Treatment-Epilepsy
Treatment can help most people with epilepsy have fewer
seizures, or stop having seizures completely.
Treatments include:
- medicines called anti-epileptic drugs (AEDs)
- surgery to remove a small part of the brain that's
causing the seizures
- a procedure to put a small electrical device
inside the body that can help control seizures
- a special diet (ketogenic diet)
that can help control seizures
Some people need treatment for life. But you might be
able to stop if your seizures disappear over time.
You may not need any treatment if you know
your seizure triggers and
are able to avoid them.
Talk to your specialist about the treatments available and
which might be best for you.
Anti-epileptic drugs (AEDs)
AEDs are the most commonly used treatment for epilepsy. They
help control seizures in around 7 out of 10 of people.
AEDs work by changing the levels of chemicals in your brain.
They do not cure epilepsy, but can stop seizures happening.
Types of AEDs
There are many AEDs.
Common types include:
- sodium valproate
- carbamazepine
- lamotrigine
- levetiracetam
- topiramate
The best type for you will depend on things like the
type of seizures you have, your age and if you're thinking of having a baby.
Some AEDs can harm an unborn baby – see living with epilepsy for more
information.
If your doctor recommends taking an AED, ask them about the
different types available and which is likely to be the most suitable for you.
Taking AEDs
AEDs are available in a number of different forms, including
tablets, capsules, liquids and syrups. You usually need to take the medicine
every day.
Your specialist will start you on a low dose and gradually
increase it until your seizures stop. If the first medicine you try does not
work, your doctor may recommend trying another type.
It's important you follow any advice about when to take AEDs
and how much to take. Never suddenly stop taking an AED – doing so could
cause a seizure.
If you have not had a seizure for a few years, ask your
doctor if you might be able to stop treatment. If they think it's safe, your
dose will be reduced gradually over time.
While taking AEDs, do not take any other medicines,
including over-the-counter medicines or complementary medicines, without
speaking to your GP or specialist. Other medicines could affect how well your
AED works.
Side effects
Side effects are common when starting treatment with AEDs.
Some may appear soon after starting treatment and pass in a few days
or weeks, while others may not appear for a few weeks.
The side effects you may get depend on the medicine you're
taking.
Common side effects of AEDs include:
- drowsiness
- a lack of energy
- agitation
- headaches
- uncontrollable shaking (tremor)
- hair loss or unwanted hair growth
- swollen gums
- rashes – contact your GP
or specialist if you get a rash, as it might mean you're having a serious
reaction to your medicine
Contact your GP or specialist if you have symptoms similar
to being drunk, such as unsteadiness, poor concentration and being sick.
This could mean your dose is too high.
For information about the side effects of your
medicine, check the information leaflet that comes with it.
Want to know more?
- Epilepsy Action: taking
epilepsy medicine
- Epilepsy Society: medication for epilepsy
Brain surgery
Surgery to remove part of your brain may be an option
if:
- AEDs are not controlling your seizures
- tests show that your seizures
are caused by a problem in a small part of your brain that can be removed
without causing serious effects
In these cases, there's a good chance that your
seizures could stop completely after surgery.
Tests before surgery
If your epilepsy is poorly controlled after trying several
AEDs, you may be referred to a specialist epilepsy centre to see if surgery
might be possible.
This will usually involve having several tests, such
as:
- brain scans
- an electroencephalogram
(EEG) – a test of your brain's electrical activity
- tests of your memory, learning
abilities and mental health
The results of these tests will help you and
your specialist decide if surgery is an option for you, and what the
result of surgery might be.
What happens during surgery?
Surgery for epilepsy is usually carried out under general anaesthetic, where you're asleep.
The surgeon makes a small cut in your scalp and creates an
opening in your skull so they can remove the affected part of the brain.
The openings in your skull and scalp are closed at the end
of the operation.
Recovery and risks
It's likely to take a few weeks or months for you to feel
back to normal after surgery.
Your seizures may not stop straight away, so you might need
to keep taking AEDs for 1 to 2 years.
There's a risk of complications from surgery,
such as problems with your memory, mood or vision. These problems may improve
over time, or they may be permanent.
Before having surgery, make sure you talk to your surgeon
about the possible risks.
Further information
- Epilepsy Action: epilepsy
surgery for adults
- Epilepsy Society: epilepsy surgery
Other procedures
If AEDs are not controlling your seizures and brain surgery
is not suitable for you, there are other procedures that could help.
Vagus nerve stimulation (VNS)
Vagus nerve stimulation (VNS) is where a small electrical
device similar to a pacemaker is
placed under the skin of your chest.
The device is attached to a wire that goes under your skin
and connects to a nerve in your neck called the vagus nerve. Bursts of
electricity are sent along the wire to the nerve.
It's thought this can help control seizures
by changing the electrical signals in the brain.
VNS does not usually stop seizures completely, but it can
help make them less severe and less frequent. You'll probably still need
to take AEDs.
Side effects of VNS include a hoarse voice, a sore
throat and a cough when the device is activated. This normally happens
every 5 minutes and lasts for 30 seconds.
The battery for the VNS device typically lasts up to 10
years, after which time another procedure will be needed to replace it.
Deep brain stimulation (DBS)
Deep brain stimulation (DBS) is similar to VNS. But the
device placed in the chest is connected to wires that run directly
into the brain.
Bursts of electricity sent along these wires can help
prevent seizures by changing the electrical signals in the brain.
DBS is a fairly new procedure that's not used very
often, so it's not yet clear how effective it is for epilepsy.
There are also some serious risks associated with
it, including bleeding on the brain, depression and
memory problems.
If your doctor suggests DBS as an option, make sure you talk
to them about the potential benefits and risks.
Further information
- Epilepsy Action: deep
brain stimulation and epilepsy
- Epilepsy Action: vagus
nerve stimulation therapy in epilepsy
- Epilepsy Society: deep
brain stimulation
- Epilepsy Society: vagus nerve stimulation
Ketogenic diet
A ketogenic diet is a diet high in fats, and low in
carbohydrates and protein. In children, the diet is thought to make seizures
less likely by changing the levels of chemicals in the brain.
The ketogenic diet was one of the main treatments for
epilepsy before AEDs were available. But it's now not widely used in
adults because a high-fat diet is linked to serious health conditions, such
as diabetes and cardiovascular disease.
A ketogenic diet is sometimes recommended for children with
seizures that are not controlled by AEDs. This is because it's been shown to
reduce the number of seizures in some children.
It should only be used under the supervision of an epilepsy
specialist with the help of a dietitian.
Further information
- Epilepsy Society: ketogenic diet
Complementary therapies
There are several complementary therapies that some people
with epilepsy feel work for them. But none has been shown to reduce
seizures conclusively in medical studies.
You should therefore be cautious about advice
from anyone other than a GP or specialist to reduce or stop taking
your medicine and try alternative treatments. Stopping your medicine without
medical supervision may cause seizures.
Herbal remedies should also be used cautiously because some
of their ingredients can interact with epilepsy medicine.
St John's Wort, a herbal remedy used for mild depression, is
not recommended for people with epilepsy because it can affect the levels of
epilepsy medicine in the blood and may stop the medicine working properly.
There are reports that some strong-smelling aromatherapy
treatments, such as hyssop, rosemary and sweet fennel, may trigger seizures in
some people.
For some people with epilepsy, stress can trigger seizures.
Stress-relieving and relaxation therapies such as exercise, yoga and meditation
may help.
