REFRACTORY EPILEPSY

Refractory Epilepsy is a type of epilepsy that is resistant to treatment. Seizures are a symptom of epilepsy. The nerve cells do not communicate normally during a seizure. The brain’s normal electrical activity is disrupted. These convulsions might last anywhere from a few seconds to several minutes. About a third of those with epilepsy will develop refractory epilepsy at some point. This means that drugs don’t manage seizures very well, if at all.

Refractory epilepsy is also referred to as:

• Epilepsy that is resistant to medication

• Epilepsy that is uncontrollable

• Epilepsy that is resistant to medication

What is the prevalence of refractory epilepsy?

Epilepsy is a frequent condition. It affects and over 70 million individuals globally. About 30 to 40 percent of these people have refractory epilepsy, according to Trusted Source.

Refractory epilepsy is a type of epilepsy that is resistant to treatment. Epilepsy that is refractory can have a significant impact on your life. Refractory epilepsy might cause problems at work or in education. They could be concerned about if their next seizure would occur. They could possibly sustain injuries as a result of the convulsions. If your doctor suspects that have refractory epilepsy, they or she may refer you to an epilepsy-focused medical center. Refractory epilepsy affects certain persons who have epilepsy or will develop it in the future. This means that drugs don’t manage seizures very well, if at all.

The sort of seizures you have may alter your therapy if you have refractory epilepsy.

  1. Primary (generalized) seizures are the most common type of seizure. This implies that both sides of your brain are involved.
  2. Seizures that are partial (focal). This indicates that seizure activity begins in a smaller area of the brain. It has the potential to spread to a larger area in the future.

Epilepsy that is refractory can have a significant impact on your life. This sort of epilepsy might cause problems at work and school. They could be concerned about if their next seizure would occur. They could possibly sustain injuries as a result of the convulsions. If your doctor suspects you suffer refractory epilepsy, he or she may refer you to a medical center that specializes in epilepsy.

Which causes refractory epilepsy in the first place?

Seizures can be caused by a variety of things, including head injuries, infections, coughs, or brain tumors. However, the etiology of seizures in epilepsy is frequently unknown.

Similarly, it is unclear why antiepilepsy medications do not assist some persons with epilepsy. Or why these treatments don’t always work. During a seizure, the electric response in the brain may become so high that drugs aren’t any longer able to regulate it. However, it is unknown why this occurs.

Symptoms:

Seizures, despite anti-seizure medication, are an indication of refractory epilepsy. Seizures can take a variety of forms and last anywhere from just a few seconds to many minutes.

You could be having convulsions, which means your body is trembling uncontrollably.

If you’re having a seizure, you might also:

  • Turn off the lights
  • You can’t control your bowels or bladder
  • Close your eyes and stare into space
  • Suddenly fall down
  • Muscles get rigid
  • Try biting your tongue

Treatment for refractory epilepsy:

The purpose of refractory epilepsy treatment, like epilepsy treatment in general, is to control seizures. There are several treatment options available, including.

Changing antiepilepsy drugs:

Your doctor may advise you to use a different Antidepressant alone or in combination with another medication. AEDs include the following:

  • Gabapentin
  • Lamotrigine
  • Zonisamide
  • Levetiracetam
  • Oxcarbazepine
  • Topiramate
  • Lacosamide

However, if you’ve already tried two AEDs and they didn’t work, it’s unlikely that another one will. This could be simply because of the way AEDs interact with your brain or body. Other treatments will have to be tried in this scenario.

The most important aspects of refractory epilepsy:

  • If your antiepilepsy medications are no longer suppressing your seizures, you have refractory epilepsy. The reason for refractory epilepsy is frequently unknown.
  • Other medications will most likely be prescribed by your healthcare professional in an attempt to control your seizures.
  • Other alternatives include an operation to remove the region of the brain in which the seizures begin or electrotherapy of a neuron leading to a brain if it does not work.

Steps to take next

Tips for getting the most out of a visit with your health professional: • Know why you’re there and what your want to get out of it.

  • Make a list of questions you’d like answered before your visit.
  • Bring someone with you to help you ask questions and remember what your doctor says.
  • Write down a list of a new diagnosis, as well as any new treatments, treatments, or tests, during the appointment. Make a note of any clear orders you receive from your provider.
  • Understand why a new medication or treatment has been prescribed for you and how this will benefit you. Also, be mindful of any potential negative consequences.
  • Find out if there are any other options for treating your problem.
  • Understand why testing or procedure is advised, as well as what the results may imply.
  • Understand what will happen if you ever do cannot take the meds or undergo the test or operation.
  • Make a note of the date, hour, and purpose of any follow-up appointments you have.
  • Know how to contact your healthcare practitioner if you have any questions.

Other Treatments

Other therapies for patients with relapsed epilepsy include vagus nerve stimulation (VNS) and the ketogenic diet. VNS is a nonpharmacologic technology that can be used as a supplementary therapy for individuals who have refractory partial seizures and are not candidates for or reluctant to undergo epilepsy surgery. This device’s pulse generator is attached to the left vagus nerve and is implanted subcutaneous injection in the left infraclavicular area. Seizure frequency is reduced by 50% in 37% of individuals in the first year of treatment, according to studies; however, seizure independence is uncommon.

The Ketogenic Diet is a high-fat, low-carbohydrate ketogenic diet, a reduced meal that has been demonstrated to help people with intractable epilepsy. Even though the method of ketone body production’s antiepileptic effect is unknown, fresh research suggests that it may reduce neuron hyperexcitability and enhance seizure control. 20 Before attempting this diet, potential problems such as metabolic alkalosis, hypoglycemia, exhaustion, and hyperlipidemia should be explored.

Prevention

Always follow your doctor’s instructions when using medications. Using your antiepilepsy medications correctly will help them operate more effectively to regulate your condition.

Taking care of refractory epilepsy

A ketogenic diet, often known as a low-carbohydrate diet, may help you control your seizures. This diet is characterized by a high-fat content and a low carbohydrate content. If you stick to this diet, you’ll need to work very closely with the doctor and take nutritional supplements as needed.

Epilepsy that won’t go away

Epilepsy syndromes that can be surgically treated have known pathophysiology and a dependable natural history that includes lack of responsiveness to chemotherapy and gradual features like developmental disability in infants and children or interictal behavioral disorders, the most common of which is depression.

Patients with surgically treatable epilepsy syndromes are the most expensive, surgical candidates because presurgical evaluation can be done noninvasively in most cases; there is a 70-90 percent chance of completely eliminating disabling seizures, as well as disabling social and psychological consequences could be avoided or reversed, but only if surgery is done early. The paradigm of a surgically treatable epilepsy syndrome is mesial right temporal epilepsy (MTLE). Other surgically treatable epilepsy syndromes involve focal epilepsies caused by discrete resectable functional lesions, epilepsies caused by diffuse hemispheric disturbances like hemimegencephaly, Rasmussen’s encephalitis, Severe form of the disease syndrome, and large porencephalic cysts, as well as gelastic seizures caused by hypothalamic hamartomas because seizures derived within this alien tissue.

MTLE is the most frequent type of epilepsy in teens and adults, as well as the most therapeutically resistant and surgically treatable. Although hippocampal sclerosis is the most common cause of MTLE, additional lesions inside the hippocampus or in neocortical locations that selectively project into mesial temporal regions can cause the same type of limbic seizures. MTLE with hippocampus sclerosis has characteristics that should warrant an early referral to epilepsy surgery.

How Can I Tell If I’m Getting The Wrong Treatment?

The reason for refractory epilepsy in certain people may be linked to the adoption of improper therapeutic strategies to treat accurately identified seizures.

The following are some of the most common causes of inappropriate or inefficient seizure treatment:

  • Taking the incorrect drug. Different kinds of seizures start in distinct areas of the brain and cause different symptoms. Some drugs that are used to treat one type of seizure may not be successful in treating another, affecting seizure control.
  • Medication doses that are incorrect or insufficient. Many individual circumstances influence how a person reacts to the medicine, and what one person considers to be too high a dosage may be deemed too low by another. Overdoing a drug can aggravate negative effects while underdoing it can result in uncontrollable seizures.
  • Toxicology and polypharmacy Communication between different medications can reduce the efficacy of certain medications, increase adverse effects, and alter seizure control in some patients who require numerous medications to manage their epilepsy.
  • Medication doses that have been missed. Although it might be difficult for some persons to keep track of their prescriptions, skipping doses or refusing to fully comply with therapy can result in breakthrough seizures and disrupt seizure control.
  • Personal behaviors and aggravating factors In many people, predisposing variables such as illness, lack of sleep, drug and alcohol use, excessive stress, and menstruation can have a substantial impact on seizure control.’ Patients with refractory epilepsy may require extra diagnostic testing to ascertain the sort of seizure they are experiencing. These techniques can aid in the diagnosis of refractory epilepsy and the location of seizures in the brain.
  • Video electroencephalogram (EEG) tracking, and simultaneous video & EEG recordings of a patient’s brain activity and body actions during a seizure are common examples. This entails a stay in an epileptic monitoring network, which is an inpatient component specifically intended for individuals with seizures that assists doctors in characterizing seizures, determining the source of the seizures, and guiding effective therapy.
  • Magnetic resonance (MRI), functional Magnetic resonance imaging, positron emission tomography (PET), and ictal single-photon emissions computerized tomography are examples of advanced imaging (SPECT).

Is it possible to prevent refractory epilepsy?

It’s conceivable that you won’t be capable of preventing all of the seizures. However, it is critical to follow your healthcare provider’s instructions when taking medications. It’s possible that if you use your drugs correctly, they’ll function better to regulate your illness.

It’s difficult to live with refractory epilepsy. People who suffer from this condition may be concerned about if their next seizures will occur. They may experience difficulties at a job or in school. It’s possible that they won’t be able to drive any longer. They could possibly sustain injuries as a result of the convulsions. It’s critical to do everything you can to reduce your risk of harm.

Some people may benefit from a ketogenic diet, which is a type of low-carbohydrate diet. This diet is characterized by a high-fat content and a low carbohydrate content. If you stick to this diet, you’ll need to work very closely with your doctor and supplement with specific nutrients as needed.

When do I need to contact my healthcare provider?

Make sure to discuss when you should call with your healthcare providers. They’ll probably tell you to contact if you:

  • You’re still having seizures
  • The intensity or frequency of your seizures increases
  • Either during your seizures, you develop new symptoms
  • Seizures that are getting worse
  • Seizures occur more frequently
  • Seizures that are longer than typical
  • A long period of unconsciousness
  • Having trouble waking up after just a seizure

Make a 911 call:

If you find yourself in any of the following situations, dial 911.

  • Having trouble breathing or waking up after a seizure
  • Seizures lasting longer than 5 minutes
  • You’ve had two seizures in a row

Is it bad to have refractory epilepsy?

The dangers of ongoing seizures may exceed the risks of therapies, even those with potentially catastrophic side effects, for patients with relapsed epilepsy.

A respected health writing specialist recognized all over the globe, together with Aneeza, created by medshelper.com