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Epilepsy Health Center

Working With Your Doctor for the Best Epilepsy Treatment

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Many people find that their epilepsy is controlled by just one medication. This is called monotherapy. Monotherapy has less risk of side effects than if you take more than one medication. It is also safer if you are planning to become pregnant. In some cases, though, one drug alone cannot control seizures. If this is true in your case, your doctor may want to try two or more drugs in combination -- polytherapy. Usually, you will start only one new medication at a time. This helps your doctor keep track of how well each one works, and whether there are any side effects.

What if medication cannot control your epilepsy? Doctors are learning more about treatment options that may help people with hard-to-control epilepsy. These include:

  • Surgery. Doctors have performed surgery for years to help patients with epilepsy. New surgical techniques have improved the outcomes. Depending on the type of seizure you have, if you have tried several medications without success, your doctor may recommend surgery.
  • Vagus nerve stimulation (VNS). A vagus nerve stimulator works a lot like a pacemaker. It is surgically implanted in the chest, and delivers short bursts of energy to the brain. Scientists have found that it reduces seizures by about 40% to 50%. It does not work in everyone. If your doctor recommends VNS, you will probably still need to take medication, but you may be able to reduce your dose.
  • Responsive neurostimulation device (RNS). This treatment option consists of a small neurostimulator implanted within the skull under the scalp. The neurostimulator is connected to one or two wires (called electrodes) that are placed where the seizures are suspected to originate within the brain or on the surface of the brain. The device detects abnormal electrical activity in the area and delivers electrical stimulation to normalize brain activity before seizure symptoms begin.

If you continue to have seizures while taking medication, there are several questions you can ask your doctor:

  • Are there any new drugs for epilepsy that might work for me?
  • Should I go to a special center for more testing?
  • Do I have the kind of epilepsy that might be treated by surgery?
  • Would my seizures respond to VNS therapy?

Having epilepsy can make it feel like you are not in complete control of your life. You can do your best to take back control by following these three steps: Work in partnership with your doctor. Keep track of information, such as when you have the seizures and the side effects of your medications. Ask questions. There are many resources available to help you manage your epilepsy and live a happy, healthy, productive life.

WebMD Medical Reference

Reviewed by Neil Lava, MD on July 20, 2014
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