There are more than 20 medications available to treat epilepsy and control seizures. Medications may keep some patients seizure-free for long periods of time, however some may interact with other medications, or have an effect on mood or body weight. These effects may be either unwanted or desirable depending on the situation. For example, some medications will treat other illnesses such as headaches, in addition to treating epilepsy. Your doctor will take all of these factors into consideration when he or she decides which combination of anti-epileptic medication will produce the best overall results for you.
Doctors might choose a ketogenic diet for patients who respond poorly to medication. When on a ketogenic diet, patients eat foods that rich in fats and oils, but low in proteins and carbohydrates. This creates a condition in the body called ketosis, which can help control seizures. Achieving a reduction in seizures requires strict compliance with the diet.
Vagus Nerve Stimulation (VNS)
In this surgical procedure, an electrode is connected to a nerve in the neck called the vagus nerve and to a battery that resembles a pacemaker. The device is implanted under the collarbone and helps prevent seizures by sending a small, regular pulse of electrical energy to the brain via stimulation of the vagus nerve.
Some patients with epilepsy have seizures that cannot be controlled with medication, and may be ideal candidates for neurosurgery. The decision to undergo surgery is based on each patient’s needs.
- Focal Resection — Surgeons identify the portion of the brain where seizures originate so that they can remove problem areas. This procedure is most often performed on the temporal lobe, but can also be performed in other parts of the brain. Your physician will recommend a thorough set of tests to determine the location of the seizure focus, and confirm that the surgery will not risk the loss of any important functions such as speech or movement.
- Corpus Callosotomy — Surgeons interrupt the pathways of seizures by separating the right and left hemispheres of the brain. To achieve this, they sever the corpus callosum which is the bundle of neural fibers connecting the two hemispheres. This procedure generally does not completely stop seizures from occurring, however seizures usually become less severe because they cannot spread to the opposite side of the brain. This procedure is rarely used, as it is considered a last resort.