In those with repeated seizures, it is vital for the doctor to be as clear as possible about their origin and type before prescribing drugs. This will minimise drug use and the risk of AED-induced seizures.
Certain types of seizures may be the result of tumours in the brain. However, the majority of cases are likely to have less easily definable origins. Indeed, some seizures may have nothing to do with the brain at all. For instance, in one Italian study, laboratory analysis showed that 77 per cent of epileptics showed the characteristics of coeliac disease (Lancet, 1992; 340: 439-43).
New evidence is emerging all the time of a deep connection between the brain and the ‘second’ brain (the complex nervous system located in the gut that mirrors the function of the central nervous system). Allergic reactions can occur in any ‘weak spot’ in the body.
The ability of AEDs to cause a worsening of seizures is not something most physicians are aware of. When a patient comes to them with a worsening of symptoms, the physician may be reluctant to remove the one thing - the drug - which may be causing the problem.
Epilepsy remains a baffling condition, but what is becoming increasingly clear is that drug treatment, while invaluable for a few, may be risky for a great many more. Like all drug treatments, it may make the problem much worse over the long run. Patients and their loved ones need to think very carefully about all their options once a diagnosis of epilepsy is made, and perhaps be more vocal over the need for proper diagnostic procedures to be carried out to determine what type of epilepsy is involved. Only then should the pros and cons of different treatment options be weighed up.
Pat Thomas