Epilepsy experts, called epileptologists, can help you explore your treatment options. Physicians treat epilepsy in several ways, including medication, surgery, and special diets. Medication is always the first option.
Anti-seizure drugs, also called seizure-preventing drugs or anticonvulsants, need to reach and stay at a certain level in your body to work properly. More than 30 anti-seizure drugs are currently approved to treat epilepsy. About half of people with epilepsy become seizure-free with their first antiseizure medication. Those who continue to have seizures may be prescribed a different medication or a combination of medications. As many as one third of people with epilepsy can't achieve adequate seizure control with medications alone, leading to considering other options, like surgery and/or special diets. Our clinical pharmacist can answer your medication questions and check for drug interactions.
If your seizures don't respond to medication, certain types of surgery may help. Surgery may be recommended when the area where seizures start (the seizure focus) can be found and removed or damaged without harming vital functions like speech or movement.
Dietary therapies can help control seizures in both children and adults, though they're used mainly in children and less often in adults. They're usually used when seizures don't respond to medicine. The most common is the ketogenic diet, a medically supervised high-fat, low-carbohydrate diet. Other diets can also help some people control seizures, including the Medium-chain triglyceride diet (MCT), Modified Atkins Diet (MAD), and Low Glycemic Index Treatment (LGIT). Most people who use a diet therapy continue taking medicine.
RNS uses a small device implanted under the scalp, in a small area of the skull or bone surrounding the brain. One or two wires from the device are placed on or under the surface of the brain where seizures start. When the device senses a seizure, it sends small pulses of electrical current through the wires to help stop or lessen it. RNS may also help people who can't have surgery, or when surgery doesn't work well enough. Like VNS, RNS doesn't cure epilepsy and may not work right away, but it can help reduce the number of seizures a person has by 40% to 60% after one to three years.
A small device (generator) is implanted under the skin on the left side of your chest. A thin wire, or electrode, runs from the generator to the vagus nerve in your neck. VNS may be an option if surgery doesn't work or isn't right for you. The benefits of VNS appear to improve over time. For example, about 45% of people have their seizures decreased by 50% or more within one to two years.
DBS is a newer type of device that also helps control seizures when surgery doesn't work or can't be done. Electrode wires are placed in a specific area of the brain, and, like VNS, the device is programmed to deliver stimulation that interrupts or stops seizures.
In noisy or crowded places, try earplugs or headphones. Listening to relaxing music or sounds can help, and so can distancing yourself by singing or focusing on another activity.
Polarized or tinted glasses can help, and so can using natural light indoors. Avoid flickering lights or patterns, such as strobe lights or flashing holiday lights.
Keeping a consistent sleep schedule and getting enough sleep are simple ways to help manage your seizures. The amount of sleep you need varies from person to person. The goal is to get enough sleep so you don't feel tired or struggle to stay awake during the day.
Avoid recreational drugs, and talk with your doctor about alcohol use. Avoid alcohol completely during high-risk times or if you've recently had surgery. As a general guideline, limit alcohol consumption to no more than one standard drink of liquor, wine, or beer on any occasion, and no more than three times per week. Avoid binge drinking or becoming intoxicated.
Hormonal changes can affect seizure patterns in some people. Try recording your seizures on a calendar to track them alongside changes in your hormones. Hormonal medicines, such as contraceptives (birth control pills) and hormone replacement therapy, may affect seizures, so be sure to talk with your doctor about any contraceptive use.
Emotional stress is an indirect trigger, and it can also be a symptom of mood problems such as anxiety or depression. During stressful times, look for ways to adjust your lifestyle and manage stress better. Our case management team can also connect you with community resources and support.
Your care works best as a partnership. When you review your epilepsy with your doctor, they should:
Working closely and regularly with your doctor can prevent many seizures, though there's no guarantee that seizures won't occur. Knowing what may trigger your seizures can help you recognize when one may be coming and prepare to lower the chance
Seizures in epilepsy may be related to brain injury, genetics, immune causes, brain structure, or metabolic causes, but most of the time the cause is unknown.
Some people notice their seizures follow a pattern or are more likely in certain situations, called triggers. Examples include flashing lights or certain noises, stress, lack of sleep, alcohol or drug use, low blood sugar, and hormonal changes
A trigger is something that happens fairly consistently before seizures, and more often than by chance. A seizure diary can help you spot triggers: note the time of day, what was happening at the time of the seizure, the environment, and any commonly reported triggers that were present. Share and discuss your seizure diary with your doctor.
Epilepsy can affect anyone: children and adults, men and women, and people of all races, religions, ethnic backgrounds, and social classes. It's most often diagnosed in childhood or after age 65, but it can occur at any age. Epilepsy is one of the most common neurological diseases.
About 3.4 million people in America have active epilepsy, and 1 in 26 people in the United States will develop it at some point in their lifetime.
Epilepsy can be serious, especially when seizures aren't controlled. Any seizure has the potential to be fatal, and people who continue to have seizures are at greater risk of complications, the most serious of which are injury and death.
One of the more common causes of death from seizures is SUDEP (Sudden Unexpected Death in Epilepsy), in which no other cause of death is found during an autopsy. SUDEP is the leading cause of death with uncontrolled seizures, and the best way to prevent it is to lower your risk by controlling seizures. Our neurologists can work with you on a plan to keep your seizures under control.
No, epilepsy is never contagious. You can't catch epilepsy from someone else, and no one can catch it from you.
For many people, epilepsy can be successfully managed, and some people may eventually become seizure-free. Whether seizures go away depends on the type of epilepsy and its cause.
Treatment may include medication, surgery, dietary therapies, or neurostimulation devices. Working with an epilepsy specialist can help you find the treatment approach that’s right for you.
It's not unusual to be unsure what kind of seizure you or your loved one has. Diagnosis is often based on what an observer saw, and those descriptions may be incomplete. Our epilepsy specialists can evaluate you and recommend a treatment plan.
Learning about epilepsy is an important part of managing it. We encourage you to explore the resources available to support you and your loved ones through your diagnosis, and our team is here to help you find them.