If you are diagnosed with epilepsy, your doctor will suggest certain treatment options that can help minimize the onset or severity of seizures, and in some cases eliminate them altogether. Over the years, new pharmaceuticals and a better understanding of the causes and variations of epilepsy have led to more effective epilepsy management.
The most common treatments for epilepsy include:
Doctors usually start by treating epilepsy with medication, generally taken by mouth. Your doctor's choice of which drug to prescribe will depend on what kind of seizures you are having. Most people with epilepsy can become seizure-free by using a single anti-epileptic drug. Others can decrease the frequency and intensity of their seizures. More than half the children with medication-controlled epilepsy can eventually stop medications and live a seizure-free life. Many adults also can discontinue medication after two or more years without seizures.
Finding the right medication and dosage can be complex. Your doctor likely will first prescribe a single drug at a relatively low dosage, and may increase the dosage gradually until your seizures are well controlled. If you've tried two or more seizure medications without success, your doctor may recommend trying a combination of two drugs or evaluate alternative options detailed below.
Vagus Nerve Stimulation
Vagus nerve stimulation is a type of treatment in which short bursts of electrical energy are directed into the brain via the vagus nerve, a large nerve in the neck. The energy comes from a battery, about the size of a silver dollar, which is surgically implanted under the skin, usually on the chest. Just how it works to prevent seizures is still being studied. The implantation is performed by a Valley surgeon and requires a minimum one-night hospital stay. Our epileptologists will adjust the stimulation parameters during outpatient follow-up visits using a hand-held wand and computer.
The ketogenic diet, which is very high in fats and low in carbohydrates, makes the body burn fat for energy instead of glucose. When carefully monitored by a medical team familiar with its use, the diet can significantly help children with epilepsy and may even prevent seizures completely.
Surgical removal of seizure-producing areas of the brain has been an accepted form of treatment for over 50 years when medicines fail to prevent seizures. However, because of new surgical techniques and new ways of identifying areas to be removed, more of these operations are being done now than ever before, and with greater success.
The surgery is typically performed when a brain lesion is identified, or in case of failure to respond to multiple medication trials. Your epileptologist will review your case and imaging studies with a neurosurgeon and neuroradiologist to determine the appropriateness and extent of surgery.