Modern medicine shares concepts “seizures” and “epilepsy”. There are two main types of seizures: epileptic or non-epileptic that are often also called psychogenic.
Epilepsy is a neurological disease in which brain activity is significantly increased. Epilepsy can be caused by trauma, infectious diseases or age-related changes in the brain function.
Epileptic seizures may appear regularly (more than once a week) or periodically.
Depending on the clinical manifestations and the brain area in which they started, epileptic seizures can be:
- with disorder of consciousness;
- without disorder of consciousness.
- absence (typical or atypical);
- tonic-clonic (myoclonic-atonic, myoclonic or myoclonic-tonic);
- myoclonic absences (tonic, atonic or clonical).
The main difference between non-epileptic seizures and epileptic ones lies in their etiology. Psychogenic seizures are related to psychiatric disorders. They can be caused by emotional distress or strong stress experienced in the distant or recent past.
Normal brain activity is maintained in psychogenic seizures, nevertheless, they can be very similar to epileptic. Because of similarity of external manifestations of non-epileptic and epileptic seizures, they are very easy to confuse. To determine an exact diagnosis, EEG-video monitoring is recommended to perform. Pharmacotherapy is prescribed for effective management of epileptic seizures.
Criteria for choosing the most effective anticonvulsant drug are type, frequency and intensity of epileptic seizures:
- drugs of choice for relief of tonic-clonic seizures are Valproate (Depacon), Phenobarbitone (Luminal), Carbamazepine (Tegretol) and Phenytoin (Dilantin);
- Ethosuximide (Zarontin) is prescribed to reduce frequency or intensity of absence seizures;
- Clonazepam (Klonopin) is effective in treatment of myoclonic seizures, especially in children.
Other popular anticonvulsants that can be taken to treat any types of epileptic seizures are Diazepam (Q-Pam), Lamotrigine (Lamictal), Levetiracetam (Keppra), Vigabatrin (Sabril), Gabapentin (Neurontin), Oxcarbazepine (Trileptal), Topiramate (Topamax) and Felbamate (Felbatol).
Anticonvulsants do not contribute to relief of non-epileptic seizures. Psychotherapy, recreational therapy or pharmacotherapy is prescribed to facilitate or prevent psychogenic seizures.
Since mental disorders are common causes of non-epileptic seizures, various neuroleptics or antidepressants, such as Venlafaxine (Effexor) or Sertraline (Zoloft) can be taken to treat them.