Epilepsy

Epilepsy refers to the chronic disorder that causes unprovoked and recurrent seizures. According to the 2015 data from the Center for Disease Control, around 1.2% of the population in the United States had active epilepsy which was composed of 3 million adults and 470,000 children.

For most cases of epilepsy, the cause cannot be identified but various factors may lead to triggering seizures. Possible causes of epilepsy include a traumatic brain injury, scarring on the brain after an injury, serious illness or very high fever, stroke, vascular diseases, lack of oxygen in the brain, brain tumor, cyst, dementia, Alzheimer’s disease, maternal drug use, prenatal injury, brain malformation, lack of oxygen at birth, AIDS, meningitis, genetic disorders, or neurological diseases.

The main symptom of this disorder are the seizures, which can be classified into two general types which are generalized seizures and the focal (or partial) seizures. The former affects the whole brain while the latter affects just one part of the brain. The manifestation of the main symptom differs from person to person and the type of seizure. Seizures are further classified into more specific types as discussed below.

Focal Seizures

Simple partial seizures

Simple partial seizures don’t involve the loss of consciousness. Symptoms include alterations in the senses, dizziness, and tingling and twitching of limbs.

Complex partial seizures

Complex partial seizures involves the loss of awareness or consciousness. Other symptoms include staring blankly, unresponsiveness, and performing repetitive movements.

Generalized Seizures

Absence seizures

Absence seizure is a type of generalized seizure which causes a blank stare. Usually involving a short loss of awareness, it might also cause repetitive movements like lip smacking or blinking.

Tonic seizures

Tonic seizures cause muscle stiffness.

Atonic seizures

Atonic seizures leads to loss of muscle control.

Clonic seizures

Clonic seizures are determined by the repeated jerky muscle movements of the face, neck, and arms.

Myoclonic seizures

This type of seizures cause a spontaneous quick twitching of the arms and legs.

Tonic-clonic seizures

This type of seizures is characterized by the stiffening of the body, shaking, loss of bladder or bowel control, and loss of consciousness.

A number of factors can trigger the epileptic seizures such as lack of sleep, illness, fever, stress, bright lights, flashing lights, patterns, caffeine, alcohol, medication, drugs, skipping meals, overeating, or specific food ingredients.

Conventional Treatment

Currently, there is no cure for epilepsy. However, this can be managed with treatment. Treatment options include antiepileptic medications, implantation of a vagus nerve stimulator, ketogenic diets, and brain surgery.

Antiepileptic medications or anticonvulsant drugs work by altering and reducing the excessive electrical activity (or excitability) of the neurons that normally causes the seizure. Below are a list of antiepileptic drugs commonly prescribed to patients with their respective side effects:

Levetiracetam

Usage of levetiracetam could cause side effects such as drowsiness, dizziness, unusual tiredness, or weakness. In some cases, it could also lead to some serious side effects such as loss of coordination, mental/mood changes (eg. irritability, aggression, agitation, anger, and anxiety), and signs of infections.

Lamotrigine

Aside from preventing and controlling seizures, lamotrigine is also prescribed to patients with bipolar disorder to help prevent extreme mood swings. The drug is thought to work by restoring the balance of certain substances that are naturally found in the brain.

Usage of the drug may cause side effects such as dizziness, drowsiness, headache, blurred or double vision, loss of coordination, shaking (tremors), nausea, vomiting, or upset stomach. In some cases, it may also cause depression, suicidal thoughts/attempts, and other mental/mood problems.

Topiramate

Aside from preventing and controlling seizures, topiramate is also prescribed to patients in order to prevent migraine headaches and decrease the frequency. Usage of this drug might cause tiredness, drowsiness, dizziness, loss of coordination, tingling of the hands and feet, loss of appetite, bad taste in the mouth, diarrhea, and weight loss. It might also cause mental problems such as confusion, slowed thinking, trouble concentrating, nervousness, memory problems, or speech and language problems. In some cases, it might also cause depression, suicidal thoughts/attempts, and other mental/mood problems.

Valproic acid

Valproic acid is used not only for treatment of seizure disorders like epilepsy, but it is also prescribed for patients with mental/mood conditions, and the prevention of migraine headaches. This drug works by restoring the balance of certain natural substances in the brain.

This drug might cause side effects such as diarrhea, dizziness, drowsiness, hair loss, blurred/double vision, change in the menstrual period, ringing in the ears, shakiness (tremor), unsteadiness, and weight changes. In some cases, it might also cause depression, suicidal thoughts/attempts, and other mental/mood problems.

Carbamazepine

Aside from preventing and controlling seizures, carbamazepine can also relieve certain types of nerve pain. The medication works by reducing the spread of seizure activity and restoring the balance of nerve activity.

However, usage of the drug might cause side effects such as nausea, vomiting, dizziness, drowsiness, constipation, dry mouth, and unsteadiness. In some cases, patients might experiences serious side effects such as severe or prolonged duration of headaches, liver problems (indicated by continuing nausea/vomiting, loss of appetite, stomach or abdominal pain, jaundice, and dark urine), kidney problems (indicated by the changes in the amount of urine), mouth sores, fainting, fast/slow/irregular heartbeat, unusual eye movements, vision changes (eg. blurred vision), joint pain, swelling of the ankles or the feet, pain, redness and swelling of the arms or legs, numbness or tingling of the hands or feet, and low levels of sodium in the blood (indicated by extreme drowsiness, mental or mood changes including confusion and seizures). It might also cause depression, suicidal thoughts/attempts, and other mental/mood problems.

Ethosuximide

Ethosuximide works by controlling the abnormal electrical activity in the brain during the occurrence of a seizure. Usage of the drug might cause side effects such as drowsiness, tiredness, headache, stomach upset, loss of appetite, nausea, vomiting, weight loss, diarrhea, and loss of coordination. It might also cause depression, suicidal thoughts/attempts, and other mental/mood problems.

Epilepsy and Medical Marijuana

Because of legalization issues, there is still very limited research on the effect of medical marijuana use on treating the symptoms of epilepsy. The results of the initial studies have shown that medical marijuana is promising in managing epilepsy.

In one study, it was found that about 37% of patients who were involved in the testing have said that their seizures have reduced. Meanwhile, 2% of the patients reported that they were completely free of seizures. However, about 80% of the patients involved also reported to have experienced side effects such as fatigue, diarrhea, and sleepiness. Such side effects are manageable and will usually go away on its own.

It was shown that strains with high cannabidiol content and lower tetrahydrocannabinol are more beneficial for patients with epilepsy. Two of the strains that fit this profile are Charlotte’s Web (sativa) and Haleigh’s Hope (hybrid), which are currently recommended and used for patients who do not respond to other forms of epilepsy treatment.