1. Rule out Nonepileptic Causes for Symptoms
Nonepileptic seizures are those that mimic epileptic seizures but have another cause. Epileptic seizures are caused by dysfunctional neurological signals in the brain's cortex while nonepileptic episodes are spurred by a complicating medical issue. Successful treatment begins with making sure your seizures are actually complex partial episodes rather than nonepileptic sensations caused by psychological or physical conditions like trauma, panic attacks, night terrors, hypoglycemia, syncope or cardiac dysfunction.
After your physician takes a thorough medical history, he may wish to conduct tests like EKGs, MRIs, blood work and CT scans to confirm your complex partial seizure diagnosis and rule out other medical conditions.
2. Take Anticonvulsants to Control Seizure Activity
Anticonvulsants--also called antiepileptics or AEDs--are prescribed as front-line treatments for complex partial and other types of seizures. While they can't cure epilepsy, they are designed to subdue the abrupt neurological misfires that cause seizure episodes. Common AEDs include gabapentin (Neurontin), carbamazepine (Tegretol), lamotrigine (Lamictal) and levetiracetam (Keppra), but there are dozens of other choices that doctors can prescribe.
Your neurologist will start you on monotherapy--administration of a single drug--initially, but may need to combine two or more medications to reduce or prevent seizure activity. While newer AEDs are considered safe, you should alert your doctor if you experience side effects like stomach upset, drowsiness, clumsiness, depression, irritability or cognitive difficulties. In rare cases, patients choose to discontinue AEDs due to the severity of their side effects, but there are many alternative medications to consider first.
3. Implement Dietary Changes
When drugs are ineffective or cause abnormalities in body function, your physician may suggest a ketonic diet or a modified Atkins program. High in fat and low in carbohydrates and proteins, these food plans are used to produce ketosis. During ketosis, your body burns fat stores rather than carbohydrates, which lowers seizure incidence or prevents episodes in some patients. The ketogenic diet is particularly restrictive and requires a strong commitment on the part of the patient and caregivers.
4. Explore Surgical Options
If 2 to 5 years of medication and dieting prove unsuccessful or are causing severe side effects, your neurologist may consider brain surgery, especially if your seizure frequency or severity is affecting your life quality or causing insurmountable physical challenges. Anterior temporal lobectomy is one of the best procedures for complex partial seizures that are ineffectively treated with AEDs. After mapping the brain to determine the sources of your seizure activity--called hot spots or epileptic foci--a surgeon will decide whether the tissue can be removed without influencing normal brain function. If your surgeon can remove the foci with a minimally invasive procedure, your seizures may slow down or even cease altogether.
Other surgical options include corpus callosotomies, vagus-nerve stimulator implants, hemispherectomies and extratemporal resections. Brain surgery is inherently risky, of course, so question your doctor and research this option at length before making a decision.
5. Take Precautions to Reduce Safety Dangers
While some activity is recommended for maintaining fitness and motor coordination, living with complex partial seizures unfortunately means avoiding high-risk activities like driving, skiing, scuba diving, climbing and operating machinery. Ask your doctor about activity and lifestyle restrictions. She may want you to refrain from things like cooking or grilling, camping or working at heights if your seizures are still uncontrolled. Prolonged exposure to flickering lights or computer games may also set off seizures in some individuals, so take precautions if you are susceptible. Keep your family members and caregivers in the loop, so they can be mindful of your safety as well.
