Logan’s mother knew something was amiss that afternoon when he wet his pants while napping beside her on the couch. Her bright and active 5-year-old son hadn’t done that in years! She tried to awaken him but couldn’t, and he lay limp and lifeless in her arms for several minutes as she called 911. He became sick to his stomach in the ambulance and then remained sleepy and confused for several more hours. His mother knew that something significant had happened. The doctors couldn’t be sure, but they suspected Logan had had a seizure.
One month later, Logan had a second episode. At that point, his astute mother knew deep inside that these were seizures, even before the doctor confirmed this with an EEG — electroencephalogram — or brain wave test.
Logan is intelligent, creative and imaginative, to the point that he likes to pretend he is Superman — and in many ways, he demonstrates the same courage as his superhero. “We were concerned,” his mother says. “When the doctor told us he needed to take daily medication, we decided to seek a second opinion.” Logan’s parents would do anything to protect their Superman from harm, but the prospect of daily medication made them uneasy.
As it turned out, after a comprehensive evaluation at Cleveland Clinic, it appeared that Logan might not need to take daily medication after all. Based on the signs and symptoms of his seizures and some very special features on his EEG, his pediatric epilepsy specialist, Dr. Elaine Wyllie, diagnosed Panayiotopoulos syndrome — an uncommon form of self-limited childhood epilepsy named after the doctor who first described it. “Children with PS usually do well in the long run and outgrow their tendency for seizures over time,” Dr. Wyllie says. “Most specialists feel that daily antiepileptic medication is not necessary.”
After a detailed discussion of the possible risks and benefits, Logan’s family elected to defer daily treatment. They instead have pre-measured doses of rescue medicine that may be given rectally to stop a seizure after it starts. Over a two-year period they used it only twice, both times with good success.
Logan’s experience reminds us that epilepsy should no longer be considered a strange and mysterious illness. We now know that it is usually an immanently treatable neurological condition. The key to a successful outcome is a full understanding of the epilepsy type and underlying cause. A meticulous history and physical examination, along with an EEG and brain MRI, usually provides a complete picture of the patient’s neurological condition.
Among the many questions asked by families every day, the following two are among the most frequent.
Does everyone with seizures need daily medication?
For most persons with epilepsy, daily medical treatment is necessary to prevent seizures. Logan is an unusual exception.
Thanks to modern research, we now have many medications for epilepsy that are safe, effective and highly tolerable. Once we have the proper medication and correct dose fine-tuned for the patient, we can usually control the seizures completely with no drug side effects. It may take a little while, but the effort will be worth it for the individual to live life to the fullest.
What if the seizures don’t stop with medication?
About one-fourth of persons with epilepsy do not respond well to medications. When a person continues to have seizures despite trials of two or more medications, then sometimes epilepsy surgery is the answer.
Epilepsy surgery may be simply viewed as removal of the malfunctioning region of the brain that is generating the seizures. Just as other surgeries, such as hip and knee replacements, have become standard over the years, epilepsy surgery is now looked upon today as one of our most effective and beneficial treatments.
To establish whether one would qualify for epilepsy surgery, an epilepsy specialist would have to do a detailed study. But if seizures are difficult to control with medication alone, it may be beneficial to explore this with a specialist at a recognized epilepsy center.
Thanks to modern research, we now have many safe and effective treatments for epilepsy, so patients and families may move forward together with confidence. As facts replace myths, we see that epilepsy is not something to fear. It is something to understand and accept in our society, with respect for the many distinguished people whose lives are touched by it.
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Epilepsy is No Longer a Mystery originally appeared on usnews.com
