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Suggest Treatment For Scars In The Brain Causing Seizures
Question: My 19-year-old son has had three seizures within 12 hours. He went through MRI and the doctor called us today to say he has scars in his brain and he may have been born with them. They are so many that he cannot go under surgery. Do you think those scars can evolve to something worse? Do you think this problem can shorten his life?
Brief Answer:
The scars won't evolve.
Detailed Answer:
I read your query carefully and I understand that you must be very concerned.
I am not sure whether these 3 seizures are his first ones and you're inquiring about the seizure effects as well, or whether he was suffering from epilepsy before but performed the MRI now and you are asking only about these scars.
In terms of the scars themselves they don't represent a direct risk anymore, since the doctors have used the term scar there is no active process anymore, only a remnant of an old lesion, won't evolve into anything
So the effect of the scars is related to the seizures which they predispose for. Unfortunately seizures do represent a risk. Whether they will shorten his lifespan depends on how well his seizures will respond and be controlled by the treatment, the less frequent the better the outcome. The added risk in epilepsy patient can be due to injuries from sudden seizures (drowning, falls, burns, driving accidents), epileptic status (when seizures can't be stopped) or from a rare phenomena called SUDEP (Sudden Unexpected Death in Epilepsy) the mechanisms of which are not well understood (but it's rare).
Of course I am talking about the general average lifespan of epilepsy patients, your son may well live a long active life, which I heartily hope.
I remain at your disposal for further questions.
The scars won't evolve.
Detailed Answer:
I read your query carefully and I understand that you must be very concerned.
I am not sure whether these 3 seizures are his first ones and you're inquiring about the seizure effects as well, or whether he was suffering from epilepsy before but performed the MRI now and you are asking only about these scars.
In terms of the scars themselves they don't represent a direct risk anymore, since the doctors have used the term scar there is no active process anymore, only a remnant of an old lesion, won't evolve into anything
So the effect of the scars is related to the seizures which they predispose for. Unfortunately seizures do represent a risk. Whether they will shorten his lifespan depends on how well his seizures will respond and be controlled by the treatment, the less frequent the better the outcome. The added risk in epilepsy patient can be due to injuries from sudden seizures (drowning, falls, burns, driving accidents), epileptic status (when seizures can't be stopped) or from a rare phenomena called SUDEP (Sudden Unexpected Death in Epilepsy) the mechanisms of which are not well understood (but it's rare).
Of course I am talking about the general average lifespan of epilepsy patients, your son may well live a long active life, which I heartily hope.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He has had his first seizure (some weeks ago) and we called 911. One week after, he had three seizures within one day. When that occurred, the doctor prescribe the medication. Since then, he has not yet had any seizure up to now. In the meantime he went through EEG and MRI, and the doctor told us today he has many scars in his brain, that could be treated by medication or a device (I think similar to vns). What do you think?
Brief Answer:
Levetiracetam is a good choice.
Detailed Answer:
Thank you for providing some more info.
Levetiracetam is a popular drug these days because of both its efficacy and its few side effects. Of course it's been only two weeks, so while it's a good start it's too early to judge its seizure control efficacy in the coming months/years, only time will tell.
I am not sure what device the doctor referred to, I believe it was for seizure control not for the removal of the scars. There are many devices under study these days such as vagal nerve stimulation, deep brain stimutlation, responsive neurostimulation, transcutaneous trigeminal nerve stimulation, transcranial magnetic stimulation and transcranial direct current stimulation. Most of them are emerging therapies and time will be needed to study their efficacy.
Anyway it's too early to speak about them, their use is considered only if several antiepilaptic drugs fail, for now you are trying only the first antiepileptic drug and it's working till now.
I hope to have been of help.
Levetiracetam is a good choice.
Detailed Answer:
Thank you for providing some more info.
Levetiracetam is a popular drug these days because of both its efficacy and its few side effects. Of course it's been only two weeks, so while it's a good start it's too early to judge its seizure control efficacy in the coming months/years, only time will tell.
I am not sure what device the doctor referred to, I believe it was for seizure control not for the removal of the scars. There are many devices under study these days such as vagal nerve stimulation, deep brain stimutlation, responsive neurostimulation, transcutaneous trigeminal nerve stimulation, transcranial magnetic stimulation and transcranial direct current stimulation. Most of them are emerging therapies and time will be needed to study their efficacy.
Anyway it's too early to speak about them, their use is considered only if several antiepilaptic drugs fail, for now you are trying only the first antiepileptic drug and it's working till now.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
And what do you mean when by the "general average lifespan of epilepsy patients"? Is it usually shorter that the lifespan of a normal person without epilepsy?
Brief Answer:
Read below
Detailed Answer:
In general compared with the general population the lipespan of an epileptic patient is shorter than a nonepileptic one, because of the risks I mentioned above related to the seizures.
I don't want you to panic from numbers though. Every individual is unique. The studies consider all epilepsy patients put together, including people who have many seizures a day despite trying multiple treatments, people with epilepsy in the setting of other accompanying conditions etc. If there is a good response to treatment without seizures or only rare ones your son has every possibility of living a long normal life.
Wishing you good health!
Read below
Detailed Answer:
In general compared with the general population the lipespan of an epileptic patient is shorter than a nonepileptic one, because of the risks I mentioned above related to the seizures.
I don't want you to panic from numbers though. Every individual is unique. The studies consider all epilepsy patients put together, including people who have many seizures a day despite trying multiple treatments, people with epilepsy in the setting of other accompanying conditions etc. If there is a good response to treatment without seizures or only rare ones your son has every possibility of living a long normal life.
Wishing you good health!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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