A Member of the University of Maryland Medical System   |   In Partnership with the University of Maryland School of Medicine

Share

Email PageEmail Print PagePrint

Home > Medical Reference > Encyclopedia (English)

Toggle: English / Spanish

Epilepsy - Treatment

Alternative Names

Temporal lobe epilepsy; Seizure disorder

Treatment:

Treatment for epilepsy may involve surgery or medication.

If epilepsy seizures are due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery to treat these disorders may make the seizures stop.

Medication to prevent seizures, called anticonvulsants, may reduce the number of future seizures.

  • These drugs are taken by mouth. Which type you are prescribed depends on the type of seizures you have.
  • Your dosage may need to be changed from time to time. You may need regular blood tests to check for side effects.
  • Always take your medication on time and as directed. Missing a dose can cause you to have a seizure. Never not stop taking or change medications without talking to your doctor first.
  • Many epilepsy medications cause birth defects. Women wishing to become pregnant should tell the doctor in advance in order to adjust medications.

Epilepsy that does not get better after two or three anti-seizure drugs have been tried is called "medically refractory epilepsy."

  • Surgery to remove the abnormal brain cells causing the seizures may be helpful for some patients.
  • Surgery to place a vagus nerve stimulator (VNS) may be recommended. This device is similiar to a heart pacemaker. It can help reduce the number of seizures.

Sometimes, children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, may also be helpful in some adults.

Lifestyle or medical changes can increase the risk for a seizure in a person with epilepsy. Talk with your doctor about:

  • New prescribed medications, vitamins, or supplements
  • Emotional stress
  • Illness, especially infection
  • Lack of sleep
  • Pregnancy
  • Skipping doses of epilepsy medications
  • Use of alcohol or other recreational drugs

Other considerations:

  • Persons with epilepsy should wear medical alert jewelry so that prompt medical treatment can be obtained if a seizure occurs.
  • Persons with poorly controlled epilepsy should not drive. Each state has a different law about which people with a history of seizures are allowed to drive.
  • Also avoid machinery or activities where loss of awareness would cause great danger, such as climbing to high places, biking, and swimming alone.

See also: Seizures - first aid.

Support Groups:

The stress caused by having epilepsy (or being a caretaker of someone with epilepsy) can often be helped by joining a support group. In these groups, members share common experiences and problems.

See: Epilepsy - support group

Expectations (prognosis):

Some people with epilepsy may be able to reduce or even stop their anti-seizure medicines after having no seizures for several years. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s.

For many people, epilepsy is a lifelong condition. In these cases, the anti-seizure drugs need to be continued. There is a very low risk of sudden death with epilepsy. However, serious injury can occur if a seizure occurs during driving or when operating equipment.

Complications:

  • Difficulty learning
  • Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia
  • Injury from falls, bumps, self-inflicted bites, driving or operating machinery during a seizure
  • Permanent brain damage (stroke or other damage)
  • Side effects of medications

Calling your health care provider:

Call your local emergency number (such as 911) if:

  • This is the first time a person has had a seizure
  • A seizure occurs in someone who is not wearing a medical ID bracelet (which has instructions explaining what to do)

In the case of someone who has had seizures before, call 911 for any of these emergency situations:

  • This is a longer seizure than the person normally has, or an unusual number of seizures for the person
  • Repeated seizures over a few minutes
  • Repeated seizures where consciousness or normal behavior is not regained between them (status epilepticus)

Call your health care provider if any new symptoms occur, including possible side effects of medications (drowsiness, restlessness, confusion, sedation, or others), nausea or vomiting, rash, loss of hair, tremors or abnormal movements, or problems with coordination.

  • Reviewed last on: 3/28/2011
  • Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Duvivier EH, Pollack Jr CV. Seizures. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 100.

French JA, Pedley TA. Clinical practice. Initial management of epilepsy. N Engl J Med. 2008;359(2):166-76.

Kornblau DH, Conway Jr EE, Caplen SM. Neurologic Disorders. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Mosby Elsevier; 2009: chap 173.

Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69:1991-2007.

Schachter SC. Seizure disorders. Med Clin North Am. March 2009;93(2).

Trescher WH, Lesser RP. The Epilepsies. In: Bradley WG, Daroff RB, Fenichel GM, Jakovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa; Butterworth-Heinemann; 2008: chap 71.

Walker SP, Permezel M, Berkovic SF. The management of epilepsy in pregnancy. BJOG. 2009;116(6):758-67.

C. L. Harden, J. Hopp, T. Y. Ting, et al. Practice Parameter update: Management issues for women with epilepsy --Focus on pregnancy (an evidence-based review). Neurology 2009;73;126

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com
 
Adam QualityA.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com
Connect with UMMC
Facebook Twitter YouTube Blog iPhone

Please rate the quality of this article.

Do you find this article to be helpful / informative?
              
Poor                                       Excellent

Do you have any brief comments on this page: (up to 255 characters)

© 2011 University of Maryland Medical Center (UMMC). All rights reserved.
UMMC is a member of the University of Maryland Medical System,
22 S. Greene Street, Baltimore, MD 21201. TDD: 1-800-735-2258 or 1.866.408.6885