Did you know that around a third of adults with epilepsy have intractable seizures? This is when anti-epilepsy medication doesn’t stop you from having seizures. While medication is normally the first route doctors will try, there is a growing number of alternative intractable epilepsy treatment options.
Let's find out about the different intractable epilepsy treatments available to you.
Getting a referral to an epilepsy center
If you have tried two or more anti-epilepsy medications but they have not stopped you from having seizures, you may have intractable epilepsy (also known as refractory or drug resistant epilepsy). If this is the case, it is certainly worth speaking to your doctor about getting a referral to a specialist epilepsy center. Epileptologists at these centers will have access to the most advanced tools for understanding your seizure. They will also be able to provide intractable epilepsy treatments.
Learn more: What is an epileptologist?
4 intractable epilepsy treatment pathways
When you visit an epilepsy treatment center, the epileptologists will look into your medical history and conduct tests to learn more about your seizures. Depending on their findings, they might recommend one of the following treatment pathways.
1. Intractable epilepsy surgery
For some people, resective surgery (where part of the brain is removed) can provide a complete cure for seizures. A neurosurgeon will remove the part of the brain that is causing the seizures.
- Advantages of intractable epilepsy surgery: It can completely cure your seizures.
- Drawbacks of intractable epilepsy surgery: Most kinds of epilepsy cannot be ‘solved’ with surgery. Having brain surgery can also be risky.
There are several kinds of brain stimulation devices which can help to reduce the frequency and severity of seizures over time. These include vagus nerve stimulation, deep brain stimulation and responsive neurostimulation. Medical devices are implanted in different parts of your body which send mild electrical pulses into your brain. This can reduce the number of seizures you have.
- Advantages of stimulation for epilepsy: Proven to help reduce the number of seizures people have over time.
- Drawbacks of stimulation for epilepsy: While improvements in quality of life can be substantial, it rarely leads to complete seizure freedom.
Research has shown that certain kinds of diet can significantly reduce the number of seizures people have by 50% or more. The ketogenic diet, where you avoid carbohydrates and get most of your energy from fats, has been shown to help many people reduce the number of seizures they experience.
- Advantages of diets for epilepsy: Do not require surgery and are relatively easy to implement.
- Drawbacks of diets for epilepsy: These diets are unusual - many people find it unpleasant to mainly eat fats.
4. Emerging intractable epilepsy treatments (such as CBD)
There are a handful of emerging treatments for intractable epilepsy, including the use of CBD, which appears to reduce the severity and frequency of seizures.
- Advantages of emerging treatments: Studies appear to indicate that CBD is effective at tackling intractable seizures - at least to a degree.
- Drawbacks of emerging treatments: We still don't know enough about how epilepsy treatment with things like CBD works, and new therapies might not be suitable for everyone.
More options for intractable epilepsy treatment
If your seizures are not controlled by medication, the good news is that there is a growing number of alternative intractable epilepsy treatment options available. These treatments may not always be available through your community neurologist or at your local hospital. If they aren’t, speak to your doctor at your next appointment about alternative treatments or ask for a referral to an epilepsy center.