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.