Epilepsy: Frequently Asked Questions
6. What are the side effects of epilepsy medications?
As is true of all drugs, the medications used to treat epilepsy have side effects. The occurrence of side effects depends on the dose, type of medication, and length of treatment. The side effects worsen with higher doses but tend to be less severe with time as the body adjusts to the medication. Anti-epileptic drugs are usually started at lower doses and increased gradually to make this adjustment easier.
Side effects of epilepsy drugs can include blurry or double vision, fatigue, sleepiness, unsteadiness, stomach upset, skin rashes, low blood cell counts, liver problems, swelling of the gums, hair loss, weight gain, and tremor.
7. What precautions should pregnant women take?
Women who have seizures can have healthy children, provided they receive good prenatal care. It is very important that women who have epilepsy discuss pregnancy with their doctors before getting pregnant.
Many seizure medications can prevent birth control pills from working effectively, which may lead to unplanned pregnancy. If pregnancy occurs unexpectedly, women should not discontinue their seizure medication without first consulting with their doctors. Abruptly discontinuing seizure medication commonly leads to more frequent seizures, which can harm the baby.
8. What is epilepsy surgery?
Epilepsy surgery involves the surgical removal of the region of the brain responsible for the abnormal electrical signals that cause seizures. This region of brain is called the epileptogenic zone. It is determined by neuroimaging studies, electrical recordings from the scalp (EEG), and clinical signs during a seizure. Epilepsy surgery can provide a "cure" for epilepsy, in that it can eliminate the source of seizures and epilepsy.
Surgery can also be done to implant devices to treat epilepsy. In vagus nerve stimulation (VNS), a device that electronically stimulates the vagus nerve (which controls activity between the brain and major internal organs) is implanted under the skin. This reduces seizure activity in some patients with partial seizures. There’s also the responsive neurostimulation device (RNS), which consists of a small neurostimulator implanted within the skull under the scalp. The neurostimulator is connected to one or two wires (called electrodes) that are placed where the seizures are suspected to originate within the brain or on the surface of the brain. The device detects abnormal electrical activity in the area and delivers electrical stimulation to normalize brain activity before seizure symptoms begin.