Epilepsy is a type of seizure disorder in which nerve cells in the brain, called neurons, behave abnormally. Neurons normally create tiny electrical signals in a regular rhythm. These signals tell other parts of the brain and body what to do.
With epilepsy, neurons create too many electrical signals, too quickly. Some doctors describe this as an electrical storm in the brain. This storm causes a wide variety of physical and mental changes known as seizures.1,2
The goal of all epilepsy treatment is to reduce the number of seizures, avoid side effects, and improve quality of life. In some people, this goal is fairly easy to reach. For others, it can be challenging to find the right combination of prescriptions and lifestyle changes. The most common treatments for epilepsy include:2
- Prescription drugs
- Surgery
- Neuromodulation
- Lifestyle changes such as a new diet
- Aids and support devices
Prescription drugs to treat epilepsy
Unlike some other health conditions, prescription medicine is usually the first treatment for someone diagnosed with epilepsy. There are dozens of different drugs prescribed for epilepsy seizures.
In general, epilepsy drugs fall into 2 types: broad-spectrum and narrow-spectrum. Broad-spectrum anti-seizure drugs treat a wide variety of seizure types. These drugs are prescribed for generalized seizures or when the seizure type is unknown. Narrow-spectrum drugs best treat focal seizures.3-5
Many people are prescribed a combination of broad- and narrow-spectrum drugs to control their seizures. Every person requires a unique drug regimen that is carefully tailored to their needs.3-5
To pick an anti-seizure drug, your doctor will consider several things about you, such as:3-5
- Type of seizure and type of epilepsy
- Age
- Other health conditions
- Pregnancy or plans for pregnancy
- Other medicines you take
- Potential drug side effects
- Cost
- Lifestyle issues such as type of work or caring for small children
Surgery
Epilepsy surgery removes a part of the brain where seizures occur. Surgery may be recommended for drug-resistant (refractory) epilepsy. This is epilepsy that is not controlled by medicine alone.
The goal of surgery is to stop seizures or limit their severity, with or without medicine. Some people may someday be able to quit taking their anti-seizure drugs and remain seizure-free.1
There are several types of epilepsy surgery. Each type is right for different kinds of seizures, areas of the brain, and ages. These surgeries include:6
- Resection surgery
- Laser interstitial thermal therapy (LITT)
- Deep brain stimulation
- Corpus callosotomy
- Hemispherectomy
- Functional hemispherectomy
- Multiple subpial transection
Neuromodulation
Anti-seizure medicines do not always control someone’s epilepsy. Sometimes the side effects of these drugs cause significant issues. If epilepsy surgery is not possible or has not helped, neuromodulation may be an option.7,8
Neuromodulation devices send small electrical currents to the brain. These electrical currents make the brain work properly by overriding the electrical signals causing seizures.7,8
There are 3 main types of devices sold in the United States:7,8
- Vagus nerve stimulation (VNS)
- Responsive neurostimulation (RNS)
- Deep brain stimulation (DBS)
Each of these devices works slightly differently. Each is implanted during surgery.
Lifestyle and diet changes
Everyday things you do, such as eating, exercising, and sleeping, can impact how often or how severe your seizures are.
There is no cure for epilepsy. But lifestyle changes let you exert some control over and play an active role in managing your condition. Some common changes are:9.10
- Learning your triggers and avoiding them
- Keeping a seizure diary
- Taking your medicine without missing any doses
- Changing your diet
- Avoiding alcohol and illegal drugs
- Exercising safely
- Avoiding infections and treating them early if they occur
- Managing stress
- Getting good sleep
- Making it easier to remember to take your anti-seizure drugs
Aids and support devices
If you have epilepsy, you probably take medicines to control seizures. You may have had surgery too. In addition, there are many aids and devices people use to improve their safety.
The most common epilepsy aids and devices include:9,10
- Medical IDs
- Medicine reminders
- Headgear
- Alarms and monitors
- Safety pillows
- Seizure alert dogs
Non-medical treatments for epilepsy
Herbs, vitamins, yoga, and meditation are popular. However, anti-seizure drugs are sensitive to other substances you may take. Other prescriptions, over-the-counter drugs, and supplements can increase or decrease the amount of anti-seizure medicine in the blood and brain. This can lead to more seizures or side effects.
Still, people with epilepsy may take supplements or use holistic methods to relieve stress and other health conditions. Generally, exercise, yoga, meditation, and massage can be used without harm. You should always check with your doctor before trying any new non-medical treatment. You should inform your doctor of all non-prescription supplements you are taking.11