Dr. Arun Sharma

Epilepsy Treatment in Dubai

Epilepsy Treatment in Dubai


The new century has seen an incredible growth in new medications developed to help treat seizures. New therapies, including surgicaltechniques and dietaryoptions, have also shown increased adoption and promise during the 21st century. If you are still struggling with seizure control, then you need to make sure you explore all the potential effective options for epilepsy treatment in Dubai. Even one seizure is too many! New medications have much different tolerance levels to help improve quality of life by reducing or ending unwanted side effects. Surgery can now be done with very little invasion versus in the past when whole parts of the skull had to be removed. Devices that stimulate parts of the brain can help control or prevent seizures. Dietary therapies, like the ketogenicdiet or modified Atkin’s diet, have great success. At www.bestneurologistdubai.com I shall brief you about seizures, epilepsy , and less harmful medications for epilepsy treatment in Dubai.

What's a seizure?

Seizures are best described as “electrical storms” in the brain.. The sudden surge of electrical activity can affect how a person acts for a short period of time and interfere with normal brain function. Anyone can have a seizure, and experiencing one doesn't necessarily mean one has epilepsy – a chronic condition affecting 65 million people worldwide.

Aura

At the beginning of a seizure, someone might experience an aura – an often indescribable sensation that can be sensory or experiential. An aura can include tingling, numbness, electric shock-like sensations, pain, a desire to move and visual and auditory hallucinations. Someone experiencing an aura might describe an out-of-body sensation, unusual taste or smell – like garlic or roses – and feelings of deja vu or unfamiliarity. It can be a strange feeling that has no other explanation .It's a peculiar feeling on the inside, like butterflies in the stomach.

Jerking

If someone having a seizure is convulsing, he or she is likely experiencing a generalized tonic-clonic seizure, also known as a grand mal seizure. During the tonic phase of this kind of seizure, muscles stiffen and the person loses consciousness and falls to the floor. That's followed by the clonic phase of the seizure, when the arms and legs begin to jerk rhythmically. This shaking typically lasts less than two minutes.

Blank stare

Take notice if a child or adult abruptly stops talking in the middle of a conversation. It could be a warning sign of an absence seizure – a type of chronic seizure named specifically for this moment of absence in someone's attention. “Sometimes they’ll just freeze momentarily and go on with what they’re doing. Oftentimes, [absence seizures] go unnoticed because the person having it doesn’t recognize they’re having it. It's particularly hard to detect this type of seizure because it may only last as long as a normal hesitation in speech.

What causes seizures?

Epilepsy is typically diagnosed after a person has had at least two seizures that weren't due to another medical condition, such as a mental illness or sleep disorder. Why a seizure occurs is often unclear, but causes include: brain malformations; lack of oxygen during birth; low levels of blood sugar, blood calcium or blood magnesium or other electrolyte disturbances; genetic disorders that affect the way someone metabolizes food; intracranial hemorrhage; and maternaldrugabuse. Other causes include fever and infections in infants and children, a congenital condition like Down syndrome, a family history of epilepsy and headtrauma. Seniors are more likely to have a seizure if they’ve had a stroke, live with Alzheimer’sdisease or have had a head trauma.

Medications

Anti-Seizure Medications

For over 80 years, the most effective treatment for epilepsy and seizure disorders has been through the use of seizure-preventing medications called anti-convulsion or anti-epileptic drugs (AEDs). While these medications do not cure epilepsy, they make it possible for many people to live normal, active lives completely free of seizures. Other people may continue to have seizures, but less frequently. And there are still those who need other treatment methods as the drugs are not effective against their seizures.

There is much variability among people and the AEDs they take including side effects and the drug’s effectiveness against their type of seizures. It often takes a good deal of time to find the right medication (mono therapy), or combination of medication (poly therapy), in the right dosage to reach an effective seizure-preventing level in a person.

There are over 20 different anti-epileptic medications available today. Most are effective for only certain types of seizures, so once a diagnosis of epilepsy and its type or types has been made, the doctor will determine which medicine might be most appropriate as a form of treatment. Most types of medications are taken by mouth in the form of tablets or capsules. They may also be prescribed in sprinkles or syrup.

No two people react the same to anti-seizure medications. One drug may effectively control one person’s seizures, while that same drug may not work at all for another. How a body metabolizes anti-seizure medication will play a big part in what dosage levels will be successful in controlling seizures. For some people, side effects can be substantial, while others experience no negative side effects at all. All of these variations, from person to person, mean that it may take a while for you and your doctor to find the right anti-seizure medication at the right dosage level for you.

In most cases, I begin treatment at a low level of the drug and gradually increase, or titrate, the levels of the drug into your system. Starting at a low level and increasing the dosage over time helps to prevent toxic levels of the drug in your system. This progression also enables the doctor to observe what you can tolerate and at what level the seizures may stop.

Taking medications as prescribed is the most important part of treatment. The medicine you take every day replaces what has been metabolized by your body, keeping the medication levels at the correct therapeutic level in your bloodstream. Skipping a dose, taking fewer pills than prescribed, or not filling your prescription on time can cause your medication level to be too low in your blood, which means that you may experience a seizure. For some people, this can happen within minutes of missing a dosage. Not complying with your prescribed medication dosages is one the biggest reasons for breakthrough seizures and/or status epilepticus.

All medications can cause side effects. Some of these are acceptable and some are not. It is possible that after awhile, some side effects may simply go away. Side effects can happen because anti-seizure medication is interacting with another drug being taken, so always inform your doctor of other medicines you are using. Anti-seizure medication may build up in the body, reaching a toxic level. If you are experiencing any side effects, such as nausea, fatigue, staggering, slurring of words, or a rash, contact www.bestneurologistdubai.com immediately.

It is important to remember that these medications will only work if they are taken regularly, every day! To help the medicine work, here are some suggestions:

  • Take the medicine at the same time every day;
  • Take the exact amount of medicine that the doctor has said–changing your dose on your own might cause you to have a seizure;
  • If medicine is a liquid, shake the bottle well before you pour the dose to ensure that the medication is properly distributed in the liquid;
  • Keep your medicines in a cool, dry place, out of children’s reach;
  • Report any side effects and seizure activity to your doctor, he may want to try a different dose or a different medication altogether;
  • Ask your doctor ahead of time what to do if you miss a dose of medication;
  • Don’t run out of medication–renew your prescription in a timely manner so you always have at least a week’s supply on hand;
  • Be careful when consuming alcohol–check with your www.bestneurologistdubai.com about how it may mix with your medicine;
  • Get enough sleep–lack of sleep is thought to trigger seizures.
Some common medicines for epilepsy treatment in Dubai include:
  • Eslicarbazepine: Some side effects: dizziness, drowsiness, nausea, headache, double vision, vomiting, fatigue, loss of coordination.
  • Lorazepam: usually reserved for continuous ,life-threatening seizures in injectable form
  • Rufinamide: Some side effects: headache, dizziness, fatigue, sleepiness, double vision, tremors, hypersensitivity syndrome, fever, rash, fluid accumulation, swollen lymph nodes, liver injury and confusion
  • Carbamazepine: Some side effects: dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare)
  • Valproate: introduced in 1978. Some side effects: upset stomach, altered bleeding time, liver toxicity, hair loss, weight gain, tremor
  • Phenytoin : introduced in 1938. Some side effects: clumsiness, insomnia, motor twitching, nausea, rash, gum overgrowth, hairiness, thickening of features
  • Tiagabine: introduced in 1997. Some side effects: tremors, dizziness, nervousness, difficulty concentrating, sleepiness, weakness
  • Levetiracetam: Some side effects: sleepiness, fatigue, poor coordination, loss of strength, dizziness
  • Clonazepam: introduced in 1975. Some side effects: drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes
  • Lamotrigine: introduced in 1994. Some side effects: dizziness, headache, blurred vision, clumsiness, sleepiness, nausea, skin rash
  • Pregabalin: Some side effects: dizziness, somnolence, ataxia, neurasthenia, weight gain
  • Gabapentin: introduced in 1993. Some side effects: sleepiness, dizziness, clumsiness, fatigue, twitching
  • Clobazam: FDA approval in June of 2011. Some side effects: somnolence, sedation, drooling, constipation, cough, dysphagia, fatigue, *Stevens Johnson Sydrome.
  • Ezogabine: Some side effects: suicidal thoughts, dizziness, vertigo, fatigue, confusion, tremors, double vision, memory problems, alertness, problems with coordination, increased urinary retention
  • Phenobarbital:introduced in 1912. Some side effects: drowsiness, irritability, hyperactivity (children), behavioral problems, difficulty concentrating, depression
  • Vigabatrin: Some side effects: sleepiness, headache, dizziness, nervousness, hyperactivity in children
  • Carbamazepine: introduced in 1974. Some side effects: dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare)
  • Topiramate: introduced in 1996. Some side effects: confusion, sleepiness, dizziness, clumsiness, difficulty thinking or talking, tingling sensation of the skin, nausea, decreased appetite
  • Oxcarbazepine: Esclicarbazepine an evolutionary medication in the same class of molecules is a once a day medication. Some side effects: difficulty concentrating, sleepiness, fatigue, dizziness, double vision, nausea, unsteadiness, rash
  • Lacosamide: Some side effects: dizziness, headaches, nausea, vomiting, double vision, sleepiness, fatigue, unsteadiness, shakiness, memory loss, mood changes, electrocardiogram changes
  • Ethosuximide: introduced in 1960. Some side effects: appetite loss, nausea, drowsiness, headache, dizziness, fatigue, rash, abnormal blood counts (rare)
  • Zonisamide: Some side effects: sleepiness, dizziness, loss of appetite, headache, nausea, irritability, difficulty concentrating, unsteadiness, fever, kidney stones, rash (should not be used in individuals allergic to sulfa drugs)