For most people with epilepsy, treatment can reduce or prevent seizures and allow many patients to remain free of seizures for the rest of their lives.
Uncontrolled seizures can have a big impact on lifestyle, restricting the individual from driving and limiting their work and leisure time activities. Although seizures themselves usually are not physically harmful to people who have epilepsy, they carry a risk of injury and death. The risk is greater for people who have many seizures, depending on the type of seizure they have. Unexpected seizures can cause falls, drowning or other accidents, and a lengthy seizure condition (status epilepticus) can lead to coma or death.
By reducing or stopping seizures, treatment may greatly improve the patient's quality of life and safety.
A correct diagnosis is vital to effectively treat epilepsy. Decisions about treatment are based first on the type of epilepsy and the kinds of seizures that occur. Treatment that controls one kind of seizure may have no effect on other kinds of seizures. Age, health and lifestyle are also important factors. Treatment options include:
- Medication. This is the first and most common approach to treating epilepsy. Antiepileptic medications do not cure epilepsy, but they help prevent seizures in well over half of the people who take them.
- Brain surgery. Some patients with partial epilepsy do not respond to medication but have great success with surgery. Surgery is highly effective in treating many pediatric epilepsies that have not responded to other medical therapies.
- Vagus nerve stimulator. This device is used with medication or surgery to reduce seizures.
- Ketogenic diet. A high-fat diet has been used with some success to treat people (especially children) who have severe, uncontrolled seizures. However, some doctors may not support its use.
Status epilepticus is a prolonged seizure or cluster of seizures that requires emergency treatment whether or not the individual has epilepsy. A seizure or cluster of seizures that goes on for more than 20 to 30 minutes during which the person does not wake up can cause brain damage. Treatment with antiepileptic medications needs to be started immediately for any seizure lasting more than five minutes. Medication used to end the seizure is given through an IV (intravenously) so that it takes effect more quickly. If IV medication is not available, medication may be given rectally or as a shot in the muscle.