Epilepsy Treatment 

Several factors determine whether doctors will treat epilepsy or wait to take action. These categories depend on age, whether the patient drives, EEG results, other neurological impairments and a history of seizures.

Epilepsy treatment can take many approaches:
Medications
Vagus Nerve Stimulation
Surgery
Diet
Complementary Therapies

Medications
The most common epilepsy treatment is antiepileptic drugs. Antiepileptic drugs successfully prevent seizures in the majority of people who take them regularly and as prescribed. The type of epilepsy determines which medications will work best. It is also important to develop a "seizure calendar" to keep track of the number of seizures experienced and when they occur.

Periodically, your doctor will order blood tests done to find out how much medicine is in your blood. Your doctor will inform you of the best time of day to have these tests done and will call you with the results to allow you to make any needed adjustments.

Vagus nerve stimulation
Another option for treatment involves using a Vagus Nerve Stimulator (VNS). It is currently approved for use in adults and children over the age of 12 who have partial seizures that resist control by other methods.

The stimulator delivers energy by a flat, round battery, about the size of a silver dollar, which is surgically implanted in the chest wall. Thin wires (electrodes) are threaded under the skin and wound around the vagus nerve in the neck. The battery is programmed to send a few seconds of electrical energy to the vagus nerve every few minutes.

If a patient feels a seizure coming on, he or she can activate the electrical discharge by passing a small magnet over the battery. In some people, this has the effect of stopping the seizure.

Patients usually cannot stop taking epilepsy medication even with the stimulator, but they often experience fewer seizures and they may be able to reduce the dose of their medication. Side effects of the vagus nerve stimulator are generally mild but may include hoarseness, ear pain, a sore throat or nausea. Adjusting the amount of stimulation can usually eliminate most side effects, although the hoarseness typically persists.

Surgery
Unfortunately, some people continue to have seizures regularly despite taking medication. For them, surgery may be helpful.

The type of surgery you will need depends upon several factors, including:
The type of seizures you have.
Where in the brain these seizures begin.
What functions the affected area of the brain controls.

These questions are answered during evaluation and testing at the Sentara Epilepsy Center. Recommendations including the risks, benefits and successful outcomes of surgery, are presented to the patient and family members. 

For more information about the types of surgeries used to treat epilepsy, see the National Institutes of Neurological Disorders and Stroke or the Epilepsy Foundation websites.

Diet
Studies have shown that, in some cases, children may experience fewer seizures if they maintain a strict diet rich in fats and low in carbohydrates. This unusual diet, called the ketogenic diet, causes the body to break down fats instead of carbohydrates to survive. This condition is called ketosis.

When carefully monitored by a medical team, the diet helps two out of three children and may prevent seizures completely in one out of three, according to the Epilepsy Foundation. It is a strict diet, and takes a strong commitment from the whole family.

The amounts of food and liquid at each meal have to be carefully worked out and weighed for each person. The diet forces the child's body to burn fat round the clock by keeping calories low and making fat products the primary food that the child is getting.

Other therapies
Some people say they feel better, or have fewer seizures, when they use remedies, such as folk medicines, herbs and megavitamin therapy. If the treating physician has no objection, and these therapies do not contain harmful substances or involve any dangerous practices – and regular medication is continued, they could be beneficial.

Sometimes, a physician may prescribe a non-traditional supplemental therapy when a patient has developed a seizure-related metabolic disorder. Stopping standard medication or a prescribed diet in favor of an unproved remedy, however, presents definite risks and is not advisable.

Additional Research
Research on every level of epilepsy treatment is ongoing, and clinical trials continue with new drugs. Dr. Bruno Maton has extensive research experience and several clinical trials are being conducted at the Sentara Epilepsy Center. Advances in imaging are providing more and better information about the structure of the brain and making it easier for doctors to locate lesions and other abnormalities.

Learn more about:

Epilepsy Symptoms
Epilepsy Diagnosis
The Sentara Epilepsy Center