Treatment of cryptogenic epilepsy

Drug treatment of epilepsy should be started after a repeated seizure. In case of a single seizure, the prescription of antiepileptic drugs cannot be justified, since they are potentially highly toxic and are not used for prophylactic purposes.

Preference is given to monotherapy. Modern research has proven that polytherapy with several drugs in small doses has not justified itself. The drug is selected strictly in accordance with the type of epilepsy and the type of epileptic seizure. Polytherapy can be justified only in the case of treatment-resistant forms of the disease, which include cryptogenic epilepsy. More than three antiepileptic drugs are not prescribed at the same time.

The medication is prescribed starting with a small dose, with a gradual increase until the therapeutic effect is achieved or the first symptoms of side effects appear. The defining property of the drug is its clinical effectiveness and tolerability.

In the absence of a therapeutic effect, it is gradually discontinued and replaced with another. It is not recommended to immediately switch to polytherapy without trying all the possibilities of monotherapy.
The use of drugs other than antiepileptic drugs is still debated. However, since cryptogenic epilepsy is difficult to treat, treatment regimens use both antiepileptic drugs that reduce the frequency and duration of seizures, and nootropic and psychotropic drugs, as well as those that have a complex effect.

In addition, operations, physiotherapy, special nutrition and vitamin therapy are used.

Antiepileptic drugs used in the treatment of epilepsy:

Carbamazepine (Finlepsin, Tegretol) is prescribed for generalized tonic-clonic epileptic seizures (major) and focal complex seizures, including those with secondary generalization. It is considered insufficiently effective for minor seizures. The pharmacological action has not been sufficiently studied, but its effectiveness has been proven. Hypothetically, the drug inactivates sodium channels in neuronal membranes, thereby reducing the generated action potential of neurons and the conduction of impulses in the synaptic cleft, which prevents the occurrence of serial discharges. This reduces the seizure readiness of brain cells and the likelihood of seizure development. In addition, its ability to activate chloride and potassium channels, restore the rhythm of potential-dependent calcium channels, and prevent the release of glutamate is assumed. Carbamazepine can be combined with other anticonvulsants. It is not prescribed to patients with blockades of various parts of the heart muscle, liver diseases, pregnant women sensitized to this drug.

The dosage is individual depending on age and the need for combination with other medications.

Levetiracetam is effective in generalized and focal seizures, the pharmacological action has not been studied enough, however, it has been established that it differs from the action of other anticonvulsants. Hypothetically, it binds to the protein component of synaptic vesicles SV2A, providing communication between neurons of the gray matter of the brain and spinal cord, which counteracts hypersynchronization of neuronal activity and leads to an anticonvulsant effect. The active substance of the drug also has a modulating effect on the receptors of inhibitory mediators - γ-aminobutyric acid and glycine through endogenous agents. The effect is selective - it does not affect normal neurotransmission, however, it inhibits excitation of glutamate receptors and epileptiform neuronal impulses induced by the GABA agonist bicuculline. It is not prescribed to patients with severe liver and kidney dysfunction, children under four years of age and adults over 65 years of age, as well as those with established sensitization to pyrolidone and its derivatives.

Ethosuximide (Suxilep, Pentidan) has proven itself to be effective in the treatment of absences. It inhibits synaptic impulses in the areas of the cerebral cortex responsible for motor skills and has an anticonvulsant effect. When taking the drug, the frequency of minor epileptic seizures and epileptiform activity of neurons decreases, and it inhibits peak-wave activity specific to disturbances of consciousness in absences. The drug can also be effective in cases of myoclonic seizures. It is not prescribed to patients sensitized to the active substance, with renal and hepatic dysfunction, porphyria, and blood diseases.

If traditional medications are ineffective, a relatively new antiepileptic drug, Lamotrigine, can be used. It is prescribed for focal and generalized seizures, in particular, for Lennox-Gastaut syndrome. It does not have such an impressive list of side effects as older drugs. Its mechanism of action has not been fully studied, but it is assumed that the drug stabilizes neuronal membranes by affecting potential-dependent sodium channels, and also stops the release of excess glutamate and aspartate without reducing their normal release. The drug is also effective for migraines, depersonalization/derealization syndrome, and other mental disorders, the symptoms of which can also be observed in epilepsy.

Gapabentin is a new word in antiepileptic treatment, it is a cyclic analogue of γ-aminobutyric acid. However, the active substance does not bind to GABA receptors, is not an inhibitor of the reuptake of this mediator, does not affect sodium channels, does not reduce the release of excitatory neurotransmitters. Its effect is absolutely new, but not known for certain. It has been established that it catalyzes the synthesis of γ-aminobutyric acid, and also opens channels for potassium ions in neuronal membranes. It also has an analgesic effect. It is used for focal seizures with transition to generalized ones. Contraindicated only in cases of patient sensitization to it.

Antiepileptic drugs have a long list of side effects, most often they are drowsiness, nausea, vomiting, skin rash. In order to prevent toxic effects during long-term treatment with high doses, periodic monitoring of the level of antiepileptic drugs in the blood is carried out.

The treatment regimen may also include Nootropil (Piracetam), which improves cognitive functions and increases the speed of thinking by normalizing metabolic processes in tissues and blood microcirculation in the vessels of the brain.

If the patient develops mental disorders, apathy, depression, hallucinations, neuroleptics or antidepressants may be prescribed.

To relieve pain in epilepsy, painkillers are prescribed, if necessary - sedatives. However, the prescription of the drug, according to international treatment standards, must be strictly justified.

The goal of epilepsy treatment is to stop seizures. If this goal is achieved and seizures are not observed for four years, drug treatment is discontinued.

Vitamins for epilepsy

Patients receiving anticonvulsant therapy need a balanced diet containing many vitamins and minerals, especially since treatment with anticonvulsants and the seizures themselves can cause a deficiency of certain vitamins and disruption of the blood formation process.

First of all, B vitamins are necessary for the normal functioning of the nervous system.

Thiamine or vitamin B1 is necessary for the high-quality transmission of nerve impulses. Its level decreases in people suffering from epilepsy, firstly, as a result of seizures, and secondly, as a result of taking anticonvulsants. Thiamine deficiency leads to anxiety, restlessness, insomnia, learning ability and speed of thinking, memory and concentration decrease, and coordination of movements is impaired. There is evidence that a significant deficiency of vitamin B1 can cause seizures. This vitamin is found in carrots, buckwheat, barley, rye and wheat grains, peas, legumes, and fresh greens.

Vitamin B2 (riboflavin) is needed by cerebral tissues, its deficiency leads to vascular insufficiency. Taking anticonvulsants causes an increased need for this vitamin in the body. In addition, without it, another vitamin of this group, B6, is poorly absorbed. Riboflavin is found in many products - cereals and grains, nuts, dairy products and green vegetables, beef, liver, herring and dark chocolate.

Nicotinic acid or vitamin B3 normalizes brain activity and is also found in many animal and plant products – liver, chicken breast, eggs, sea fish, potatoes, carrots, asparagus, celery, mushrooms.

Choline or vitamin B4 strengthens cell membranes, normalizes their structure, and acetylcholine is synthesized with its help. In general, our nervous system cannot function normally without this vitamin. Products containing it are not a deficiency. These are unrefined vegetable oils, nuts and seeds, egg yolks, liver, sprouted wheat grains, oatmeal, cabbage, and potatoes.

Other B vitamins are also necessary for the normal functioning of the nervous system: pyridoxine, folic acid, levocarnitine, cyanocobalamin. Vitamins of this group are also necessary for normal hematopoiesis, which is often disrupted when taking anticonvulsants. Products containing these vitamins are quite affordable: cereals, milk, cottage cheese, cheese, meat, eggs, fruits and vegetables.

The full spectrum of B vitamins is contained in brewer's yeast, in addition they also contain zinc, iron, magnesium, calcium, phosphorus, selenium, manganese, as well as vitamins H and D.

Vitamins A, C, E are no less necessary in the treatment of epilepsy, as antioxidants and immunomodulators. They are contained in many multivitamin-mineral complexes. However, it is much better to provide the patient with adequate nutrition, since vitamins obtained from food are almost impossible to overdose on, the body will remove the excess. It simply will not absorb them. But with synthetic ones, everything is more complicated.

In addition to a diet based on wholesome nutrition, epileptics reduce their salt intake to 10 g per day, liquid intake to 1-1.5 liters, and completely exclude spicy foods and alcoholic beverages.

Physiotherapy treatment

The treatment regimen for epilepsy uses general physiological procedures that have a calming effect on the central nervous system. The goal of such procedures is to reduce the excitability of brain nerve cells, normalize cellular metabolism, and remove excess fluid.

Ultraviolet irradiation, soothing baths, wet wraps, medicinal electrophoresis with calcium, magnesium, and sedatives may be prescribed.

Acupuncture and Vojta therapy (a kind of therapeutic exercise combined with massage) are used, which helps restore motor functions and reduce the number of seizures. The latter method is used to treat patients from a very early age, and good results are also noted in adult patients.

Physiotherapy treatment helps to restore the impaired functions of the central nervous system more quickly and efficiently, however, it is impossible to cure epilepsy using physical therapy alone.

Folk remedies

There are many folk medicine recipes for epilepsy or falling sickness. People have always tried to get rid of this serious disease and have come up with different methods.

For example, to stop an epileptic seizure, it is recommended to cover the patient with a black woolen cloth (a blanket, a rug). The main thing is that the patient does not guess that this is being done to him during the seizure. If you cover regularly, then the seizures should go away within a year.

Another way to stop a generalized epileptic seizure: when the patient has fallen, it is recommended to step on his little finger of the left hand.

At least these methods are completely compatible with drug therapy and do not even require prior consultation.

Traditional healers also recommend epileptics to fast for three days out of ten or switch to a raw food diet. It is unclear how fasting is compatible with a full diet, especially such a frequent one. But eating more raw vegetables and fruits is clearly good advice.

In case of epilepsy, it is recommended to make a compress on the spine. To do this, mix equal parts of olive oil and beeswax, melted together with the honey that was in it. Soak a long piece of fabric with this mixture, place it along the entire length of the spinal column and attach it with frequent transverse strips of adhesive tape. Walk with such a compress constantly, changing it when the mixture dries. The frequency of seizures should decrease, and then they will stop bothering the patient altogether.

Treatment with egg injections. Take a fresh fertilized chicken egg, wash it and wipe the shell with alcohol. Beat the egg into a sterilized jar (250-300 ml). While stirring the egg, gradually pour in 150 ml of 0.9% sodium chloride solution purchased at a pharmacy. Mix well until smooth, draw into a syringe and make an intramuscular injection. A single dose of the drug for patients 13 years and older is 5 ml, infants are given 0.5 ml, at one year of age - 1 ml, two to three full years - 1.5 ml, 4-5 full years - 2 ml, 6-7 full years - 3 ml, 8-9 full years - 3.5 ml, 10-12 full years - 4 ml. Injections are done once a week, on the same day and at the same time. For male patients - on Mondays, Tuesdays, Thursdays, for female patients - on other days of the week. More than eight such injections in a row cannot be done. It is recommended to take the treatment in spring or autumn. If necessary, the course can be repeated after a year (in severe cases, two courses per year are allowed).

This recipe is based on the method of Dr. Kapustin G.A. The living substance from the egg (literally taken out from under the chicken and used immediately) is a powerful immunostimulant that helps in cases of incurable diseases. Even in advanced cases. It can be added that in China and Japan, quail eggs are used to treat incurable diseases.

Despite its effectiveness, it is better not to conduct embryonic therapy at home; there are clinics that conduct courses of such treatment. The body's reaction to the introduction of foreign protein is unpredictable, usually the temperature rises (for some - up to 37.5℃, and for others up to 41℃).

Much safer is herbal treatment. For example, you can take the following course of treatment.

We prepare a collection of dried and crushed plant materials:

• one and a half parts each of lemon balm, peppermint, and elecampane root;
• three parts sweet woodruff and sweet clover;
• four parts hop cones.

Mix and brew two tablespoons of the mixture in a thermos with boiling water (500 ml) overnight. In the morning, strain and drink 2/3 cup of warm infusion half an hour before three meals. Together with the infusion, you need to take ½ teaspoon of flower pollen. At the same time, you need to drink another infusion of branches and leaves of black currant, bird cherry, rose hips. Both fresh and dry leaves are suitable. The branches are finely chopped, the leaves are crushed. The components are mixed in equal parts. Fill a three-liter teapot with this mixture, pour boiling water over it, close the lid and wrap it up for four hours. Then drink one and a half glasses of infusion six times a day (every four hours). Children's dose is half as much. The treatment is long, up to a year, but effective.

You can collect and dry the leaves of the parasitic plant mistletoe. Brew them in the following proportions: a liter of water per 10 tablespoons of crushed dry leaves. Boil over low heat for 10 minutes. Strain. Soak an old linen sheet in the decoction. Squeeze lightly, wrap the patient, put him in a bed covered with oilcloth, cover him and let him sleep until the morning (until the sheet dries). Repeat the procedure for a long time, until a long-term remission occurs.

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Homeopathy

Epilepsy is a fairly serious disease of the nervous system; modern medicine denies the possibility of dealing with it only with homeopathy.

However, this is a controversial issue. Homeopathic treatment of epilepsy does not recognize the suppression of seizures, on which treatment with anticonvulsants is based, because even stopping their use does not guarantee the absence of personality changes.

Classical homeopathy does not use drugs with targeted anticonvulsant action to treat epilepsy. When prescribing drugs, many factors are taken into account. For the treatment to be successful, it is necessary to consult a doctor who has experience in using homeopathic drugs, a specialist in this field of medicine. Homeopathy can usually give good results even in cases where official medicine is powerless.

In addition, there are homeopathic preparations produced by the pharmaceutical industry. They lack individuality, but dilutions in small doses of active substances do not cause harmful side effects. These preparations have a mild effect and can be combined with drugs, help to relieve the side effects of antiepileptic drugs, reduce the frequency and severity of attacks, and help reduce the doses of anticonvulsants.

Hyperexcitation of the central nervous system can be stopped with the help of Valerian-heel drops, they can be used in the period preceding the attack, when the patient feels anxious, worried, has a headache, is irritated or depressed. If the drug is used at the time of the prodromal aura, it may even be possible to prevent the attack. Although this drug is intended for course use. The drops contain eight components, including:

Valerian (Valeriana officinalis) – used for anxiety disorders, neurasthenia and increased excitability, if the patient feels as if he is in a dream, seems to be a different person, for panic attacks, headaches, nervous tics;

St. John's wort (Hyperiсum perforatum) is the main homeopathic antidepressant;

Ammonium bromide (Ammonium bromatum) is a remedy for meticulous, pedantic, idealistic neurasthenics, an antidepressant, used for epilepsy, when the aura begins with discomfort in the stomach or suffocation;

Potassium bromide (Kalium bromatum) – fear of mental disorder, paresthesia, anxiety, overexcitation, convulsions, used for epilepsy as a single drug;

Sodium bromide (Natrium bromatum) – eliminates loss of strength.

Picric acid (Acidum picrinicum) – relieves the effects of mental and nervous fatigue;

Common hops (Humulus lupulus) – used for clouded consciousness with preserved mental functions;

Melissa officinalis – neuroses and neurasthenia, as an immunostimulant;

Oats (Avena sativa) – nootropic action;

Hawthorn (Crataegus) – improves blood circulation in the cerebral vessels, soothes;

Chamomile (Chamomilla reсutita) – sedative effect;

Prescribed to children from the age of two, five drops diluted in 100 ml of water, upon reaching the age of six, ten drops are dripped into water per dose, from the age of twelve - an adult dose of 15 drops, at night it can be increased to 20 drops. The frequency of administration is three times a day, half an hour after it you can eat. If desired, you can take the required dose 60 minutes after eating.

To improve cerebral circulation, normalize metabolic processes, slow down mental and intellectual degradation, such a drug as Cerebrum compositum will help. This is a whole homeopathic composition, including 26 components of different origin, among which are black henbane (Hyoscyamus niger), St. Ignatius beans (Ignatia), citvar seed (Cina), potassium dichromate (Kalium bichromicum) and phosphate (Kalium phosphoricum), used in homeopathic practice as monopreparations for the treatment of epileptic seizures, as well as other substances that help restore and normalize brain function.

The drug is injectable and is used intramuscularly, subcutaneously and intradermally, and, if necessary, intravenously.

Injections are given one to three times a week. A single dose for patients aged six years and over is a whole ampoule, for children aged 1-2 years the ampoule is divided into four to six parts, for 3-5 years – into two or three parts.

You can use the solution for oral administration by diluting the contents of the ampoule in a quarter glass of clean water. The portion should be drunk during the day, divided into equal parts and held in the mouth before swallowing.

Nervo-heel tablets can help to be prescribed to a patient for the treatment of epilepsy. The complex includes:

Scabies nosode (Psorinum-Nosode), St. Ignatius beans (Ignatia), substance from the ink bag of cuttlefish (Sepia officinalis) - homeopathic antidepressants, also used in the treatment of schizophrenia, epilepsy and other mental pathologies;

Phosphoric acid (Acidum phosphoricum) – used for symptoms of mental exhaustion, emotional shock, memory loss, suicide attempts;

Potassium bromide (Kalium bromatum) – fear of mental disorder, paresthesia, anxiety, overexcitement, convulsions;

Valerian-zinc salt (Zincum isovalerianicum) – insomnia, convulsions, other manifestations of dysfunction of the nervous system.

From the age of three, it is used sublingually, one whole tablet at a time, the scheme for relieving acute conditions is: taking a single dose at fifteen-minute intervals, but no more than eight times in a row, then every eight hours half an hour before meals or an hour after them.

For children under three years of age, the tablet is divided in half for one dose.

After the use of complex allopathic therapy with antiepileptic drugs to eliminate the consequences of massive drug intoxication, as well as to strengthen the immune system, restore respiratory and reparative, metabolic processes in the tissues of the brain, liver, kidneys and other organs, Lymphomyosot, PsoriNokhel N are prescribed - drugs in the form of drops for oral administration. The second drug also has a moderate anticonvulsant effect.

In complex treatment, it is possible to use drugs that prevent hypoxic processes in tissues and metabolic disorders, Ubiquinone compositum and Coenzyme compositum. These are injection drugs, however, the contents of the ampoules can be used for oral administration. The dose and frequency of administration are prescribed by the doctor.

Surgical treatment

Epilepsy is sometimes treated with surgery to eliminate the cause of the seizures. However, when the patient is diagnosed with cryptogenic epilepsy, they usually do not have specific hematomas, traumatic or congenital structural abnormalities, neoplasms, or vascular malformations that can be corrected with surgery.

And if surgical pathologies are detected, then the diagnosis is specified. It is cryptogenic epilepsy that is not treated surgically.