Epilepsy Treatments

Epilepsy Treatments

There are a number of treatment options available for people living with epilepsy. As there are many different ways to treat epilepsy, people living with epilepsy should work closely with their healthcare team to identify the best treatment approach.

Treatment options are often placed in one of the following categories: medical or lifestyle.

Medical

Antiepileptic drugs (AEDs)

The most common approach to treating epilepsy is to prescribe antiepileptic drugs (AEDs). The choice of which drug to prescribe, and at what dosage, depends on many different factors, including the type of seizures a person has, the person’s lifestyle and age, comorbidities1 (the simultaneous presence of two chronic diseases or conditions in a patient) and how frequently the seizures occur.2

Surgery

When seizures cannot be adequately controlled by medications, doctors may recommend patients be evaluated for surgery. Doctors generally recommend surgery only after patients have tried a number of different medications without success, or if there is an identifiable brain lesion—a damaged or dysfunctional area—believed to cause the seizures.1

Devices

Vagus nerve stimulation is designed to prevent seizures by sending regular, mild pulses of electrical energy to the brain via the vagus nerve. With this treatment approach, a vagus nerve stimulator (VNS), a battery-powered device, is surgically implanted under the skin of the chest and attached to the vagus nerve in the lower neck.2

Responsive neurostimulation (RNS system) senses and records brain electrical activity, and delivers electrical stimulation where the seizures are suspected to originate. The RNS system consists of a stimulator implanted in the skull under the scalp and leads implanted in the brain and is intended to interrupt brain activity before the patient experiences clinical seizures.3

Lifestyle

Diet

A strict diet rich in fats and low in carbohydrates, called the ketogenic diet, has been shown to reduce seizure frequency in some children whose seizures are poorly controlled with medication.1 A modified Atkins diet, which has some similar components to the traditional ketogenic diet, may also be effective.1

Complimentary or Alternative Therapies

Some people living with epilepsy are treated with complementary or alternative therapies. “Complementary” generally refers to using a non-mainstream approach together with conventional medicine while “alternative” refers to using a non-mainstream approach in place of conventional medicine.4 True alternative medicine is not common. Most people use non-mainstream approaches along with conventional treatments.4 As more information is gathered, complimentary therapies are now being used by many traditional health care providers and may be covered by health insurance plans. Complimentary or alternative therapies can include natural products (e.g., herbs, vitamins, minerals) and mind and body practices (e.g., acupuncture, massage therapy, healing touch).5

References:
  1. Andalusian Epilepsy Society. (2010). Antiepileptic treatment in patients with epilepsy and other comorbidities. Available through: http://www.sciencedirect.com/science/article/pii/S1059131110001123.
  2. National Institute of Neurological Disorders and Stroke. Seizures and Epilepsy: Hope Through Research. http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm#263103109. Link accessed on: September 8, 2014.
  3. U.S. Food and Drug Administration. RNS® System – P100026. http://www.fda.gov/medicaldevices/productsandmedicalprocedures/deviceapprovalsandclearances/recently-approveddevices/ucm376685.htm. Link accessed on: September 11, 2014.
  4. National Institutes of Health; Complementary, Alternative, or Integrative Health: What's In a Name? http://nccam.nih.gov/health/whatiscam. Link accessed on: September 29, 2014.
  5. Epilepsy Foundation. Treatment. http://www.epilepsy.com/information/professionals/diagnosis-treatment/treatment. Link accessed on: September 8, 2014.