What are newer treatment options for epileptic seizures?

Question

Hi doctor,

My seizures are getting more frequent despite the medication. I am 31 years old and was diagnosed with epilepsy after my first grand mal seizure two years ago. Now I am having three to four episodes a week, mostly the smaller ones where I zone out and stare (complex partial, they call it), but I had two big ones this month where I fell and bit my tongue. I take Lamotrigine 200 mg twice daily, but it is not working like before. The worst part is that I am afraid to go out alone. What if I have a seizure in public? People do not know how to help. I found myself in an ambulance last week with no memory of what happened. Can my dose be increased? Are there better medicines? I read about those VNS devices. Would that help someone like me? I am so tired of living in fear all the time.

Please help me.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

I am really sorry you are dealing with this. What you are describing is serious and understandably frightening.

What is happening:

You are having more frequent seizures, including both complex partial seizures (staring spells) and tonic-clonic seizures (grand mal).
Your current medication, Lamotrigine, worked before but is no longer effective.
This is affecting your safety, your job, your independence, and your mental health.

What does this mean?

Your epilepsy may now be considered drug-resistant, which happens in some people.
Your dose may need to be adjusted, or you might need to add or change medications, but only under a neurologist’s care.

What else can help?

A vagus nerve stimulator (VNS) is often used for people with drug-resistant epilepsy. It is an implanted device that can reduce seizure frequency.
Seizure rescue medications might be an option if approved by your doctor. These can be used during an episode to stop or lessen the seizure.
An updated EEG (electroencephalogram) or MRI (magnetic resonance imaging) may be needed, especially if your seizure pattern has changed.

Practical steps for now:

Keep a seizure diary that tracks the date, time, duration, and any possible triggers for each episode.
Wear a medical alert bracelet or carry a seizure ID card.
Share seizure first aid information with your roommate and coworkers so they know how to help if a seizure happens.

Thank you.