Not everyone who has one seizure has another one. A seizure can be an isolated incident. Your health care provider may decide not to start treatment until you've had more than one.
The optimal goal in seizure treatment is to find the best possible therapy to stop seizures with the fewest side effects.
Medications
Many medicines are available to treat temporal lobe seizures. However, many people don't achieve seizure control with medicines alone. Side effects also are common. They can include fatigue, weight gain and dizziness.
Discuss possible side effects with your health care provider when considering treatment options. Also ask what effect your seizure medicines may have on other medicines you take. Some anti-seizure medicines can make oral contraceptives less effective, for example.
Surgical or other procedures
When anti-seizure medicines aren't effective, other treatments may be an option:
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Surgery. The goal of surgery is to stop seizures from happening. This is often done through a traditional surgery, where surgeons operate to remove the area of the brain where seizures begin. In certain people, surgeons may be able to use MRI-guided laser therapy as a less invasive way to destroy the area of damaged tissue that causes seizures.
Surgery works best for people who have seizures that always originate in the same place in their brains. Surgery generally isn't an option if your seizures come from more than one area of the brain. Surgery also may not be an option if the focus of your seizure can't be identified. This also may be true if your seizures come from a part of the brain that performs vital functions.
- Vagus nerve stimulation. A device implanted underneath the skin of your chest stimulates the vagus nerve in your neck. This sends signals to your brain that inhibit seizures. With vagus nerve stimulation, you may still need to take medicine. But you may be able to lower the dose.
- Responsive neurostimulation. During responsive neurostimulation, a device implanted on the surface of your brain or within brain tissue can detect seizure activity. The device then delivers an electrical stimulation to the area to stop the seizure.
- Deep brain stimulation. For this therapy, a surgeon implants electrodes within certain areas of the brain. The electrodes produce electrical impulses that regulate brain activity to stop seizures. The electrodes attach to a pacemaker-like device placed under the skin of your chest. This device controls the amount of stimulation produced.
- Dietary therapy. A ketogenic diet can improve seizure control. The diet is high in fat and low in carbohydrates. It can be hard to follow because the diet is restrictive. Variations on a ketogenic diet also may provide some benefit but are less effective. They include the low glycemic index and modified Atkins diets.
Pregnancy and seizures
Women who've had previous seizures typically are able to have healthy pregnancies. But it's important to know that certain medicines can lead to birth defects.
In particular, valproic acid has been associated with cognitive deficits and neural tube defects, such as spina bifida. Valproic acid is one possible medicine for generalized seizures. The American Academy of Neurology recommends that women don't use valproic acid during pregnancy because of risks to the baby.
Discuss these risks with your health care provider. In addition to the risk of birth defects, pregnancy can alter medicine levels. If you've had seizures, it's important to talk to a health care provider about your medicines before you become pregnant.
In some cases, it may be appropriate to change the dose of seizure medicine you take before or during pregnancy. Medicines also may be switched during pregnancy.
Contraception and anti-seizure medicines
It also is important to know that some anti-seizure medicines can alter the effectiveness of oral contraceptives, which are forms of birth control. And some oral contraceptives can speed up the absorption of seizure medicines. Check with your health care provider to evaluate whether your medicine interacts with your oral contraceptive. Ask if other forms of contraception need to be considered.