EPILEPSY: THE FACTS-NEW DRUGS AND SURGERY
In the past, many new drugs were tested on their ability to stop experimental seizures in animals. This is what happened with drugs such as phenobarbitone, phenytoin, carbamazepine, and sodium valproate. Because such a drug’s action is not just on stopping seizures, other effects, some adverse, are common. More recently through biochemical and neurological research, a number of chemicals, have been identified which appear to have a crucial role in epilepsy. One of these, gamma aminobutyric acid (GABA), acts by inhibiting or stopping seizures. One new drug, vigabatrin, has been developed to increase the concentration of this substance within the brain, and so prevent seizures from happening. Other neurotransmitters called glutamate and aspartate can stimulate a seizure, or make a seizure more likely to happen. Lamotrigine is a new drug designed specifically to reduce the concentration of these substances in the brain and therefore prevent seizures. There are other drugs which are being assessed in a similar way, and which may become generally available in the next few years. Examples include gabapentin, oxcarbazepine, topirimate, remacemide, and zonisamide. It is to be hoped that such drugs
‘tailor-made’ to interfere with specific chemical processes will be associated with fewer
side-effects, and will therefore be safer, and more acceptable to patients.
Surgery-It is likely that the surgical treatment of epilepsy will increase over the next decade. This is because scanning and EEG techniques will become more advanced, and more widely available, thereby enabling the identification of subtle abnormalities within the brain responsible for seizures, some of which will be capable of being removed surgically. It is likely that more specialist centres will become established to perform such surgery, and the operations will be undertaken at a younger age.
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