Treatment Overview

Treatment can reduce or prevent seizures in most people who have epilepsy. This can improve quality of life. Controlling your epilepsy also lowers the risk of falling and other complications that can happen when you have a seizure.

First your doctor will figure out what type of epilepsy and what kinds of seizures you have. Treatment that controls one kind of seizure may have no effect on other kinds. Your doctor will also think about your age, health, and lifestyle when he or she plans your treatment.

It may take time for you and your doctor to find the right combination, schedule, and dosage of medicines to manage your epilepsy. The goal is to prevent seizures while causing as few side effects as possible. With the help of your doctor, you can weigh the benefits of a particular treatment against its drawbacks, including side effects, health risks, and cost.

After you and your doctor figure out the treatment that works best for you, make sure to follow your treatment exactly as prescribed.

Initial treatment

Initial treatment for epilepsy depends on the severity, frequency, and type of seizures and whether a cause for your condition has been identified. Medicine is the first and most common approach. Antiepileptic medicines do not cure epilepsy. But they help prevent seizures in well over half of the people who take them. For information about medicines for epilepsy, see Medications.

See information on:

Epilepsy: Taking Your Medicines Properly.

It is not always clear whether to begin treatment after a first seizure. It is hard to predict whether you will have more seizures. Antiepileptic medicines are not usually prescribed unless you have risk factors for having another seizure, such as brain injury, abnormal test results, or a family history of epilepsy.

Ongoing treatment

If epileptic seizures continue even though you are being treated, additional or other antiepileptic medicines may be tried.

In addition to medicines, other treatments may be added to help reduce the frequency and severity of epileptic seizures, including:

• Ketogenic diet, which is a high-fat diet that has been used with some success to treat people, especially children, who have severe, uncontrolled seizures. Some doctors may not support its use.
• Vagus nerve stimulation. The stimulator device is used with medicine or surgery.
• Brain surgery. Some people with epileptic seizures do not respond to medicine but have great success with surgery.

Surgery is not used just as a last resort to treat epilepsy. Although brain surgery may sound frightening, it can successfully reduce seizures that are harmful, severe, frequent, or do not respond to medicines. Surgery can greatly improve the lives of some carefully screened people who have epilepsy. If you would like to know if surgery is a good choice for you, talk with your doctor.

Treatment if the condition gets worse

If you have epilepsy with seizures that have not been controlled with medicines or other treatments, you may want to think about having surgery to reduce the frequency and severity of the seizures. While brain surgery may sound frightening, it can be effective in reducing epileptic seizures and can greatly improve the quality of your life. Surgery for epilepsy may involve removing an area of abnormal tissue in the brain (such as a tumor or scar tissue) or the specific area of brain tissue where seizures begin. For information about surgeries for epilepsy, see Surgery.

What to think about

Early treatment may reduce the risk of progressing to more frequent and severe seizures.

You are more likely to have additional seizures if you have had two or more seizures. Doctors usually recommend treatment in these cases.