How is epilepsy treated?

Medication

Once a diagnosis of epilepsy is made, a physician will decide the best treatment strategy. Seizures can be controlled with medications in the majority (about two-thirds) of patients with epilepsy. Specific medications are used for specific seizure types, and some medications work in a number of kinds of seizures.

Here are some helpful hints to improving your epilepsy treatment

  • Tell a physician immediately if you don't feel well when you take your medication, because in most cases, it is possible to adjust the medication or change to another one. It is important to always first talk to your physician before stopping or changing your seizure medication.
  • Keep a "seizure log" or write down on a calendar when you have a seizure and any relevant details to bring to your appointment. This will help your physician help you better.
  • Keep in your wallet or purse at all times a complete list of your medications with the names, doses, and times you take them.
  • Check with your physician or pharmacist before taking any new medications, over the counter drugs or herbal treatments to make sure they will not interact with your seizure medication.
  • If you start having more frequent or severe seizures than usual, call your physician.
  • Make sure you understand how you can reach your physician when you have a problem.
  • Most importantly, when something is unclear to you, ask questions! You are the most important partner in your epilepsy treatment.

Non-pharmacologic therapy (treatment other than medications)

  • Other treatment options are available when medications are ineffective and disabling seizures continue. A Neurologist can determine which options are best for each patient. Here is a brief description of each:
    • Ketogenic Diet: A special diet rich in fats and low in carbohydrates which must be carefully administered by a Physician and Nutritionist. This option is used with severe and multiple types of generalized seizures most frequently in children.
    • Vagal Nerve Stimulator: This device is implanted in the chest wall and has a wire ("lead") which connects to a nerve in the neck. The device is programmed to deliver regularly timed electrical impulses to the nerve which are then relayed to the brain. This sometimes reduces seizures.

Epilepsy Surgery

    • Resective Surgery: For some patients, removal of the area of brain identified to cause the seizures can be performed. Extensive testing is necessary first to determine if this can be done safely.
    • Disconnection Procedures: For some patients with disabling seizures, surgical procedures can be performed to limit the spread of seizures. This type of surgery is performed when it is not safe to resect the seizure focus. Examples are callosotomy or multiple subpial transections.