Epilepsy

Epilepsy: general overwiev.

Epilepsy is a common name for a group of neurological disorders characterized by recurrent epileptic seizures caused by abnormal neuronal activity in the cortex of the brain. While modern science cannot explain the certain reason of epilepsy, there are some known factors provoking the disease including following:

• brain injury,
• stroke,
• brain tumors,
• infections of the brain,
• birth defects,
• genetic mutations.

World Health Organization states that as of 2019, about 50 million people in the world have epilepsy (https://www.who.int/news-room/fact-sheets/detail/epilepsy).

Epileptic seizures

Epileptic seizure is a period of symptoms caused by abnormally excessive or synchronous neuronal activity in the brain. The outward effect may vary greatly depending of the seizure type. There are several classifications of the seizure types, most include such types as focal (partial) seizures, including simple ones, when the consciousness is not impaired and complex ones; generalized seizures, including absence seizures, myoclonic, tonic, clonic, tonic-clonic and atonic seizures.

How to diagnose epilepsy

Diagnosis of epilepsy is difficult due to similar outward effects of different diseases, like syncope, migraines, panic attacks and many others, and the misdiagnosis is not uncommon. In order to distinguish epilepsy from other diseases the following diagnostic methods are recommended:

electroencephalogram (EEG), being the most common method, still can’t be considered a perfect one due to possible false positive result and the cases when EEG should be performed for a sleeping or sleep deprived patient,

1. CT scan and MRI for detecting structural problems in and around the brain,
2. testing of electrolyte, blood glucose and calcium levels,
3. testing of blood prolactin level within the first 20 minutes following a seizure,
4. urine biochemistry and blood testing looking for metabolic disorders in children.

Special attention is required for pediatric patients since children may have behaviors that look alike the epileptic seizures but are not, including breath-holding spells, night terrors, tics and others.

Effective treatment of epilepsy

Currently, there is no single medicine for epilepsy effective for each patient. First of all, our society needs to support people with epilepsy with their self-management for treating the epilepsy. We need to spread out the knowledge about the first aid to a person having an epileptic seizure. And of course, we need to make daily medications for epileptic patients more available.

Japanese medicines for epilepsy are effective for treating various types of epileptic seizures, all of them being fully tested before the certification. We can particularly recommend the following anti-epileptic medications from Japan:

• Mystan tablets (Clobazam) for myoclonic, myoclonic-absent, simple partial, complex partial, tonic seizures, for certain types of status epilepticus and for add-on therapy in difficult to treat focal epilepsies;
• Excegran tablets (zonisamide) for temporal lobe epilepsy, focal impaired awareness (complex partial seizures), refractory seizures, secondarily generalized seizures (bilateral tonic-clonic seizures) and focal aware (simple partial) seizures;
• Fycompa tablets (perampanel) for partial-onset seizures with or without secondarily generalized seizures and for tonic-clonic attacks.

The choice of the Japanese medicines for epilepsy should be discussed with your consulting doctor. Please also note that specialists recommend to start the therapy only once the diagnosis of epilepsy is confirmed and the patients should be treated with a single AED (monotherapy) wherever possible (National Clinical Guideline Centre. The Epilepsies: The diagnosis and management of the epilepsies in adults and children in primary and secondary care (PDF). National Institute for Health and Clinical Excellence. 2012, January, pp. 57–83).