When Seizure Types Change: Part II


If in fact an evaluation has been made that confirms your seizure type has changed you may need to change medications. If you are now having seizures when they had previously been controlled it may mean that the medication you were taking does not work for the type of seizure you are now having.

A thorough evaluation is needed, as discussed in the previous blog, which will provide information about your new seizure type, why you are having a new seizure type, what this means in terms of controlling your epilepsy; and it will aid in choosing treatment.

Medications are usually the first line of treatment for seizures. They are chosen based upon seizure type. Your medication may need to be changed or a new medication may need to be added if your seizure type has changed.

Other things to think about when choosing a new medication are:

  • previous response to medications of the same class,
  • your age,
  • gender,
  • weight, allergies,
  •  and possible interactions with other medications that you are taking.

 The following is a list of some seizure types and some syndromes.

Absence, Atonic, Simple partial, Complex partial, Generalized, Generalized tonic-clonic, Myoclonic, Secondary, generalized tonic-clonic, Tonic, Infantile spasms, Lennox-Gastaut Syndrome. This is not a complete list of all seizure types.

The International League Against Epilepsy (ILAE) is currently proposing a new method to classify seizure types. Focal seizures are described according to the way they look to the observer. Seizures causes include genetic; structural/metabolic or unknown.

Below is a list of antiepileptic medications (drugs), commonly called AEDs, using generic names:

ACTHCarbamazepine, ClobazamClonazepamClorazepateDiazepam, Diazepam Rectal Gel,  Divalproex sodiumEthosuximide, Phenytoin Sodium,   Ezogabine,  Felbamate, GabapentinLacosamideLamotrigineLevetiracetamLorazepam, OxcarbazepinePhenobarbital , PregabalinPrimidoneRufinamide, TiagabineTopiramate, Valproate, Vigabatrin, and  Zonisamide.

Some of these medications are used only for very specific seizure types while others may be used for a variety of seizure types. Your health care provider should discuss with you why one medication would be the best choice for you.

It may be that for you the medication does not control seizures. There are other options for treatment which include surgery, the use of the vagus nerve stimulator in conjunction with medication and the ketogenic diet is also a good treatment in certain situations.