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Treatment for epilepsy

  • The goal of epilepsy treatment is to stop seizures or control them as best as possible. 

    For a majority of individuals with epilepsy, seizures can be controlled by taking one or more antiepileptic medications. The primary treatment approach is to control seizures with medications. Currently, there are more than 20 anti-epileptic medications available. However, approximately one third of people with epilepsy will not have their seizures controlled by medications alone.

    Seizures that are not controlled within the first 12 months of treatment, or after trying a second antiepileptic medication, could mean that a person has what is known as refractory or difficult to control epilepsy.  For these individuals, brain surgery or an implanted device may help to control seizures. New advances in technology and surgical techniques are improving outcomes for individuals that have difficult to control epilepsy.

    Medications

    Medicines used to treat seizures are referred to as anticonvulsant medications, antiepileptic drugs (AEDs), or anti-seizure medications. Medication is the primary method of treatment for epilepsy. It is important to understand that medications can help to control seizures or prevent them from happening but they do not cure or correct the problem that caused the seizures. 

    Approximately 70 percent of individuals with epilepsy will have their seizures controlled after trying one or two antiepileptic drugs (AEDs). There are different types of anticonvulsant medications and certain types of medications are more effective for certain types of seizures. As with most other medications, anti-epileptic drugs can potentially cause side effects. The doctor will recommend a medication they think will best control the patient’s seizures without causing side effects.  

    Epilepsy surgery

    For approximately 30 percent of individuals with epilepsy, seizures are not controlled with anti-epileptic drugs (AEDs) alone. For these individuals, epilepsy surgery may be an option. Epilepsy surgery can dramatically improve seizure control; in many cases, seizures may be completed controlled following surgery. Some individuals that are not candidates for epilepsy surgery may be helped by implanted devices.

    Vagus nerve stimulation

    For approximately 30 percent of individuals with epilepsy, seizures are not controlled with antiepileptic drugs (AEDs) alone. For these individuals, if respective epilepsy surgery is not an option, an implantable device may improve seizure control. The device works by stimulating the vagus nerve with a mild electrical charge. No brain surgery is involved.

    Responsive neurostimulation

    Responsive neurostimulation is a new approach to treating uncontrolled seizures. A device that is implanted under the scalp and in the skull by neurosurgeons continually monitors the brain for abnormal electrical activity. When the device sense the abnormal activity it delivers a mild electrical stimulus to disrupt the abnormal activity before a seizure occurs. 

  • Reviewed by: Patricia E. Penovich, MD, Minnesota Epilepsy Group
    First published: 04/04/2016
    Last reviewed: 03/25/2016

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