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Working With Your Doctor for the Best Epilepsy Treatment


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?

One thing to keep in mind: Osteoporosis is a weakening of the bone structure that can occur as you get older. Some anti-seizure drugs for epilepsy can increase the risk of developing osteoporosis if you take them for a long time. Because osteoporosis affects women far more than men, it is particularly important that you discuss this with your doctor when you plan your epilepsy treatment. You can then work together on ways to help protect your bone health. This would include eating a diet high in calcium, taking calcium and vitamin D supplements, getting lots of exercise, and avoiding alcohol and cigarettes.

Since all people are different, what works for one person with the same kind of seizures you have may not work for you. You may find the right medicine right away, or you and your doctor may have to try two or more to find the one that is effective for you. When you first start taking a new drug, it's a good idea to keep track of any side effects you experience and tell your doctor about them. You may not be sure whether a symptom you experience -- like depression or weight gain -- is caused by the medication. If you're not sure, it's safest to tell your doctor about it, anyway. Then you can both discuss the severity of the side effects and what to do about them.

Many people find that their epilepsy is controlled by just one medication. This is called monotherapy. Monotherapy has less risk of side effects than if you take more than one medication. It is also safer if you are planning to become pregnant. In some cases, though, one drug alone cannot control seizures. If this is true in your case, your doctor may want to try two or more drugs in combination -- polytherapy. Usually, you will start only one new medication at a time. This helps your doctor keep track of how well each one works, and whether there are any side effects.

What if medication cannot control your epilepsy? Doctors are learning more about treatment options that may help people with hard-to-control epilepsy. These include:

  • Surgery. Doctors have performed surgery for years to help patients with epilepsy. New surgical techniques have improved the outcomes. Depending on the type of seizure you have, if you have tried several medications without success, your doctor may recommend surgery.
  • Vagus nerve stimulation (VNS). A vagus nerve stimulator works a lot like a pacemaker. It is surgically implanted in the chest, and delivers short bursts of energy to the brain. Scientists have found that it reduces seizures by about 40% to 50%. It does not work in everyone. If your doctor recommends VNS, you will probably still need to take medication, but you may be able to reduce your dose.
  • Responsive neurostimulation device (RNS). This treatment option 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.

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