Dravet Syndrome Seizure Treatment Options People with Dravet Syndrome often experience a variety of different types of seizures, including prolonged ones. To help, there's Fintepla, a medication approved to treat seizures caused by Dravet syndrome. Fintepla Fintepla works by targeting the brain’s electrical activity, helping to reduce the number and severity of seizures. Doctors prescribe Fintepla when other medications haven’t been effective in controlling seizures. This treatment has shown positive results in many patients, making it an essential option for managing Dravet syndrome. Medications for Dravet Syndrome Seizures Clobazam: This drug is often prescribed alongside other treatments. It helps to control seizures by calming the brain and reducing electrical activity. Valproate: This medication is used to control a variety of seizure types. However, it is not always the best choice for younger children due to its potential side effects. Topiramate: Used to prevent seizures, this medication works by affecting the brain's electrical signals. [youmaylike] Doctors may need to try different combinations of medications to find what works best for the individual. It’s important for patients and their families to closely monitor the medications and any side effects. Dietary Approaches: The Ketogenic Diet For some individuals with Dravet Syndrome, medications may not be enough to control seizures. In these cases, dietary treatments, such as the ketogenic diet, can be very helpful. The ketogenic diet is high in fats and low in carbohydrates, and it forces the body to use fat for energy instead of carbohydrates. This change in metabolism can help reduce seizures. The ketogenic diet should only be followed under the supervision of a doctor or dietitian, as it requires careful planning to ensure that the person gets the proper nutrition. Some children with Dravet Syndrome may experience a significant reduction in seizures after starting the ketogenic diet. Vagus Nerve Stimulation (VNS) Vagus Nerve Stimulation (VNS) is another treatment option for Dravet Syndrome. This therapy involves implanting a small device under the skin in the chest. The device sends electrical signals to the brain through the vagus nerve, which can help reduce the frequency and severity of seizures. The device can be programmed to give a burst of electrical stimulation when a seizure is detected, helping to stop the seizure or make it less severe. VNS is often considered when medications and diet do not provide enough seizure control. It is typically used in combination with other treatments. Surgical Options In some rare cases, surgery may be an option for treating Dravet Syndrome. If seizures are only coming from one part of the brain and medications do not help, surgery may be performed to remove that part of the brain. This surgery is called a lobectomy or hemispherectomy, depending on the area of the brain involved. Surgical options are not suitable for everyone, and doctors will carefully evaluate the risks and benefits before recommending surgery. Supportive Therapies While medications and other treatments are important for managing seizures, other therapies can be helpful in improving quality of life for individuals with Dravet Syndrome. These may include: Physical therapy: This helps improve mobility and strength, which can be affected by seizures. Occupational therapy: Helps individuals learn daily skills to live as independently as possible. Speech therapy: Helps improve communication skills, which may be affected by seizures. Ongoing Monitoring and Care Managing Dravet Syndrome requires ongoing care. It is essential for individuals with the condition to have regular check-ups with their doctor to monitor their progress and adjust treatment plans as needed. Seizures can sometimes change over time, and it is important to stay flexible with treatment options. The Best Approaches to Seizure Control While Dravet Syndrome can be challenging, there are many treatment options available. With the right combination of medications, diet, therapy and support, people with Dravet Syndrome can lead fuller lives. It is important to work closely with healthcare providers to find the best treatment plan for each individual.
Diabetic Macular Edema Explained
Diabetic macular edema (DME) is a complication of diabetes that occurs when excess fluid starts to build up in the eye's macula. The macula is the part of the eye that allows us to focus and see fine details, and it is located in the retina, which is full of blood vessels. High blood sugar levels can damage the retina's blood vessels. The damaged blood vessels then begin to leak fluid, thereby causing swelling and other complications. This damage is called retinopathy and generally develops over time.
What Causes Diabetic Macular Edema?
As earlier stated, DME usually occurs due to high blood sugar levels. Other factors such as high blood pressure and high cholesterol levels can also contribute to blood vessel damage. In other instances of diabetes, pregnancy may also increase the risk of developing DME.
Risk Factors
Since DME results from high blood sugar levels, it is common for people with diabetes, especially uncontrolled diabetes, to be at risk for DME. Additional risk factors that can lead to DME include:
- Poor blood sugar management
- High cholesterol
- High blood pressure
- Kidney disease (nephropathy)
- Sleep apnea
- Pregnancy
Associated Symptoms of Diabetic Macular Edema
In its early stages, there may be no symptoms. However, if you have diabetes, it is important to see an eye care doctor every year so they can examine your eyes for any changes. If you also notice any sign of retinopathy or DME, early treatment can prevent or restore vision loss. Let’s take a look at some of the common signs and symptoms of diabetic macular edema:
- Blurry or blocked central vision
- Distorted or "wavy" central vision (called metamorphopsia)
- Seeing floaters or strings of floaters in your vision
- Blind or dark areas or spots in your field of vision
- Difficulty reading at any distance
- Colors appear more washed out than usual
When to Call the Doctor
Call your eye doctor right away if you notice any of the above symptoms. Be sure to tell your eye doctor if you have any of the following symptoms:
- Blurry vision
- Seeing colors that look washed out
- Seeing more floaters in your vision
- Double vision
Diagnosis and Different Treatment Options
Diabetic macular edema can be diagnosed through a comprehensive eye examination. There are effective treatments available for DME. Be sure to talk to your doctor to find the right option that will work for you. If you have received a DME diagnosis, ensure that you start treatment quickly to help prevent long-term eye damage and vision loss. Your doctor can recommend any of the following treatments:
Laser Therapy
Laser therapy involves the use of tiny lasers to target damaged areas in the retina. This process seals leaking blood vessels and prevents abnormal blood vessel growth. Laser therapy is effective in maintaining your current vision level and helps prevent further loss of vision. You’ll likely need several laser treatments overtime to repair eye damage and may require additional treatments if more eye damage occurs.
Anti-VEGF Shots
When you have DME, your body tends to produce a protein called VEGF in excess. When this happens, your blood vessels begin to grow too quickly; so, they are weak and leak blood and fluid into your retina and macula.
There are three types of anti-VEGF medicines usually used for DME; they include aflibercept (Eylea), bevacizumab (Avastin), and ranibizumab (Lucentis). These Anti-VEGF shots help to inhibit the effects of the VEGF protein. However, anti-VEGF shots may not be helpful for everyone and should not be used during pregnancy.
Focal-Grid Macular Laser Surgery
This treatment type works by sealing blood vessels in your retina to slow leaking and bring down swelling. If you have DME in both eyes, your doctor will treat one eye at a time, usually within a few weeks. In some cases, a laser may be used along with anti-VEGF shots if the shots alone are not helping.
Corticosteroids
These drugs are often called steroids and are used to target inflammation. They are usually prescribed to help lessen swelling in your retina. Steroids are usually not as effective as anti-VEGF shots, and they can cause other eye problems, like cataracts and glaucoma. They are not traditionally given as first treatment.
NSAID Eye Drops
Doctors sometimes use eye drops as a preventive measure for DME before or after you have eye surgery. These drugs are called non-steroidal anti-inflammatory drugs (NSAIDs) because they help fight inflammation like steroids but do not have the same side effects. Doctors usually prescribe NSAIDs to prevent or ease swelling.
Can Diabetic Macular Edema Be Prevented?
You may not be able to prevent macular edema if you have diabetes, a pre-existing eye condition, or have suffered an eye injury in the past. However, you can follow the nutrition and lifestyle recommendations from your health care provider to avoid developing diabetes in the first place. You will likely be advised to do the following:
- Keep your blood sugar level under control. Check your blood sugar level several times a day (ask your doctor exactly how often). The American Diabetes Association recommends people with diabetes keep their A1C levels under 7%.
- Stop smoking or do not start. Ask your doctor for help quitting. Smoking increases your risk of diabetic retinopathy, age-related macular degeneration, and blocked retinal blood vessels. All those toxins damage the eyes’ tiny vessels.
- Exercise often. Try not to go more than two days between exercising. If you do, the glucose-metabolizing effects of physical exercise will wear off.
- Eat healthy. Follow your doctor's nutritional guidelines but, in general, avoid junk food and fast food, and try to eat more fresh fruits and vegetables, especially dark, leafy greens such as spinach, kale, and collard greens.