Treatment

Over the past decade, treatment options have increased for frontal lobe seizures. There are newer types of anti-seizure medications as well as a variety of surgical procedures that may help if medications don't work.

Medications

All anti-seizure drugs seem to work equally well at controlling frontal lobe seizures, but not everyone becomes seizure-free on medication. Your doctor may try different types of anti-seizure drugs or have you take a combination of drugs to control your seizures. Researchers are continuing to look for new and more-effective medications.

Surgery

If your seizures can't be controlled adequately with medications, your doctor may recommend surgery. In general, surgery for seizures that aren't well-controlled by medication may be quite successful. Surgery involves pinpointing the areas of the brain where seizures occur.

Two newer imaging techniques — single-photon emission computerized tomography (SPECT) and subtraction ictal SPECT coregistered to MRI (SISCOM) — are very helpful at identifying the area generating seizures.

Another imaging technique, known as brain mapping, is commonly used before epilepsy surgery. Brain mapping involves implanting electrodes directly into an area of the brain and using electrical stimulation to determine whether that area has an important function, which would rule out surgery on that area. In addition, functional MRI (fMRI) is used to map the language area of the brain.

Surgery for epilepsy may involve:

  • Removing the focal point. If your seizures always begin in one specific spot in your brain, removing that small portion of brain tissue may reduce or eliminate your seizures.
  • Isolating the focal point. If the portion of the brain that's causing seizures is too vital to remove, surgeons may make a series of cuts to help isolate that section of the brain. This prevents seizures from moving into other parts of the brain.
  • Stimulating the vagus nerve. Vagus nerve stimulation involves implanting a device — similar to a cardiac pacemaker — to stimulate your vagus nerve. This procedure usually reduces the number of seizures people experience.
  • Responding to a seizure. A responsive neurostimulator (RNS) is a newer type of implanted device. It is activated only when you begin to have a seizure, and it stops the seizure from occurring.

Alternative medicine

People with common neurological conditions, including seizures, may turn to complementary and alternative medicine for treatment, such as:

  • Herbal medicines
  • Acupuncture
  • Psychotherapy
  • Mind-body techniques
  • Homeopathy

Researchers are looking into these therapies, hoping to determine their safety and effectiveness, but good evidence is mostly still lacking. There is some evidence that a strict high-fat, low-carbohydrate (ketogenic) diet may be effective, particularly for children.

Many people with epilepsy use herbal remedies in particular. However, there is little evidence for their effectiveness and some can cause an increased risk of seizures.

Marijuana (cannabis) is one of the most commonly used herbal remedies for treating epilepsy. Current evidence does not show that cannabis is useful for treating epilepsy. However, little data are available and research into its usefulness is ongoing. It's important to let your doctor know if you are using cannabis.

The Food and Drug Administration does not regulate herbal products, and they can interact with other anti-epileptic drugs you take, putting your health at risk. Make sure to talk with your doctor before taking any herbal or dietary supplements for your seizures.

Sept. 22, 2016
References
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