What Are the Treatments for Epilepsy?

After you’re diagnosed with epilepsy, you have several ways to get treatment. Medication, a special diet, an implant that works on your nerves or brain, and surgery could all help you feel better.

Seizure Medication

Your doctor will likely want you to try this first. It works for about 7 out of 10 people with epilepsy. Epilepsy medications, sometimes called anti-seizure or anticonvulsant medications, change the way your brain cells work and send messages to each other.

The kind of medication your doctor suggests depends on a few things:

  • The type of seizures you have
  • How likely it is you’ll have more seizures
  • Your age
  • Your sex
  • Other medical conditions you have
  • If you want to get pregnant

Drugs that work for one person might not work for another. You might have to try more than one. Most people who take medication for epilepsy find a good fit on the first or second try.

You might have to start with a low dose and slowly add more. It depends which medication you take.

You’ll probably get a blood test before you start your medication. While you’re taking it, the doctor will want you to get blood tests to see how your body handles the treatment.

How often you need them depends on your type of epilepsy medication, other drugs you take, and any health conditions you might have.

Tell your doctor about the other medications or supplements you take, even if you buy them over the counter (without a prescription). Seizure medications can interact with other drugs and make them not work as well.

Side Effects

Some are more severe than others. Ask your doctor about your specific medication side effects. Depending on which medication you take, side effects may include:

  • Tiredness
  • Dizziness
  • Weight gain
  • Thinning bones
  • Rashes
  • Clumsiness
  • Trouble talking
  • Trouble remembering things
  • Trouble thinking
  • Mood changes
  • Weight loss

More serious side effects can be:

Call your doctor right away if you have suicidal thoughts. If you have any concerns about side effects from your medication, do not just stop taking the medication on your own or skip a dose without talking to your doctor first.

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How to Get Off Your Medication

Some people are able to stop their seizure medication. This should only be done with your doctor’s advice and help.

If you haven’t had any seizures in at least 2 to 4 years, your doctor may help you slowly stop your medication.

Some types of seizures only happen in children and younger teenagers. If you’re an older teenager or young adult, your doctor might think it’s safe for you to stop your medication.

Ketogenic Diet

This diet is high in fats and low in carbohydrates. Your doctor may suggest it, depending on the type of seizures you have. But it isn’t something you should try to do yourself. Talk to your doctor and a nutritionist first.

Usually the ketogenic diet is given to children when medication hasn’t helped their seizures, but some studies show that it can also work for adults.

It can make you feel sluggish at first. Later side effects may include:

Nerve Stimulation

There are two kinds of nerve stimulation:

Vagus nerve stimulation. This nerve runs from your chest and abdomen, through your neck, and up to the lower part of your brain. It controls things that are automatic in your body, like your heartbeat.

Your doctor will put a small device called a vagus nerve stimulator under the skin of your chest, and connect it to the nerve.

The device sends small bursts of electricity through the nerve to your brain. You’ll probably still have to take medication. This device can be adjusted by a neurologist at your appointments in order to find the settings that work for you. It does not work for everyone.

Responsive neurostimulation. This treatment involves  surgically implanting a small gadget called a neurostimulator. Your doctor puts it under your skull bone. It looks for patterns in your brain activity that can lead to a seizure. When the neurostimulator sees one of these patterns, it sends out a little pulse to interrupt it. Not every person is able to have this device, it is based on the type of epilepsy

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Surgery

There are two main kinds:

Resective surgery. The surgeon will remove the part of your brain that causes the seizures. This surgery is most often done when the part of the brain causing the seizures is very small, has very good boundaries, and doesn’t control things like your speech, movement, sight, or hearing.

Disconnective surgery. Instead of removing part of your brain, the surgeon will cut the paths between the nerves in your brain that are involved in your seizures.

WebMD Medical Reference Reviewed by Christopher Melinosky on July 24, 2019

Sources

SOURCES:

The Epilepsy Foundation: “Blood Testing,” “Choosing a First Medicine,” “Drug Interactions,” “How Medicines Work,” “If First Medicine Doesn’t Work,” “Ketogenic Diet,” “Responsive Neurostimulation,” “Seizure and Epilepsy Medicines,” “Stopping Medication,” “Vagus Nerve Stimulation (VNS),” “What’s First?”

Medscape: “Epilepsy and Seizures Medication.”

Mayo Clinic: “Epilepsy: Treatment.”

Yale School of Medicine Comprehensive Epilepsy Center: “How is epilepsy treated?”

UCSF Medical Center: “Epilepsy Treatment.”

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