Table of ContentsView AllTable of ContentsPrescriptionsSurgeriesSpecialist-Driven TherapiesDietsLifestyleComplementary MedicineFuture of TreatmentFrequently Asked QuestionsNext in Epilepsy GuideCoping With Epilepsy
Table of ContentsView All
View All
Table of Contents
Prescriptions
Surgeries
Specialist-Driven Therapies
Diets
Lifestyle
Complementary Medicine
Future of Treatment
Frequently Asked Questions
Next in Epilepsy Guide
Epilepsyis usually treated with prescription drugs to control seizures, but it may also involve surgery, nerve stimulation devices, or special diets, depending on your situation and how well your seizures are controlled with medication. Multiple new epilepsy treatments are on the horizon, as well.
Regardless of the treatment course you follow, the end goals are the same: to allow you to live your fullest life, prevent seizures, and minimize the effects of managing your disorder. Finding the right path for you can take some time.
Verywell / Emily Roberts
Once you’re diagnosed with epilepsy, your healthcare provider’s first act will likely be prescribing anti-seizure medication (antiepileptic drugs) to control yourseizures. Most people’s seizures can be controlled with just one medication, but some people may need more.
The kind and dosage your healthcare provider prescribes for you will depend on many factors, such as your age, the type and frequency of your seizures, and other medications you’re taking. It can take some trial and error to find the best drug and dosage with the fewest side effects for you.
Some side effects may go away after you’ve been on the medication for a week or two and your body has had a chance to adjust. If they don’t taper off, or if they’re severe or bothersome, talk to your healthcare provider right away.
With some medications, missing a dose isn’t a problem. However, missing even a single dose of your anti-seizure medication may cause you to lose control of your seizures.It’s extremely important to take your medication exactly as prescribed and talk to your healthcare provider if you’re having any difficulties with it.
Many people are able to control their seizures with antiepileptic drugs and, after a few years without any seizures, can eventually stop taking them. Stopping your anti-seizure medication too early or on your own can create serious problems, so be sure to work with your healthcare provider on deciding if and when to stop treatment.
There aremore than 20 different typesof antiepileptic drugs available, including:
Epilepsy Medication: Types and Available Options
Generic Medications
In the United States,nine out of 10prescriptions are filled with generic drugs. However, generic antiepileptic medications are associated with some problems.
Even though they contain the same active ingredient as brand names, the inactive ingredients in generics may vastly differ between brands. The amount of medication that your body absorbs may also differ. Also, while uncommon, it’s possible to be allergic to a certain inactive ingredient.
The Epilepsy Foundationadvises caution when switching from brand name to generic medications or switching between generic brands. For people with difficult-to-control seizures, generic versions probably aren’t a good idea. However, if your seizures are generally well-controlled, a generic will likely be safe; just make sure that you talk to your pharmacist about getting your medication from the same manufacturer every time.
Always talk to your healthcare provider before making the jump to another brand or manufacturer. He or she may check the medication level in your blood before and after you switch to make sure you’re getting a therapeutic dose and, if not, adjust your dose or put you back on the brand name. Our Doctor Discussion Guide below can help you start that conversation.
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In about 30 percent of people with epilepsy, two or more medications, together or separately, fail to control seizures.That’s known as drug-resistant or refractory epilepsy. If you’re in this subgroup, your healthcare provider may bring up surgery.
Surgery is recommendedwhen you have a brain lesion, tumor, or mass that’s causing your seizures, as well as when you have focal seizures (only occurring in one part of your brain) that aren’t controlled with medications.
The right surgery for you will depend on what type of epilepsy you have as well as the results of your pre-surgical evaluation and testing. This evaluation and testing helps your healthcare provider locate the origins of your seizures and see how surgery may affect your everyday activities.
Testing may include electroencephalograms (EEGs), imaging tests to check for tumors or abscesses, and functional neurological testing to make sure that the surgery won’t affect abilities such as speaking and reading.
Surgery always has risks, so these must be weighed along with the benefits. For many people, surgery can significantly reduce or even stop seizures, but in others, it doesn’t help. Risks include changes in your personality or your ability to think, though these aren’t common.
If you do have surgery, even if you’re seizure-free, you’ll still need to take anti-epileptics in general for at least one year. Surgery may also make it possible for you to take fewer medications and/or reduce your dose, though.
Four types of surgery are used to treat epilepsy.
Lobectomy
This is the most common type of epilepsy surgery and it comes in two forms: temporal and frontal. Lobectomy is only for focal seizures, meaning that they start in a localized area of the brain.
Temporal lobectomy:
Frontal lobectomy:
Multiple Subpial Transection
When your seizures start in an area of the brain that can’t be taken out, you may have multiple subpial transections.
Corpus Callosotomy
The brain is made up of a left and right hemisphere. The corpus callosum connects and facilitates communication between them. However, the corpus callosum isn’t necessary to survive.
In a corpus callosotomy:
This surgery is mostly done in children whose seizures start on one side of the brain and spread to the other. Usually, your surgeon will cut the front two-thirds first and only sever it complete if that doesn’t decrease the frequency of seizures.
Side effects include:
Though this surgery can greatly reduce the frequency of seizures, it doesn’t stop the seizures in the hemisphere in which they start, and focal seizures may be even worse afterward.
Hemispherectomy
Hemispherectomy is one of the oldest surgical techniques forepilepsy. It involves:
In the past, most or all of the hemisphere was removed, but the procedure has evolved over time.
This surgery is usually used for children, but it can be helpful for some adults, too. A hemispherectomy is only performed if:
The two most common types of hemispherectomy include:
Both types result in70 percentof patients becoming completely seizure-free. For patients who still have seizures after surgery, antiepileptic medication may be needed, but the dosage may be lower.
Seizures rarely get worse after this surgery. Sometimes, a repeat hemispherectomy is needed, and the outcome for this is also typically good.
If surgery isn’t an option for you or you simply want to try other alternatives first, you have some other treatments to consider. These specialist-driven therapies are all adjunctive treatments, meaning that they are additions to drug therapies—not replacements for them.
Vagus Nerve Stimulation
Vagus nerve stimulation, also known asVNS therapy, is FDA-approved to treat seizures in adults and children over 4 years old whose seizures aren’t controlled after trying at least two medications.
Similar to a pacemaker, a vagus nerve stimulator is a small device that’s implanted under the skin on your chest, and a wire runs to the vagus nerve in your neck. It’s unclear exactly how it works, but the stimulator delivers regular electrical pulses through the vagus nerve to your brain, lessening the severity and frequency of seizures. This may lead to needing less medication.
VNS therapy, on average:
One reviewfound that within four months after implantation:
The same review also reported that about 60 percent were doing just as well 24–48 months later, with around 8 percent achieving seizure freedom.
Responsive Neurostimulation
Responsive neurostimulation is like a pacemaker for your brain. It continuously monitors brain waves, analyzes patterns to detect activity that may lead to a seizure. Then, it responds with electrical stimulation that returns brainwaves to normal, preventing the seizure.
The device is adjusted to your individual needs, placed within your skull, and connected to one or two electrodes on your brain.
This therapy is for people whose seizures aren’t controlled after trying at least two medications. It’s FDA-approved for adults withfocal epilepsyand, as with VNS therapy, the effects seem toget better over time.
Deep Brain Stimulation
Indeep brain stimulation(DBS), electrodes are placed in a specific part of your brain, often the thalamus. They’re connected to a device that’s implanted under the skin in your chest that sends electrical impulses to your brain. This can lessen or even stop seizures.
The FDA has approved this treatment for adults with focal epilepsy that isn’t controlled after trying three or more medications.
These effects also appear to increase with time.In one study:
Dietary changesmay help in the management of your condition but should never be considered a sole treatment option. These should only be considered with your healthcare provider’s input and monitoring, as well as the help of a dietitian.
Ketogenic Diet
Theketogenic dietis often prescribed in cases where seizures aren’t responding to two or more medications, particularly in children. This high-fat, low-carbohydrate diet is strict and can be difficult to follow. It’s especially helpful for certain epilepsy syndromes and makes it possible for some people to take lower doses of medications.
2:13The Ketogenic Diet and Epilepsy
2:13
The Ketogenic Diet and Epilepsy
Studies show:
Potential side effects include:
If you opt for the ketogenic diet, you’ll probably need to take nutritional supplements to make up for the diet’s imbalances. This diet should only always be medically supervised.
Modified Atkins Diet
Themodified Atkins diet (MAD)is a less restrictive and newer version of the ketogenic diet that can be used for both adults and children.
While the foods are similar to the ketogenic diet, fluids, proteins, and calories aren’t restricted and there’s more freedom when it comes to eating out. The MAD encourages fewer carbohydrates and more fat than the standard Atkins diet.
This diet seems to have similar results to the classic ketogenic diet.Studies show:
Potential side effects include weight loss, higher cholesterol in adults, and feeling ill, especially at first.
Low Glycemic Index Diet
Another less restrictive version of the ketogenic diet, the low glycemic index treatment (LGIT) focuses more on carbohydrates that have a low glycemic index. It doesn’t restrict fluids or protein, and food is based on portion sizes rather than weights.
There haven’t been many high-quality studies done on the effects of LGIT, but it seems to be beneficial in reducing seizures.
Gluten-Free Diet
Some research shows that the rate ofceliac disease(an autoimmune disorder that causes gluten sensitivity) is significantly more common in people with epilepsy than in the general public. This has led to speculation that gluten may have a role in causing or contributing to the development of seizures.
A2013 British studyexploring the rate of neurological disorders in people with celiac disease found that 4 percent had epilepsy, compared to 1 percent in the general population. Other studies have confirmed rates ranging from 4 percent to 6 percent.
Still, it’s difficult to establish a link between gluten sensitivity and seizures because currently there’s nostandard measure of gluten sensitivityoutside of celiac disease.
While this is an area with little research, you can find lots of anecdotes about people who say they’ve stopped having seizures after going gluten free. Claims are especially rampant when it comes to children, with some people proclaiming the diet more effective than drugs.
It’s tempting to believe these kinds of success stories, but it pays to remember that seizure frequency often decreases over time, and early childhood epilepsy often goes away on its own.
Adopting healthy habitsmay help control your epilepsy, as well.
Get Enough Sleep
Sleep deprivation can trigger seizures in some people, so make sure you get enough. If you have trouble getting to sleep or wake up often, talk to your healthcare provider. You can also try to:
Manage Stress
Stress is another potential trigger for seizures. If you’re under too much stress, try delegating some responsibilities to others.
Learn relaxation techniques such as deep breathing, meditation, and progressive muscle relaxation. Take time out for activities you enjoy and find hobbies that help you unwind.
Exercise
Besides helping you stay physically healthy, exercise can also help you sleep better, boost mood and self-esteem, reduce anxiety, relieve stress, and stave off depression.
Don’t exercise too close to bedtime, though, or you may have trouble drifting off.
Take Your Medications
Be sure to take your medications exactly as prescribed so you can attain the best seizure control possible. Don’t ever change your dose or stop taking your medication without consulting your healthcare provider.
Depending on your epilepsy type, you may eventually go without seizures for long enough that you can try going off your meds. This should only be done with your healthcare provider’s permission and supervision.
Wearing a medical alert bracelet that lists your medications is extremely important when you have epilepsy so that, in an emergency, medical personnel know better how to help you. You can buy one online or at some local pharmacies and drug stores.
Causes and Risk Factors of Epilepsy
There are some complementary and alternative medicine (CAM) treatments that you may want to consider including alongside (not in place of) your regular therapies.
Music
Studies on therelationship of music to seizuressuggest that regularly listening to Mozart, particularly Mozart’s Sonata for Two Pianos in D Major (K448), helps reduce seizures and EEG abnormalities in children. This is called the Mozart Effect.
One studyof both children and adults who listened to Mozart K448 for 10 minutes, three times a week for three months showed that the effect was 25 percent more prevalent in children. However, both groups had fewer EEG abnormalities and decreased seizures.
No one knows what the relationship is between the music and the decrease in seizure activity, and more research is needed to confirm this effect altogether.
Yoga
ACochrane reviewon yoga for epilepsy concluded that it may be beneficial in controlling seizures, but there isn’t sufficient evidence to recommend it as a treatment.
Biofeedback
Also known as neurofeedback, biofeedback is a technique that allows you to measure your body’s responses to seizure triggers (among other things). With time, you can use this information to help control automatic functions such as your heart rate and respiration, potentially reducing the frequency of seizures.
Biofeedback uses sensors attached to your body, so it’s non-invasive. It also has no side effects.
Multiple small studies have shown thatit does help reduce seizures. This seems to be especially true with biofeedback usinggalvanic skin response (GSR), which measures the amount of sweat in your hands. Still, more studies need to be done.
Blue-Tinted Lenses
Some evidence suggests that wearing sunglasses with blue-tinted lenses may help people with photosensitive epilepsy, but the research is limited and out of date.
Art
Epilepsy can have a marginalizing effect that may lead to feelings of sadness and low self-confidence. Preliminary research suggests that a multi-week art therapy program calledStudio E: The Epilepsy Art Therapy Programmay help boost self-esteem in people with epilepsy.
Natural Treatment Options for Epilepsy
The Future of Treatment
A lot of work is being done in the quest for less invasive and more effective epilepsy treatments, including a few things that are still in experimental stages.
Stereotactic Radiosurgery
Stereotactic radiosurgery, or stereotactic laser ablation, may help people who:
During the procedure, targeted radiation destroys tissue in the part of the brain that causes seizures. Preliminary evidence shows that it’seffective for controlling seizures in mesial temporal lobe, the most common type of focal epilepsy.
Thermal Ablation
Also known as laser interstitial thermal therapy or LITT procedure, thermal ablation is anadvanced form of stereotactic radiosurgerythat uses magnetic resonance imaging (MRI) to locate the tissue to be destroyed. It’s much more precise and has fewer risks than traditional surgery.
Studies have been limited and small, but MRI-guided LITT looks like a promising treatment withfewer side effects and better outcomesthan other minimally invasive procedures.
External Nerve Stimulation
External trigeminal nerve stimulation (eTNS) is similar to vagus nerve stimulation, but the device is worn externally rather than implanted.
One specific device, the Monarch eTNS System, has been approved in Europe and Canada and is being researched in the United States.
A2017 audit of the treatmentin Britain found that people without intellectual disabilities had a significant improvement in both quality of life and mood, as well as an 11 percent decrease in seizures. The authors declared it safe and flexible but also stated the need for further controlled studies to confirm its effectiveness.
Subthreshold Cortical Stimulation
Inone study10 out of 13 participants who had the treatment said their epilepsy became less severe. Most of them also had at least a 50 percent reduction in seizure frequency. This treatment may be especially helpful for people with focal epilepsy who aren’t candidates for surgery.
Frequently Asked QuestionsA number of factors could cause a breakthrough seizure, or one that happens despite treatment that’s been successful in the past. These can include a missed medication, the wrong dosage of medication, stress, lack of sleep, alcohol, recreational drugs, and playing video games.These medications reduce the abnormal electrical activity in the brain that causes seizures. They may do this in different ways. Some change how neurotransmitters, or brain chemicals, send messages. Others affect how ions move in and out of brain cells, affecting electrical activity.Don’t stop taking your medication without talking with your healthcare provider. Stopping medication suddenly can cause dangerous side effects and trigger seizures. Your practitioner may consider slowly tapering your medication and eventually stopping it if you’ve had a seizure-free period for two to four years. They’ll also take into consideration the number of seizures you had before the medication and the results from a neurological exam.Learn MoreCan Epilepsy Go Away?
A number of factors could cause a breakthrough seizure, or one that happens despite treatment that’s been successful in the past. These can include a missed medication, the wrong dosage of medication, stress, lack of sleep, alcohol, recreational drugs, and playing video games.
These medications reduce the abnormal electrical activity in the brain that causes seizures. They may do this in different ways. Some change how neurotransmitters, or brain chemicals, send messages. Others affect how ions move in and out of brain cells, affecting electrical activity.
Don’t stop taking your medication without talking with your healthcare provider. Stopping medication suddenly can cause dangerous side effects and trigger seizures. Your practitioner may consider slowly tapering your medication and eventually stopping it if you’ve had a seizure-free period for two to four years. They’ll also take into consideration the number of seizures you had before the medication and the results from a neurological exam.Learn MoreCan Epilepsy Go Away?
Don’t stop taking your medication without talking with your healthcare provider. Stopping medication suddenly can cause dangerous side effects and trigger seizures. Your practitioner may consider slowly tapering your medication and eventually stopping it if you’ve had a seizure-free period for two to four years. They’ll also take into consideration the number of seizures you had before the medication and the results from a neurological exam.
Learn MoreCan Epilepsy Go Away?
Coping With Epilepsy
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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