Can epilepsy be cured?
Yes, in some cases epilepsy can be cured. According to the standards of The International League Against Epilepsy, a patient can be considered cured when they have been seizure-free for ten years, and at least five years without taking antiepileptic medication. There are cases when this happens with some types of epilepsy that disappear with age, and it can also happen as a result of a procedure such as surgery.
What is epilepsy?
Epilepsy is a brain disease characterized by a predisposition to recurrent seizures.
Epileptic seizures occur as the result of episodes of excessive electrical activity in the brain. There are different kinds of epileptic seizures, and they can vary in duration and intensity. In some seizures, the patient may lose consciousness and suffer uncontrollable muscle spasms, while other seizures may be limited to alterations in consciousness and/or behavior, as well as strange sensations.
Generalized epilepsy
A patient is said to have generalized epilepsy when the epileptic discharges begin in both sides of the brain simultaneously, in a diffuse way, not at a specific focal point. Someone with generalized epilepsy can have absence seizures, myoclonic seizures, or generalized tonic-clonic seizures.
Tonic-clonic seizures are characterized by loss of consciousness and muscle rigidity followed by rhythmic movements and spasms throughout the body. During this kind of seizure, the person may bite their tongue, lose control of their sphincters, and have difficulty breathing.
Absence seizures, on the other hand, are characterized by a brief alteration in consciousness that lasts for a few seconds. The person may appear to be “absent,” or have a blank expression, and not respond normally to their environment. Other signs of an absence seizure are rapid blinking and repetitive movements of the lips or hands.
Childhood absence epilepsy is a syndrome that usually disappears spontaneously by the time the child reaches adolescence. Juvenile absence epilepsy, however, usually persists into adulthood and may be accompanied by generalized tonic-clonic seizures.
Juvenile myoclonic epilepsy combines both myoclonic and generalized seizures, and usually responds well to medication, although treatment is usually needed for long periods of time.
Focal epilepsy
Focal seizures differ from generalized seizures because they begin in a specific part of the brain.
The symptoms vary depending on the region of the brain that is affected. Among the usual symptoms are involuntary movements, or abnormal sensations (such as tingling or a feeling of electricity) in a part of the body.
During a focal seizure the patient may also find their vision disturbed, or feel a change in mood, or even intense feelings of fear.
Treatment for epilepsy
Several factors must be considered to determine the best treatment, including the type of epilepsy, the frequency and severity of crises and the needs of the individual patient. The treatment must be adapted to the particularities of each case.
Antiepileptic drugs (AEDs) are the first line of treatment for epilepsy, and seizure medicines successfully control seizures for about 70% of people with epilepsy.
Epilepsy medication
Antiepileptic drugs are the most common treatment for controlling seizures. There are currently many drugs available and epilepsy medications today are much safer than they were in the past.
However, up to a third of the people who have epilepsy continue to suffer from seizures despite medication. This is referred to as refractory or drug-resistant epilepsy. In these cases, there are other treatments to consider.
Surgery
When a patient’s seizures cannot be controlled with medication, epilepsy surgery may be an option if there is a specific area of the brain that can be identified as responsible for the seizures, and that area can be surgically removed or disconnected without neurological damage to the patient.
Studies show that up to 60% of the patients who have this surgery become seizure free.
Vagus Nerve Stimulation
Vagus nerve stimulation (VNS) involves surgery to implant a device that electrically stimulates the vagus nerve.
This nerve has connections with many parts of the brain, and when it receives intermittent stimulation, it reduces the excessive brain activity that causes seizures.
Stimulation of the anterior nucleus of the thalamus
This treatment involves implanting electrodes to stimulate the anterior nucleus of the thalamus, a region deep in the brain. It has proven to be an effective option for treating patients with drug-resistant epilepsy and for whom epilepsy surgery is not possible, especially in epilepsy of the frontal or temporal lobe.
Ketogenic diet
A high-fat, low-carb diet can help reduce seizures in some patients with epilepsy. This treatment is used mainly for some severe childhood epilepsies.
Latest advances in epilepsy treatment
Epilepsy surgery is still underutilized, as we mentioned in this earlier post: International Epilepsy Day.
In Spain, it is estimated that there are about 24,000 people with drug-resistant epilepsy who could benefit from surgical treatment.
It’s important to know that advances in minimally invasive neurosurgery techniques (such as laser surgery) have greatly increased the safety and effectiveness of the most common surgeries. And neurostimulation techniques have also advanced, meaning that these techniques could also benefit more patients.
Instituto Clavel, specialists in epilepsy treatment
We hope that this post about epilepsy has helped you understand this brain disease better.
Although it is true that some people with epilepsy will need to take medication throughout their lives, these medications include new drugs that are safer and more effective. And it’s also good to know that there are cases in which epilepsy is cured and there is no need to continue the medication.
In the case of drug-resistant epilepsies, there are more and more surgical and neurostimulation alternatives, which are minimally invasive and highly successful.
At Instituto Clavel, we have a team of neurologists and neurosurgeons who are specialists in epilepsy.
If you have any other questions about this disease, or would like to have a consultation regarding your particular case, we encourage you to make an appointment with one of our expert doctors.
We also invite you to read our post on some of the Frequently Asked Questions About Epilepsy.
Dr. Mar Carreño
NEUROLOGIST
SPECIALIST IN PEDIATRIC AND ADULT EPILEPSY.
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