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intractable epilepsy

Frequently Asked Questions Can Epilepsy Be Healed?

What is the probability that epilepsy will heal?

For people suffering from epilepsy, “Is epilepsy cured?” And “What is the probability of being cured?” Is of the utmost concern. Epilepsy can be divided into various categories according to the type of abnormal electrical discharge that occurs from a part of the brain, the type that occurs entirely, the age, the type of seizure, and the state of brain waves. Depending on the classification, it is divided into “complete cure” and “cure by suppressing seizures”. According to the epilepsy clinical practice guidelines, epidemiologically, about 10% of people have epilepsy that is completely cured with age. Also, according to Lattanzi and others, 70% of people are said to be able to control seizures by treatment. However, the fact is that the probability depends on the type of epilepsy.

Will epilepsy be completely cured?

You may have heard that epilepsy heals completely with age. The epilepsy is called idiopathic focal epilepsy. This is further classified into two types: benign pediatric epilepsy (also known as Roland epilepsy), in which sharp waveforms (spike waves) are often detected in the center and temporal region of the brain when brain waves are taken, and mainly from the back of the head. It is divided into Panayiotopoulos type that emits abnormal discharge. These epilepsies are more likely to develop in children and are said to heal completely with age. Since it is rare for other epilepsy to disappear with age, the policy is to control seizures with drugs.

Can epilepsy be cured by surgery?

Basically, the seizures are suppressed by drugs, but if the location of the brain that is the cause of the epilepsy attack can be identified and that part is excised, surgery is performed when there are no sequelae or the sequelae are within the allowable range. Is selected. Although it depends on the surgical part of the brain, according to overseas research, it seems that about 20% to 50% of people have had seizures subsided by surgery. Even in Japan, the recurrence rate of seizures after surgery is several percent per year, and even after 10 years, half of them continue to have no seizures. However, brain surgery is risky, so if you want to consider the possibility of surgery, you should consult with your instructor.

Will epileptic seizures heal?

If you are trying to control an epileptic seizure, start with a small dose of one drug (the first drug chosen depends on the type of seizure). After that, increase the dose little by little while observing side effects, and if the seizures still do not subside, start the next candidate drug from a small amount again. If one drug does not fit, you may use more than one drug, but about 70% of people can control their seizures by taking the antiepileptic drug correctly. However, there are some epileptic seizures for which the drug does not work, and even if the seizure has subsided, it may recur. In such cases, the current situation in Japan is to consider surgery or repeat trial and error with drug treatment.

Will Epilepsy Cure Memory Disorders?

If you are suffering from an epileptic seizure, you may be worried about memory problems. In fact, since epilepsy is a disease related to the brain, it may not be possible to elicit memory well due to epilepsy attacks, stress, distraction, information processing delay, reaction delay, etc. The actual treatment is

  • Reduce seizures with antiepileptic drugs
  • Relieve mental instability and anxiety with antidepressants
  • Improve sleep quality

However, even people who do not have epilepsy can have a condition in which they cannot remember or pull out well. Therefore, I think it’s a good idea to consult with your teacher or medical staff first without feeling a big shrinkage. If you don’t get the understanding of the people around you, it can become stressful and worse, so you need the understanding of the people around you. In addition, you may be able to cure your memory disorder by your own actions, such as taking notes on important things.

Differences in the characteristics of epilepsy treatment by age

Treatment of epilepsy in adults

The probability of having another seizure within 5 years after the first seizure is about 35%, and the probability of having another seizure within 1 year after the second seizure is 73%. Therefore, the standard for starting epilepsy treatment in adults is usually after two seizures. In the case of females, I think that is a concern because of the age at which they can give birth. However, many epilepsy is not inherited, and many people give birth to healthy children without any problems even if they take antiepileptic drugs. Of course, the effect on the foetation varies depending on the drug and dose, but basically the risk can be reduced by treating with one drug with less teratogenicity and minimizing the dose. In addition, you may use oral contraceptives, but some epilepsy drugs reduce the effect of contraception, so be sure to tell your doctor or pharmacist about the contraceptives. With regard to driving, if the epileptic seizure is calm and the doctor diagnoses it as possible, you may be allowed to drive (see the Road Traffic Act and the Car Driving Injury Penalty Act for details).

Treatment of epilepsy in adolescence

Adolescent epilepsy is categorized as childhood epilepsy (around 1 month to 18 years of age) according to the treatment policy. If you have epilepsy symptoms during adolescence, you may feel anxious about your school life and relationships with your friends. The anxiety may be even greater, especially if the seizure is accompanied by unconsciousness or convulsions. In addition, I think that memory problems may be a concern in terms of study. However, treatments and recommended drugs for any type of seizure have been established and it is possible to control the seizure.

Since memory impairment often depends on psychological conditions and stress, it may be possible to prevent deterioration by understanding from surrounding adults and supporting the family.

Epilepsy treatment for children

If you develop epilepsy as a child or child, your family may be very worried. Some types of epilepsy are said to have a high incidence in children, so you may suspect epilepsy when you have seizures. However, in the case of children, there are many non-epileptic symptoms such as febrile seizures, so caution is required. Treatment is well established, even for children. There is also childhood epilepsy, which is said to be an intractable disease, but it is said to be about 10% of the total, and the frequency is low. Even if it is an intractable disease, new therapeutic agents are attracting attention overseas, and it can be said that seizures may be sufficiently controlled.

Epilepsy treatment for the elderly

In the elderly, 60% to 90% of patients have a recurrence after the first seizure, so treatment is often started from the first time. In this respect, the chances of developing epilepsy are higher than in adults. In addition, many elderly people have other diseases besides epileptic seizures, and I think they may be worried about treatment methods. However, treatment methods have been established, such as the recommended drugs vary depending on whether or not there are other diseases. In addition, for those with decreased kidney function, drugs that are metabolized by the liver may be used, and conversely, for those with decreased liver function, drugs that are metabolized by the kidney may be used. It can also be treated so as not to put a heavy burden on the liver.

Reference website

Simona Lattanzi, Francesco Brigo, Eugen Trinka, Gaetano Zaccara, Claudia Cagnetti, 

Cinzia Del Giovane et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis

Téllez-Zenteno F José, Dhar Raj, Wiebe Samuel. 

Long-term Seizure Outcomes Following Epilepsy Surgery: A Systematic Review and Meta-Analysis

 

Epilepsy Foundation “Diagnosing And Treating Memory Problems”

Epilepsy practice guidelines

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