepsy should meet with her health care team to reassess the current need for antiseizure medications and to determine a the optimal medication to balance seizure control and avoid birth defects and b the lowest dose for going into a planned pregnancy. Any transitions to either a new medication or dosage should be phased in prior to the pregnancy, if possible. For all women with epilepsy during pregnancy, approximately percent will have seizure worsening, but another percent will have seizure improvement.
For most medicines, monthly monitoring of blood levels of the antiseizure medicines can help to assure continued seizure control. Many of the birth defects seen with antiseizure medications occur in the first six weeks of pregnancy, often before a woman is aware she is pregnant.
In addition, up to 50 percent of pregnancies in the U. For these reasons, the discussion about the medications should occur early between the health care professional and any woman with epilepsy who is in her childbearing years.
For all women thinking of becoming pregnant, using supplemental folic acid beginning prior to conception and continuing the supplement during pregnancy is an important way to lower the risk for birth defects and developmental delays. Prenatal multivitamins should also be used prior to the beginning of pregnancy. Pregnant women with epilepsy should get plenty of sleep and avoid other triggers or missed medications to avoid worsening of seizures.
Most pregnant women with epilepsy can deliver with the same choices as women without any medical complications. During the labor and delivery, it is important that the woman be allowed to take her same formulations and doses of antiseizure drugs at her usual times; it is often helpful for her to bring her medications from home.
If a seizure does occur during labor and delivery, intravenous short-acting medications can be given if necessary. It is unusual for the newborns of women with epilepsy to experience symptoms of withdrawal from the mother's antiseizure medication unless she is on phenobarbital or a standing dose of benzodiazepines , but the symptoms resolve quickly and there are usually no serious or long-term effects.
The use of antiseizure medications is considered safe for women who choose to breastfeed their child. On very rare occasions, the baby may become excessively drowsy or feed poorly, and these problems should be closely monitored. However, experts believe the benefits of breastfeeding outweigh the risks except in rare circumstances. One large study showed that the children who were breastfed by mothers with epilepsy on antiseizure medications performed better on learning and developmental scales than the babies who were not breastfed.
It is common for the antiseizure medication dosing to be adjusted again in the postpartum setting, especially if the dose was altered during pregnancy.
With the appropriate selection of safe antiseizure medicines during pregnancy, use of supplemental folic acid, and ideally, with pre-pregnancy planning, most women with epilepsy can have a healthy pregnancy with good outcomes for themselves and their developing child. The mission of the National Institute of Neurological Disorders and Stroke NINDS is to seek fundamental knowledge about the brain and nervous system and to use the knowledge to reduce the burden of neurological disease.
The NINDS conducts and supports research to better understand and diagnose epilepsy, develop new treatments, and ultimately, prevent epilepsy. Researchers hope to learn the epileptogenesis of these disorders — how the epilepsies develop, and how, where, and why neurons begin to display the abnormal firing patterns that cause epileptic seizures.
Researchers are learning more about the fundamental processes — known as mechanisms — that lead to epileptogenesis. With every mechanism that is discovered come new potential targets for drug therapies to interrupt the processes that lead to the development of epilepsy.
Basic science studies continue to investigate how neurotransmitters chemicals which carry signals from one nerve cell to another interact with brain cells to control nerve firing and how non-neuronal cells in the brain contribute to seizures. For example, studies are focusing on the role of gamma-aminobutyric acid GABA , a key neurotransmitter that inhibits activity in the central nervous system. Research on GABA has led to drugs that alter the amount of this neurotransmitter in the brain or change how the brain responds to it.
Researchers also are studying the role of excitatory neurotransmitters such as glutamate. In some cases, the epilepsies may result from changes in the ability of supportive brain cells called glia to regulate glutamate levels.
Researchers have found that when astrocytes — a type of glial cell that play a critical housekeeping role by removing excessive levels of glutamate — are impaired, levels of glutamate rise excessively in the spaces between brain cells, which may contribute to the onset of seizures. The blood-brain barrier plays in important protective role between the circulatory systems and the fluid surrounding the brain, as it keeps toxins in the blood from reaching the brain. However, this protective layer of cells and other components can also block potentially beneficial medications from reaching the brain.
Scientists are looking for ways to overcome this barrier for the sake of expanding therapeutic options. For example, in one study people with drug-resistant epilepsy are receiving infusions of neurotransmitter-specific agents directly into the epileptic focus. In another study, researchers are looking at a protein that is part of the blood-brain barrier, called P-glycoprotein P-gp.
Levels of P-gp are higher in people with epilepsy than in people without it. These different levels of P-gp may explain why some people have seizures that do not respond well to medications. NINDS-funded researchers want to see if manipulating P-gp levels can affect the response to epilepsy medications. The brain chemical serotonin helps neurons communicate. Previous research suggests that serotonin activity may be lower in brain areas where seizures start, and that increasing activity at the serotonin receptor site on nerve cells may help prevent seizures.
NINDS-funded researchers are studying an experimental medication aimed at increasing the activity of serotonin receptors to see if it can reduce seizure frequency in people whose seizures are not well controlled on antiseizure medication.
Research has shown that the cell membrane that surrounds each neuron plays an important role in epilepsy because it allows neurons to generate electrical impulses.
Scientists are studying details of the membrane structure, how molecules move in and out of membranes, and how the cell nourishes and repairs the membrane. A disruption in any of these processes may lead to seizures. Ongoing research is focused on developing better animal models that more closely reflect the mechanisms that cause epilepsy in humans so that they can be used to more effectively screen potential treatments for the epilepsies. The ASP annually has screened hundreds of new chemical agents from academic, industrial, and government participants using a battery of models of potential efficacy and side-effect liability.
Results are compared to those obtained with standard marketed antiepileptic drugs. The ASP has played a role in the identification and development of numerous marketed antiseizure drugs, including felbamate, topiramate, lacosamide, and retigabine. Current efforts emphasize unmet medical needs in epilepsy, such as treatments for refractory epilepsies, the development of epilepsy in previously unaffected individuals, and disease progression.
NINDS-funded researchers are looking at drug combinations that would help boost the effectiveness of medication therapy. For example, one trial is looking at the ability of an antianxiety medication to increase brain activity in specific regions, which could in turn decrease epileptic seizures. Neonatal seizures frequently lead to epilepsy as well as to significant cognitive and motor disabilities.
At the same time, safe and completely effective antiseizure medications for these newborns are lacking. Current treatment options are generally ineffective and have significant side effects. NINDS-funded investigators are working to identify better treatment options for neonates and to test them in randomized controlled trials. Researchers continue to engineer technologic advances to assist in the diagnosis of the epilepsies and to identify the source focus of the seizures in the brain.
While these arrays have not yet been used in humans, they are a promising advance toward expanded options for epilepsy diagnosis and treatment. Researchers are striving to make surgery for epilepsy safer by minimizing the language deficits that can occur afterwards. Using functional magnetic resonance imaging fMRI as well as other imaging technologies, researchers are helping to improve preoperative planning by more accurately mapping areas of the brain that are important for the ability to understand and speak language — which will help surgeons to preserve those areas during surgery.
Doctors also are experimenting with brain scans called functional magnetic resonance imaging fMRI , magnetic resonance spectroscopy MRS that can detect abnormalities in the brain's biochemical processes, and with near-infrared spectroscopy, a technique that can detect oxygen levels in brain tissue. Researchers also continue to develop minimally-invasive approaches to treat an epilepsy focus via heat thermoablation , transcranial ultrasound, or high-powered x-rays stereotactic radiosurgery.
For example, minimally invasive MRI-guided laser surgery is being studied for the treatment of the epilepsies associated with tumors such as hypothalamic hamartomas and tuberous sclerosis complex. The technique involves drilling a very small hole in the skull through which a thermal laser is inserted to ablate an epileptogenic zone under MRI-guidance.
Advances in understanding the human genome have spurred continued efforts to identify genes responsible for epileptic conditions. NINDS is a large supporter of research investigating genes responsible for epilepsies and disorders of human cognition that gain a foothold during early brain development.
Continued progress in the identification of genetic causes of the epilepsies could guide the care and medical management of individuals and, in the case of heritable mutations, will help affected families understand their risks.
The innovative program encourages collaborations, including sharing of data and resources, between researchers from a variety of disciplines and institutions regardless of geographic location, that may lead to advances in prevention, diagnosis, or treatment of the epilepsies and related comorbidities. Epi4K investigators are analyzing the genomes of at least 4, people with well-characterized epilepsies. Through this work, researchers have successfully identified mutations associated with Dravet syndrome, infantile spasms, and Lennox-Gastaut syndrome.
Most important, these discoveries will give researchers the basis for screening agents for their potential therapeutic effects. The discovery of genetic mutations that are linked to specific epilepsy syndromes suggests the possibility of using gene-directed therapies to counter the effects of these mutations. Gene therapies remain the subject of many studies in animal models of epilepsy, and the number of potential approaches continues to expand.
Cell therapy differs from gene therapy in that instead of introducing genetic material, cell therapy involves the transplantation of whole cells into a brain.
In animal studies, for example, NINDS-funded researchers have successfully controlled seizures in mice by grafting special types of neurons that produce the inhibitory neurotransmitter GABA into the hippocampus region of their brains.
NINDS, non-profit lay and professional organizations, and the Centers for Disease Control and Prevention are providing significant funding toward studies aimed at better understanding SUDEP risk factors and mechanisms, which may point the way toward developing strategies for screening and prevention. Several devices in the early stages of development aim to provide a warning when a seizure has the potential to put someone at risk for SUDEP.
The brain tissue and data is collected, evaluated, stored, and made available to researchers via a network of brain and tissue repositories in standardized way for the study of neurological, psychiatric and developmental disorders, including epilepsy. After the seizure ends, the person will probably be groggy and tired. He or she also may have a headache and be confused or embarrassed. Try to help the person find a place to rest. If necessary, offer to call a taxi, a friend, or a relative to help the person get home safely.
Box Bethesda, MD Suite San Francisco, CA info caregiver. Box Harrisburg, PA irsa irsa. Epilepsy Therapy Project P. Pendleton Street Middleburg, VA info epilepsytherapyproject. Dravet Syndrome Foundation P. Box Waddell, AZ admin hopeforhh. Due to the large number of epilepsy syndromes and treatments, only a few are discussed in this booklet. Additional information may be available from health care professionals, medical libraries, patient advocacy organizations, or by calling the NINDS Office of Communications and Public Liaison.
The person may stare into space for several seconds and may have some twitching or mild jerking of muscles. These auras are actually simple focal seizures in which the person maintains consciousness. It usually involves a cluster of short seizures with a sudden onset and termination. These seizures may cause loss of consciousness, falls, or abnormal movements such as convulsions.
During these seizures the infant may bend and cry out. Seizures can be either focal or generalized, and may cause strange sensations, hallucinations, or emotional changes. Nonepileptic events may include psychogenic seizures or symptoms of medical conditions such as sleep disorders, Tourette syndrome, or cardiac arrhythmia. Pseudoseizure is an older term for nonepileptic seizure. This protein regulates enzymes that break down other proteins. Seizure triggers do not cause epilepsy but can lead to first seizures or cause breakthrough seizures in people who otherwise experience good seizure control with their medication.
Although there is no strict definition for the time at which a seizure turns into status epilepticus, most people agree that any seizure lasting longer than 5 minutes should, for practical purposes, be treated as though it was status epilepticus. Repeated seizures without regaining consciousness between the events is also considered a form of status epilepticus. Epilepsy increases the risk of unexplained death about two-fold. NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency.
Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.
Skip to main content. Enter Search Term Submit Search. The Epilepsies and Seizures: What are the epilepsies? What causes the epilepsies? Focal Seizures Generalized Seizures What are the different kinds of epilepsy? When are seizures not epilepsy?
How can epilepsy be treated?
The Epilepsies and Seizures: Hope Through Research
Jul 31, There isn't much you can do to stop a seizure once it starts. But you can help protect someone from harm during one. Some seizures are more. Last time I posted to this forum I was in despair over the seizures my daughter was suffering. My teenage daughter started having complex partial and simple. Mar 19, "No seizures, no side effects" is the goal of epilepsy treatment. While seizure medicines are the mainstay of epilepsy treatment, there are other.