Treatment Options for Seizures and Epilepsy

Your treatment plan will depend upon a number of factors, including:

  • Type of seizures you have
  • How the seizures affect you
  • Your age
  • Your lifestyle

Because each person’s treatment is unique and individualized, we cannot provide a one-size-fits-all description of treatment. But there are some general options for treating epilepsy. Your treatment plan will include one of or a combination of these options:

Watchful Waiting

Not all people with seizures will require treatment. If you’ve only had one seizure, or your seizures don’t put you in danger, we may take a watch and wait approach rather than starting medication right away.

Back to top

Medication

If we agree that a medical approach to treatment is best for you, we will start with medication. The medication we use falls into a class of drugs called anti-epileptic drugs (AEDs). Significant progress has been made in medical management of epilepsy in the last several decades. The number of available AEDs has increased from a handful in the early 1980s to more than 20 today. The new generation of AEDs is not necessarily more effective than the old medications, but they are a lot more tolerable in terms of side effects. With new choices, patients have more opportunities to find the right medication that provides satisfying seizure control and minimizes the side effects. Unfortunately, AEDs only control the symptoms of epilepsy, but do not cure it. In approximately 30 percent of patients, seizures cannot be adequately controlled with medication. For these patients, non-medical treatment such as surgery, vagus nerve stimulation, and ketogenic diet can be effective options.

There are also some reports suggesting that medical marijuana may help seizure control. Epilepsy is one of the conditions for which its use is approved. If you have questions about whether this might be an option for your type of epilepsy, contact your doctor.

Back to top

Surgery

If your seizures cannot be controlled with medications, surgery may offer the best opportunity for you to achieve seizure freedom. At the University of Chicago Medicine, we perform several different types of surgeries to treat epilepsy.

Back to top

Vagus Nerve Stimulation (VNS)

Some patients find relief from seizures with vagus nerve stimulation (VNS), an effective alternative to traditional surgery. In this minimally invasive procedure, your surgeon will implant a small device in your chest wall that sends electrical pulses to the vagus nerve in the neck. The goal is to block the faulty brain messages that cause seizures. Research shows that about 30 percent of people treated with VNS experience major improvement in seizure control. Another 30 percent experience some improvement. Most patients who undergo VNS must continue on epilepsy drugs, but some can reduce their dosage. At the University of Chicago Medicine, we use VNS for patients who are not responsive to medical treatment and for whom traditional epilepsy surgery is not an option. We also conduct an extensive evaluation on all VNS patients prior to surgery to make sure VNS is the best treatment option.

Back to top

Dietary Changes

Changes in diet can be effective for some people who have seizures. There is a specific diet we sometimes recommend called a ketogenic diet, but most often, we reserve it for children. This diet is high in fat and low in carbohydrates, so it forces the body to burn fat for energy rather than carbohydrates. When the body burns fat, it produces ketones, and higher ketones may lead to improved seizure control.

Back to top

More Information