“Epilepsy is not a rare disorder, 1 in 26 people will develop epilepsy during their lifetime. It can occur on its own or alongside other health conditions of the brain, such as:

• Cerebral palsy
• Intellectual disability
• Autism
• Alzheimer’s disease
• Traumatic brain injury
• Stroke

There are rare epilepsies that affect a small number of people. Seizures may be difficult to control and there is a higher chance of other health conditions occurring.”

Epilepsy Foundation (Facts About Seizures and Epilepsy | Epilepsy Foundation)

Epilepsy is a medical disorder in which seizures can occur anytime, anywhere. An epileptic seizure is an excessive, uncontrolled burst of electrical activity from nerve cells in the brain –  essentially an electrical storm. There are many types of seizures that cause symptoms ranging from lightning-fast muscle jerks lasting less than a second to full body convulsions lasting two or three minutes.

Epilepsy, if not well-controlled, can greatly worsen a person’s quality of life and can cause severe injury or death. And every person with epilepsy responds in a unique and often unpredictable way to treatment, so we need as many treatments as possible.

The medical community continually tests and approves new treatments. Here are 10 treatments, both basic and advanced, that I’ve tried to rank from least to most envasive. However, almost all treatments involve some degree of risk. Discuss your options carefully with your neurologist to pick the best treatment for you as you should for any condition.

Request an appointment to discuss your epilepsy treatment options.

1. Lifestyle changes and complementary or alternative treatments

This topic is too often neglected but can have a major, positive impact on seizure control. Though there is little evidence for the effectiveness of most complementary and alternative medications, healthy lifestyle changes can go a long way toward reducing the risk of having a seizure.

Your neurologist should address these questions with you before developing a treatment plan:

● How is your sleep quality?

● Do you have chronic anxiety, depression, or excessive stress?

● Do you take other medications that may affect your epilepsy medication or directly increase the risk you will have a seizure?

● Does your use of alcohol, caffeine, or herbal remedies affect your seizure control?

The complementary and alternative therapies below can be added to your treatment plan. Because there is not a lot of medical research on their effectiveness for epilepsy, it’s important to discuss each treatment with your neurologist:

● Acupuncture

● Aerobic exercise

● Biofeedback (training to voluntarily control seizures)

● Meditation

● Yoga

I don’t hesitate to recommend aerobic exercise and meditation for all my patients — both usually are win-win treatments! It’s rare that doctors would recommend only lifestyle changes or complementary/alternative treatments for epilepsy; however, these might work sometimes.

I recently had a patient who, after experiencing a single seizure, was diagnosed with a genetic form of epilepsy. She was a student whose seizure occurred after several nights of staying up late studying and

drinking alcohol excessively. It was clear that her risk of having a seizure was higher than normal. However, it was possible that in the setting of a healthier lifestyle this might not occur. After discussing options, she and her parents decided to delay taking medication and first try to make lifestyle changes, including getting more sleep and minimizing or avoiding alcohol.

There is not much evidence that herbal remedies help with epilepsy. But medical marijuana, which is number four on this list, proves that plants have chemicals that can stop epileptic seizures (see below). At this time, we know of no other natural herb that helps with seizures. In fact, some herbs, such as the Chinese herb ma huang, can trigger or worsen seizures. Ma huang is a natural ephedra, which is similar to a stimulant hormone in our bodies. Stimulants tend to worsen seizures, so doctors are hesitant to recommend any herbal remedies at this time.

2. Diet

For many years, a special diet has been used to control certain types of epilepsy. One in particular – the ketogenic diet – gained public attention with the 1997 movie “First Do No Harm.” In this film, which is based on a true story, Meryl Streep plays the mother of a son whose epilepsy fails to respond to conventional treatments, including epilepsy surgery. She takes him to Johns Hopkins Medical Center, which pioneered the use of the ketogenic diet and demonstrated its effectiveness. Her son responded wonderfully to the diet and became seizure-free.

The ketogenic diet is strict. It severely limits carbohydrates and maximizes fats and proteins. This low-carbohydrate diet triggers ketosis, an alternate metabolic pathway in the body that somehow works against seizures. Variations in the amount of fats and proteins relative to the amount of carbohydrates are allowed. One such variation is the Modified Atkins Diet.

The ketogenic diet is challenging and is used mostly for children. A few studies have shown its effectiveness in adults, but, as one might expect, it’s difficult for most adults to maintain such a strict diet. Choosing this type of therapy requires support from experienced nurses, dietitians, and physicians who can help guide food and drink choices.

Although it may seem like the ketogenic diet has been recently created, it’s not a newly discovered way of eating. In fact, the ketogenic diet was first put into practice in the 1920s as a treatment for people with epilepsy after research demonstrated that fasting reduced seizure activity.

What exactly is the ketogenic diet? The ketogenic diet is an eating pattern that includes high amounts of fat, low to moderate amounts of protein, and very little carbohydrates. The keto diet is typically rich in foods like butter, cheese, eggs, meat, nuts, oils, seafood, and seeds. It does not allow much, if any, room for fruits, vegetables, grains, potatoes, sweets, or other carbohydrate-rich foods.

Although there are variations to the ketogenic diet, they all share a primary objective of restricting carbohydrate intake. A typical ketogenic eating plan aims for about five percent of calories from carbohydrates, 20 percent from protein, and 75 percent from dietary fats. On a 2,000-calorie-per-day ketogenic diet, this equates to about 100 calories (25 grams) of carbohydrates, 400 calories (100 grams) of protein, and 1,500 calories (167 grams) of dietary fat.

4. Medical marijuana

Medical marijuana is a term that now refers to one of more than 80 chemical compounds found in the cannabis plant – cannabidiol oil or CBD oil. This treatment came to national attention in 2013 with the story of Charlotte, a child living with Dravet syndrome in Colorado. Dravet syndrome is a severe form of genetic epilepsy, and Charlotte was having many seizures every day. CBD oil helped effectively manage Charlotte’s seizures, which has led to formal clinical studies that have proved its effectiveness.

CBD oil lacks the compound tetrahydrocannabinol (THC), so it does not appear to cause any significant mood-altering effects (“getting high”), at least compared to smoking the marijuana leaves. As of May 2018, there have been two major, scientifically rigorous clinical studies that have shown that Epidiolex, a form of CBD oil pending FDA approval, is relatively safe and effective in Dravet Syndrome and the Lennox-Gastaut Syndrome. It has been approved by the scientific advisory committee of the FDA, but final approval is pending. At this time, CBD oil is expensive. We need more research to assess its efficacy for other types of epilepsy and its possible long-term effects.

5. Medication trials

At any time, a patient may be invited to participate in a trial of an experimental medication. Since about 1993, this is how all medications have received FDA approval. Often, patients are invited to join a trial after they have failed a number of other FDA-approved medications.

The advantages of participating in a clinical trial include:

● Access to new medication

● Close support and follow-up with the epilepsy team

● The opportunity to help medical researchers develop new treatments

The goal of medication clinical trials is to make sure the drugs are safe and effective. Clinical trials are experimental studies, so there is some risk involved with participating. However, clinical research teams follow extremely strict federal, state, and hospital guidelines to ensure that the risks are minimized.

6. Extracranial neurostimulators

Neurostimulators deliver electrical stimulation to the brain. Some stimulate nerves that are not in the brain, which then transfer the electrical stimulation to the brain; we refer to these as extracranial stimulators.

The first and most common stimulation of this type is the vagus nerve stimulation (VNS), in which an electrode is wrapped around the vagus nerve on the left side of the neck and a computer battery is implanted under the skin below the collar bone. We start with the stimulator set to deliver a 30-second electrical impulse every five minutes. Each patient has a magnet that activates the device immediately and at a higher intensity if a seizure occurs. Newer versions of the VNS also can trigger a stimulus when the patient’s heartbeat goes too fast, which often happens with an epileptic seizure.

Another type of neurostimulation currently being investigated is external trigeminal nerve stimulation. This therapy stimulates a nerve on the face and does not require surgery.

7. Immunotherapy

Occasionally, epilepsy is caused by the patient’s immune system attacking the brain. Autoimmune epilepsy is a relatively recently recognized cause of epilepsy that cannot be controlled with anti-seizure medications alone.

Typically, the patient produces antibodies that attack parts of the brain, and these antibodies can be identified with a blood test. Some patients have autoimmune epilepsy, but no antibody can be identified at this time.

Treatment options include:

● High-dose steroids

● Administering a collection of human antibodies through the veins

● Plasma exchange to filter the blood of disease-causing antibodies

● Other medications that suppress the overly active immune system

8. Responsive neurostimulation (RNS®)

If epileptic seizures are coming from one specific region of the brain, and they cannot be stopped with medications or other therapies we have discussed, the patient can be a candidate for intracranial neurostimulation.

This first requires identifying exactly where the seizures are coming from – the seizure focus. Sometimes this can be done by recording the patient’s seizures with electrodes on the scalp using video-EEG. Often, however, we need to use intracranial electrodes to confidently determine the location of the seizure focus.

If the patient does not want surgery, if there is more than one seizure focus, or if it would be too risky to remove the seizure focus, the patient can choose intracranial automatic neurostimulation, a system developed by NeuroPace Inc.

The neurosurgeon inserts electrodes within one or more brain regions where seizures start. The electrodes detect the onset of a seizure and trigger an immediate electrical impulse in the seizure focus, which we hope will stop the seizure. It’s like fighting fire with fire. This is similar to automatic heart defibrillators for patients with potentially fatal heart arrhythmias. The main risks are scalp infections and bleeding when the electrodes are inserted.

9. Deep brain stimulation (DBS)

DBS is similar to RNS®, but the electrodes are implanted in a deep brain region called the thalamus. It has been shown effective for focal seizures, which start consistently in one specific area of the brain. Unlike RNS, it stimulates on a regular basis rather than triggering only when a seizure starts. The stimulation is directly within the brain. Also unlike RNS, it is not necessary to localize where the seizure starts. As of May 2018, the FDA has approved DBS for patients with focal epilepsy. 

10. Brain surgery

Brain surgery to remove the seizure focus is the most effective method to completely stop seizures. First, we must find the seizure focus and make sure it can be safely removed. This always involves a stay in the epilepsy monitoring unit to record seizures with simultaneous video and EEG.

Sometimes the seizure focus cannot be determined with electrodes on the scalp, and we need to put electrodes directly within the brain. This is called intracranial EEG. The most common location in the brain for epilepsy surgery is the temporal lobe. About 60 percent to 80 percent of patients become seizure-free with this type of surgery.

A new technique is laser surgery, which involves destroying the seizure focus with heat rather than removing it. This technique is especially useful for seizures coming from deep structures in the brain and is much less invasive. Other types of surgeries include “disconnections,” in which the seizure focus is not removed but rather is prevented surgically from spreading to other areas of the brain.

The goal is to stop all seizures and to avoid any side effects that would affect the quality or safety of the patient’s life. The process sometimes can be a struggle, but we will never give up. By the time you read this, I hope there will be more treatments approved and in testing. Be sure to have a detailed discussion with your neurologist about an up-to-date treatment plan that works best for you.

“Anyone can develop epilepsy. It affects both men and women of all races, ethnic backgrounds, and ages.

Epilepsy has many possible causes, but about half of people living with epilepsy do not know the cause. In some cases, epilepsy is clearly linked to genetic factors, developmental brain abnormalities, infection, traumatic brain injury (TBI), stroke, brain tumors, or other identifiable problems. Anything that disturbs the normal pattern of nerve cell activity—from illness to brain damage to brain development problems—can lead to seizures.

Epilepsy may develop because of problems in the brain’s wiring, an imbalance of nerve signaling in the brain (in which some cells are unusually active or stop other brain cells from sending messages), or some combination of these factors. Sometimes, when the brain tries to repair itself after a head injury, stroke, or other problem, it can unintentionally create nerve connection issues that lead to seizures.”

National Institute of Neurological Disorders and Stroke – NIH (Home | National Institute of Neurological Disorders and Stroke)

Old Lists Below on Seizure Classification:

Most Updated List on Classifications of Seizures by the Epilepsy Foundation:

Types of seizures whether with a etiology or unknown:

I-Partial seizures (seizures beginning local)

1-simple partial seizures-(the person is conscious and not impaired).  With motor symptoms, autonomic symptoms and even psychic symptoms.

2.)-Complex partial seizures-(the person is with impairment of consciousness)

II-Generalized seizures-(bilaterally symmetrical and without local onset).

3.) Tonic clonic seizures – Grand Mal

See Above the most updated,being 2017, on classifications of seizures list by the Epilepsy Foundation.

Treatment:

1-Epilepsy is sometimes referred to as a long-term condition, as people often live with it for many years, or for life. Although generally epilepsy cannot be ‘cured’, for most people, seizures can be ‘controlled’ (stopped) so that epilepsy has little or no impact on their lives. So treatment is often about managing seizures in the long-term.

Most people with epilepsy take anti-epileptic drugs (AEDs) to stop their seizures from happening. However, there are other treatment options for people whose seizures are not controlled by anti-epileptic drugs (AEDs).

2-The ketogenic diet is one treatment option for children with epilepsy whose seizures are not controlled with AEDs. The diet may help to reduce the number or severity of seizures and can often have positive effects on behaviour.

3-Vagus nerve stimulation therapy is a treatment for epilepsy that involves a stimulator (or ‘pulse generator’) which is connected, inside the body, to the left vagus nerve in the neck. The stimulator send regular, mild electrical stimulations through this nerve to help calm down the irregular electrical brain activity that leads to seizures.

There are several ways to treat epilepsy. How well each treatment works varies from one person to another. Vagus nerve stimulation therapy is a form of treatment for people with epilepsy whose seizures are not controlled with medication.

4-There are different kinds of epilepsy surgery. One kind of surgery involves removing a specific area of the brain which is thought to be causing the seizures. Another kind involves separating the part of the brain that is causing seizures from the rest of the brain.

Surgery may be possible for both adults and children, and might be considered if:

• you have tried several AEDs and none of them have stopped or significantly reduced your seizures; and
• a cause for your epilepsy can be found in a specific area of your brain, and this is an area where surgery is possible.

Whether you are suitable for surgery is something that you may like to talk about with your GP or neurologist. If you meet these criteria and are considered for surgery, you will need to have further tests before you can have the surgery.

If you are referred for surgery you will probably go to a specialist centre for tests. There are many different pre-surgical tests you might have before you can be given the go-ahead for surgery. This could include further MRI scans, an EEG (electroencephalogram) and video telemetry (an EEG while also being filmed). Other types of scans may also be done, which trace a chemical injected into the body. This can show detailed information about where seizures start in the brain.

Memory and psychological tests are also used to see how your memory and lifestyle might be affected after the surgery. These types of tests also help the doctors to see how you are likely to cope with the impact of having this type of surgery.

The tests will confirm whether:

• the surgeons can reach the epileptogenic lesion during surgery and can remove it safely without causing new problems;
• other parts of your brain could be affected by the surgery, for example the parts that control your speech, sight, movement or hearing;
• you have a good chance of having your seizures stopped by the surgery; and
• you have any other medical conditions that would stop you from having this kind of surgery.

The results from the pre-surgical tests will help you and your neurologist decide whether surgery is an option for you, and what the result of the surgery might be.

Your specialist will also talk with you about the possible risks and benefits of having surgery.

For many people the results show that surgery is not an option: the majority of people who are recommended for surgery, and have these tests carried out, are unable to have surgery.

Take the action and make your life one without seizures occurring putting your life on HOLD you need to TAKE CARE OF YOURSELF!    That is all up to you, the patient diagnosed with it or questioning if they have seizures.

“Active Epilepsy is the following:

Adults—an adult has active epilepsy if they were diagnosed with epilepsy or a seizure disorder and they are currently taking medicine to control it or had at least one seizure in the last 12 months (or both).

Children—a child has active epilepsy if their parent or guardian reports that a health care provider ever told them their child had epilepsy or seizure disorder, and their child currently has epilepsy or seizure disorder.”

Center for Disease Control and Prevention – CDC (Epilepsy Facts and Stats | Epilepsy | CDC)

Possible causes of Epilepsy:

Their epilepsy that is diagnosed with a IDIOPATHIC cause – meaning unknown cause and the patient could grow out of it in childhood in some cases (not all) depending on the type of seizure disorder and if the child doesn’t grow out of it the condition becomes chronic (for life).

Genetic influence (heredity). Some types of epilepsy run in families. In these instances, it’s likely that there’s a genetic influence. Researchers have linked some types of epilepsy to specific genes. But some people have genetic epilepsy that isn’t hereditary. Genetic changes can occur in a child without being passed down from a parent.For most people, genes are only part of the cause of epilepsy. Certain genes may make a person more sensitive to environmental conditions that trigger seizures.

• A genetic tendency, passed down from one or both parents (inherited).
• A genetic tendency that is not inherited, but is a new change in the person’s genes.

Although heredity has been known since antiquity to cause epilepsy, the progress to date in identifying the genetic basis of epilepsy has been limited primarily to the discovery of single gene mutations that cause epilepsy in relatively rare families. For the more common types of epilepsy, heredity plays a subtler role, and it is thought that a combination of mutations in multiple genes likely determine an individual’s susceptibility to seizures, as well as the responsiveness to antiepileptic medications.

Epilepsy can be caused by genetic factors (inherited) or acquired (a etiology—cause) , although in most cases it arises in part from both. The neurology and neurological sciences of Stanford Epilepsy Center Dr. Robert S. Fischer Ph D. presents in the article Genetic Causes of Epilepsy.

He also presents in this article our genes are the instruction set for building the human body. Genes reside on chromosomes.

Going to the basics is every person has 46 chromosomes, carrying a total of about 30,000 genes. We get half our chromosomes from our mother and half from our father. While genes determine the structure of our body, they also control the excitability of our brain cells. Defective genes can make hyperexcitable brain cells, which are prone to seizures.

In recent years, several epilepsy conditions have been linked to mutations in genes, but the matter is complicated by the fact that different genes may be involved in different circumstances.

In general, the most common epilepsy conditions, including partial seizures, seem to be more acquired than genetic.

Gene testing will soon be able to identify predispositions to epilepsy, allowing doctors to help a patient get treatment and to assist with family counseling. One day, doctors may simply be able to swap a patient’s cheek, test his or her genes, and predict response to various epilepsy medicines, eliminating much of the trial and error in medication choice that goes on today. Eventually, we may even be able to repair or replace defective genes that predispose a person to epilepsy, a process called gene therapy.

Lastly, Dr. Robert Fischer Ph D presented in his article, that I found very interesting, the general population has about a 1% risk of developing epilepsy.  Meanwhile, children of mothers with epilepsy have a 3 to 9% risk of inheriting this disease, while children of fathers have a 1.5 to 3% risk of inheritence. Still, the actual risk is upon the specific type of epilepsy. For example, partial seizures are less likely to run in families than are generalized seizures. In any event, with the usual forms of epilepsy, even if a parent does have the condition, there is more than a 90% chance that their child will not. So most epilepsies are acquired than inherited.

Clearly, genes determine a great deal of who we are, including our possible risk for epilepsy but slim versus a actual cause. But what happens to us in life and what we do is still the larger part of the risk for epilepsy.

A person given this diagnosis in the 1970’s, or before  and even up to the early 1990’s was quiet about ever letting people know about this since in the 1970’s and back with lack of knowledge, information to the public and definitely technology versus now.  Epilepsy is much more an accepted disease in the overall community compared to 20-25 years ago and back.  Heck in the 1970’s and back these patients when having a seizure episode were characterized as “Freaks”.  This was due to ignorance and lack of information to society/community but due to the past 20 to 25 years with the computer used more as a must in our lives with media, television and even our government they all have made it possible for society everywhere in the world to learn and understand diseases with acceptance in wanting to help those, particularly the US, but we still need a healthier America. It will take time to get there with the many multicultural lives that all live in the U.S. which practice differently on how important a healthy diet is with exercise balanced with rest.  Also including stress well controlled is not always in America on their top priority list in living.  Stress can even be a catalyst for a seizure but not the cause.

For a person diagnosed with or without a cause of epilepsy these steps in learning about the disease with higher technology and continuous research with medications over the years has allowed them to be able to live a completely healthy life doing the same things other people do without the disease but only if the patient is UNDER COMPLETE CONTROL  which includes being COMPLIANT with your Rx; this does exist in America.

Compliant meaning taking their medications everyday as ordered by their neurologist with yearly or sooner follow-up visits with blood levels of the anti-seizure medications there on.  This is the only way one with chronic epilepsy is guaranteed that living this way MAY stop the seizures from occurring (inactive epilepsy you can call it — meaning you’ll always have the disease but can put the seizure activity in a remission by medications preventing the seizure.)

How Epilepsy is Diagnosed:

The purpose for intial visits is for the Neurologist to determine if the patient is having a seizure or something else and to determine what diagnotic tooling tests to start with to help the doctor to find out the problem.  Apart from the description of the seizure, there are other things that can help to explain why your seizures have happened. Your medical history and any other medical conditions will also be considered as part of your diagnosis.

If you have a seizure you may not remember what has happened. It can be helpful to have a description of what happened from someone who saw your seizure, to pass on to your GP or specialist.

Here are some questions that may help you or someone who witnessed your seizure to record useful information about what happened:

Before the seizure

• Did anything trigger (set off) the seizure – for example, did you feel tired, hungry, or unwell?
• Did you have any warning that the seizure was going to happen?
• Did your mood change – for example, were you excited, anxious or quiet?
• Did you make any sound, such as crying out or mumbling?
• Did you notice any unusual sensations, such as an odd smell or taste, or a rising feeling in your stomach?
• Where were you and what were you doing before the seizure?
• TIME the seizure when it started and ended to tell the MD if not in the hospital!!

During the seizure

• Did you appear to be ‘blank’ or stare into space?
• Did you lose consciousness or become confused?
• Did you do anything unusual such as mumble, wander about or fiddle with your clothing?
• Did your colour change (become pale or flushed) and if so, where (face or lips)?
• Did your breathing change (for example, become noisy or look difficult)?
• Did any part of your body move, jerk or twitch?
• Did you fall down, or go stiff or floppy?
• Did you wet yourself?
• Did you bite your tongue or cheek?

After the seizure

• How did you feel after the seizure – did you feel tired, worn out or need to sleep?
• How long was it before you were able to carry on as normal?
• Did you notice anything else?

For F/U (follow up) visits is for the neurologist to see how well your seizures are under control by taking drug blood levels of the anti seizure medication your taking to make sure the medication is in a therapeutic drug level and if not he or she will make dose changes in the med(s) your on.  Possible do a EEG (electroencephalogram); the only test to decipher if you have spikes in your brain waves indicating you had a seizure determining from which lobe of the brain is having the seizures (a 26 lead to wires on the brain, which is painless).  Go to the expert for keeping you on the right track.  Its just like based on the principle why a person gets a check up on there car by seeing the mechanic (the car’s doctor) who fixes it.  The expert,  the Neurologist,  fix your seizures or get them under control.

“Epilepsy remains one of the most prevalent neurological disorders affecting Americans across all age groups, demographics, and socioeconomic backgrounds. As we move through 2025, the latest data from the Centers for Disease Control and Prevention reveals that epilepsy continues to impact millions of lives, with approximately 3.4 million Americans currently living with this condition. This neurological disorder, characterized by recurrent seizures, affects not only the individuals diagnosed but also their families, caregivers, and communities at large.”

The Global Statistics (https://www.theglobalstatistics.com/united-states-epilepsy-statistics/)

What is epilepsy?

 Most people with epilepsy are otherwise healthy; as long as it’s well controlled like most other diseases.  A seizure is a physical manifestation of paroxysmal and abnormal electrical firing of neurons in the brain.  Think of it as numerous voltage (hyperexcitability of neurons) going throughout the brain meaning brain waves going in all directions with the brain saying its too much activity going through my organ and can’t think normally; instead the brain goes through a shock.   In simpler terms the brain is  getting too much brain wave excitability for the organ to register in what to do causing the brain to go into a type of a seizure.

When the seizure occurs there is a decrease in oxygen since the brain isn’t capable to send messages during the seizure.  The problem it too much electrical stimulation is happening in the brain causing the type of seizure to come on.  If the seizure continues to repeat one right after another the person is in status epilepticus and if the seizures do not stop the person can lead to a neuronal death;  like John Travolta’s son who died of this for example.

The term seizure disorder may refer to any number of conditions that result  in such a paroxysmal electrical discharge.  These conditions could be metabolic or structural in nature.

For example, if a metabolic condition this could be “Canavan disease” which is primarily a disease of demyelination.  Your myelin sheath that protects and insulates the nerves is being destroyed and can cause a seizure as one of the symptoms.

*Another example being metabolic is thought to be caused by brain acetate deficiency resulting from a defect of N–acetylaspartic acid (NAA) catabolism (meaning breakdown is occurring).  Accumulation of NAA, a compound thought to be responsible for maintaining cerebral fluid balance, can lead to cerebral edema and neurological injury, like a seizure as one symptoms of the disease.

*Sometimes there is a known cause and than there is just idiopathic, unknown cause for the epilepsy which if starts in childhood can resolve by the child growing out it, like in petite mal seizures but other times that is not the case and goes into motor/focal or grand mal that is permanent so the individual needs Rx for life.

Remember, not all seizures are due to epilepsy. Other conditions that can look like epilepsy include fainting, or very low blood sugar in some people being treated for diabetes.

Remember, etiology (the cause) of Epilepsy can be generally a sign of underlying pathology involving the brain–knowing the cause.  To find this out diagnostic tooling be a neurologist who specializes in epilepsy is the best resource to go to.  The epilepsy may be the first sign of a nervous system disease (ex. Brain tumor), or it may be a sign of a systemic or metabolic derangement.  Where the treatment may be able to resolve the seizure symptom completely where this wasn’t a seizure disorder or epilepsy but just a symptom due to another disorder that may be 100% cured, like a operable tumor removed surgically from the brain.

Check out Part II tomorrow!

“Each November, the COPD Foundation and its community plan a full month of advocacy and awareness activities to increase awareness of chronic obstructive pulmonary disease (COPD). You can help by joining us to spread the word about COPD and chronic lung disease awareness, prevention, and treatment.

COPD remains a leading cause of death worldwide, ranking as the third leading cause of death globally in 2023¹ and the fifth leading cause of death in the United States in 2024².

COPD is (currently) incurable, but with the right diagnosis and treatment, there are many things you can do to breathe better, enjoy life, and live for many years.”

COPD Foundation (COPD Awareness Month | COPD Foundation)

If you have COPD, you may have symptoms such as:

• trouble breathing
• cough
• wheezing
• tightness in your chest

Smoking often causes COPD, but in some cases, breathing in toxins from the environment is the cause.

There’s currently no cure for COPD, and the damage to the lungs and airways is permanent.

However, several medications can help reduce inflammation and open your airways to help you breathe easier with COPD.

Short Acting Bronchodilators:

Bronchodilators help open your airways to make breathing easier. Your doctor may prescribe short-acting bronchodilators for an emergency situation or for quick relief as needed.

You take them using an inhaler or nebulizer.

Examples of short-acting bronchodilators include:

• albuterol (Proair HFA, Ventolin HFA)
• levalbuterol (Xopenex)
• ipratropium (Atrovent HFA)
• albuterol/ipratropium (Combivent Respimat)

Short-acting bronchodilators can cause side effects such as:

• dry mouth
• headache
• cough

These effects should go away over time.

Other side effects include:

• tremors (shaking)
• nervousness
• a fast heartbeat

If you have a heart condition, tell your doctor before taking a short-acting bronchodilator.

Corticosteroids:

With COPD, your airways can be inflamed, causing them to become swollen and irritated. Inflammation makes it harder to breathe.

Corticosteroids are a type of medication that reduces inflammation in the body, making air flow easier in the lungs.

Several types of corticosteroids are available. Some are inhalable and should be used every day as directed. They’re usually prescribed in combination with a long-acting COPD drug.

Other corticosteroids are injected or taken by mouth. These forms are used on a short-term basis when your COPD suddenly gets worse.

The corticosteroids that doctors most often prescribe for COPD are:

• Fluticasone (Flovent). This comes as an inhaler you use twice daily. Side effects can include headache, sore throat, voice changes, nausea, cold-like symptoms, and thrush.
• Budesonide (Pulmicort). This comes as a handheld inhaler or for use in a nebulizer. Side effects can include colds and thrush.
• Prednisolone. This comes as a pill, liquid, or shot. It’s usually given for emergency rescue treatment. Side effects can include headache, muscle weakness, upset stomach, and weight gain.

Methylxanthines:

For some people with severe COPD, the typical first-line treatments, such as fast-acting bronchodilators and corticosteroids, don’t seem to help when used on their own.

When this happens, some doctors prescribe a drug called theophylline along with a bronchodilator.

Theophylline works as an anti-inflammatory drug and relaxes the muscles in the airways. It comes as a pill or liquid you take daily.

Side effects of theophylline can include:

• nausea or vomiting
• tremors
• headache
• trouble sleeping

Long Acting Bronchodilators:

Long-acting bronchodilators are medications that are used to treat COPD over a longer period of time. They’re usually taken once or twice daily using inhalers or nebulizers.

Because these drugs work gradually to help ease breathing, they don’t act as quickly as rescue medication. They’re not meant to be used in an emergency situation.

The long-acting bronchodilators currently available are:

• aclidinium (Tudorza)
• arformoterol (Brovana)
• formoterol (Foradil, Perforomist)
• glycopyrrolate (Seebri Neohaler, Lonhala Magnair)
• indacaterol (Arcapta)
• olodaterol (Striverdi Respimat)
• revefenacin (Yupelri)
• salmeterol (Serevent)
• tiotropium (Spiriva)
• umeclidinium (Incruse Ellipta)

Side effects of long-acting bronchodilators can include:

• dry mouth
• dizziness
• tremors
• runny nose
• irritated or scratchy throat
• upset stomach

More serious side effects include:

• blurry vision
• rapid or irregular heart rate
• an allergic reaction with rash or swelling

Combination Drugs:

Several COPD drugs come as combination medications. These are mainly combinations of either two long-acting bronchodilators or an inhaled corticosteroid and a long-acting bronchodilator.

For people with COPD who experience shortness of breath or trouble breathing during exercise, the American Thoracic Society strongly recommends a long-acting beta agonist (LABA) combined with a long- acting muscarinic antagonist (LAMA).

Triple therapy, a combination of an inhaled corticosteroid and two long-acting bronchodilators, is recommended for those who continue to have shortness of breath or trouble breathing and are currently using LABA and LAMA combination therapy.

Recommended LABA/LAMA combination bronchodilator therapies include:

• aclidinium/formoterol (Duaklir)
• glycopyrrolate/formoterol (Bevespi Aerosphere)
• tiotropium/olodaterol (Stiolto Respimat)
• umeclidinium/vilanterol (Anoro Ellipta)

Combinations of an inhaled corticosteroid and a long-acting bronchodilator include:

• budesonide/formoterol (Symbicort)
• fluticasone/salmeterol (Advair)
• fluticasone/vilanterol (Breo Ellipta)

Combinations of an inhaled corticosteroid and two long-acting bronchodilators, called triple therapy, include fluticasone/vilanterol/umeclidinium (Trelegy Ellipta).

A 2018 research reviewTrusted Source found that triple therapy reduced flare-ups and improved lung function in people with advanced COPD.

According to current guidelines, the inhaled corticosteroid may be withdrawn if you have not had a flare-up in the past year.

However, it also indicated that pneumonia was more likely to develop with triple therapy than with a combination of two medications.

Antibiotics:

Regular treatment with antibiotics like azithromycin and erythromycin may help manage COPD.

Long term antibiotic therapy needs further research studies.

Cancer Medications for COPD:

Several cancer drugs could possibly help reduce inflammation and limit damage from COPD.

A 2019 study found that the drug tyrphostin AG825 helped lower inflammation levels in zebrafish.

The medication also sped up the rate of death of neutrophils, which are cells that promote inflammation, in mice with inflamed lungs similar to COPD.

Research is still limited on using tyrphostin AG825 and similar drugs for COPD and other inflammatory conditions. Eventually, they may become a treatment option for COPD.

Different types of medications treat different aspects and symptoms of COPD. Your doctor will prescribe medications that will best treat your particular condition.

Types of surgery for COPD:

Some considerations for surgery candidates include:

• You must be strong enough to have the surgery.
• You must participate in a pulmonary rehabilitation program.
• You cannot be a current smoker.

Some lung surgeries require that the lung damage must be in an area that is localized (a specific area) and can be removed. The decision for surgery is based on the results of many tests. Talk to your doctor to find out if lung surgery is right for you.

There are two types of lung surgery performed to address COPD:

• Bullectomy is a procedure where doctors remove one or more of the very large bullae or blebs from the lungs. Bullae are large air sacs that form from hundreds of destroyed alveoli. These air spaces can become so large that they crowd out the better functioning lung and interfere with breathing. For those people, removing the destroyed air sacs improves breathing.
• Lung Volume Reduction Surgery (LVRS) is a procedure to help people with severe emphysema affecting the upper lung lobes. LVRS is not a cure for COPD but can improve one’s exercise capacity and quality of life. The goal of the surgery is to reduce the size of the lungs by removing about 30 percent of the most diseased lung tissues so that the remaining healthier portion can perform better. LVRS also can allow the diaphragm to return to its normal shape, helping you breathe more efficiently. The surgery has been shown to help improve breathing ability, lung capacity and overall quality of life among those who qualify for it.

Surgery Transplantation for patients who are candidates:

Lung transplantation can prolong and dramatically improve quality of life for patients with advanced lung diseases. The Center for Advanced Lung Disease and Lung Transplantation at NewYork-Presbyterian/Columbia University Irving Medical Center is one of the oldest in the United States, having performed more than 1,300 lung and heart-lung transplants since 1988. Between 2001 and 2019, with the launch of new program leadership, they performed over 1,000 lung transplants.

Their patient survival rates are much higher than the national average — even though they treat sicker patients than most U.S. centers. We’ve also worked to expand the pool of donor lungs through innovative technologies. Over the years, they have earned a reputation for our clinical expertise and rigorous commitment to excellence.