Dr. Soaham Desai

The primary aim of the treatment in patients suffering from seizure is leasing a seizure-free life without giving way to any adverse effects. This goal can be accomplished in over 60 percent people with the help of anticonvulsants. Some patients also experience adverse effects since they suffer from a seizure which is refractory to medical therapy. Here are some of the common treatment options for seizures:

1. Monotherapy: Sometimes, monotherapy is given as it reduces the chance of all sorts of adverse effects and even avoids drug interactions. Moreover, this type of treatment approach is much less expensive than polytherapy since many older generation of the anticonvulsant agent comprises of hepatic enzyme which is responsible for reducing the serum level of the concomitant drug which leads to an increase in the dosage level of such medicines.
2. Social And vocational rehabilitation: People suffering from problems in psychosocial adjustments after the diagnosis may also need social and vocational rehabilitation. Many physicians do not pay enough attention to the consequences that an epilepsy diagnosis may leave on the patient. For instance, people with epilepsy may have a fear of experiencing next attack of seizure and they may be unable to work at heights or drive.
3. Consulting an expert: It is important to refer patients with intractable spells to epileptologist or neurologist for subsequent workup. A neurosurgical consultation may also be needed when the patient has to be treated surgically.

Importance of anticonvulsant therapy
Patients who have had already suffered from recurrent attacks of unprovoked seizure may need treatment with an anticonvulsant. This treatment is not recommended until the person has risk factors for suffering from the problem yet again. The primary means of treating seizure is anticonvulsant therapy where the most suitable drug is chosen based on accurate diagnosis of the syndrome as a response to specific anticonvulsants may vary from one patient to another. The difference in response may reflect the various pathophysiologic mechanisms in different types of seizures.

Types of anticonvulsant therapy
Some of the anticonvulsant therapy medication may have multiple action mechanism while some have an only single mechanism of action. Some of the most common variants of the therapy include:

1. Neuronal potassium channel referred to as KCNQ opener
2. Blockers of unique binding sites such as perampanel, gabapentin, and levetiracetam
3. H-current modulators such as lamotrigine and gabapentin
4. Carbonic anhydrase inhibitors such as zonisamide and topiramate
5. Alpha-amino 3-hydroxy 5-methyl 4-isoxazole propionic acid receptor blockers like topiramate and perampanel.
6. N and L-calcium channel blockers like zonisamide, valproate, topiramate, and lamotrigine

Even though there are so many types of drugs available, all of them cannot be used for the treatment of seizures. Doctors would evaluate the condition thoroughly before prescribing a medication that can be helpful in reducing the severity of the condition. In case you have a concern or query you can always consult an expert & get answers to your questions!