What are the current treatments for epilepsy?

  Medication: It is the main method of epilepsy treatment. With the rational application of new antiepileptic drugs, about 70% of patients with epilepsy are able to control their seizures satisfactorily. Therefore, epilepsy is not a lifelong disease as previously thought, and most patients can be cured.  Surgical procedures: These include drug-refractory partial epilepsy with or without intracranial lesions. Examples include medial temporal lobe epilepsy with or without hippocampal sclerosis, cortical developmental malformations, benign tumors, and softening foci. The effectiveness rate is about 60-80%.  Ketogenic diet therapy: mainly used in infants and children with refractory epilepsy. Epilepsy is treated by simulating starvation therapy.  Neuromodulation therapy: functional magnetic stimulation and functional electrical stimulation are used to repair the malfunctioning nervous system. This is a completely new treatment. Neuromodulation therapy for epilepsy has become one of the most promising treatments. The techniques include: transcranial magnetic stimulation (rTMS), vagus nerve stimulation Potential advantages of neuromodulation: the modulatory effect is reversible; the parameters of action are adjustable depending on the patient’s needs; stimulation of a single target of action may also affect multiple epileptogenic foci; functional area epileptogenic foci can also be treated with neuromodulation.  Which epilepsy patients are more suitable for rTMS treatment?  The article “Antiepileptic effects of low frequency repetitive transcranial magnetic stimulation: A meta-analysis” published in 2011 in Epilepsy Res. “showed that patients with cortical dysplasia or epileptogenic foci located in the cortex had better efficacy, with an effectiveness of 0.71, 95% CI of 0.30-1.12, with significant clinical efficacy. Low-frequency rTMS stimulation of focal cortical epileptogenic foci has been shown to significantly reduce the number of seizures (71% seizure reduction during treatment) and even achieve complete seizure freedom in some patients (66%).  Safety of rTMS Most patients tolerate it well, except for a few patients who experience seizures during rTMS, and the reported adverse effects are usually mild and transient, such as headache, dizziness, and nonspecific discomfort. No reports of rTMS-induced status epilepticus or life-threatening seizures have been reported.