The goal in epilepsy treatment is to reduce or eliminate the
frequency of seizures. The current standard treatment mostly revolves around
medications. Treatments will either be
short-term or long-term, depending on the type of epilepsy you have.
Your doctor may include other forms of treatment, including
dietary changes, exercise, and other healthy lifestyle choices. They may ask
that you curb any unhealthy choices and behaviors that can interfere with
Surgery is an option, but it’s only used in severe cases when
medication is ineffective.
Most epilepsy is treatable with medication. There are a number
of drugs available. Some are useful for easing a variety of seizures, while
others work best on specific types. Certain medications are used to complement
primary seizure treatments.
There are numerous side effects that come with drug treatment. The
kind of side effects a person might encounter depends on the drug or drugs
being used to treat their epilepsy.
Some common side effects of epilepsy medications include:
- vision problems
- coordination difficulties
- speech problems
- upset stomach
- mild skin rash
The two main classifications of antiepileptic drugs (AEDs) are
narrow-spectrum AEDs and broad-spectrum AEDs. Narrow-spectrum AEDs work on
specific types of seizures, while broad-spectrum AEDs work on multiple types of
seizures and other conditions.
(Tegretol): This drug tends to be more effective with
partial and tonic-clonic seizures. Side effects include
fatigue, double vision, loss of coordination, and possibly an effect on
the body’s calcium and vitamin D metabolism. It can also, in rare cases,
cause a decrease in infection-fighting cells in the blood.
(Zarontin): This drug only works against absence
seizures. Side effects include drowsiness and fatigue, headaches, hiccups,
and nausea. It can also cause rash and suppression of blood cell
production in the bone marrow (leukopenia or pancytopenia).
(Neurontin): This drug can be effective against partial
and secondary generalized seizures. Side effects are usually few and mild
with Gabapentin. They include sleepiness and fatigue, dizziness, and lack
(Luminal): This is one of the first drugs that was
found to be effective in fighting seizures and it is still occasionally
used. It’s effective against many types of seizures. The drawbacks of this
drug include fatigue, rash, drowsiness, blurred vision, dizziness, and
lack of coordination. Other side effects include behavioral changes and
loss of focus and concentration. Long-term use can also increase the risk
of osteoporosis and anemia.
(Dilantin): This is another older epilepsy drug.
Unlike phenobarbital, Phenytoin tends to be more effective with partial
and tonic-clonic seizures than with other types. Side effects can include
dizziness, loss of coordination, slurred speech, tremors, loss of
concentration, and jerking of the eyes. Some of the more pronounced side
effects include facial hair growth in women, increased growth of the gums,
- Tiagabine Hydrochloride
(Gabitril): This drug is effective against partial seizures. It can
cause dizziness, headaches, sleepiness, and tremors.
(Klonopin): This drug is effective against a wide
spectrum of seizure types. The major problem with this drug is tolerance.
The body can get used to the medication, causing it to stop working. It
can also cause sleepiness, a loss of coordination, swelling in the legs,
memory problems, and in some cases an increase in seizures.
(Felbatol): This drug fights a wide range of seizures.
Serious side effects, such as failure of the liver or bone marrow, have
been associated with this drug.
(Lamictal): This is a newer drug that is effective
against most seizures. This drug can cause a serious rash, headache,
dizziness, clumsy movements, and double vision.
(Mysoline): This is another longtime anticonvulsant
that’s effective against a wide range of seizures. This drug has side
effects similar to those of phenobarbital and is used less often than other
(Topamax): This can be used in conjunction with other
drugs and is effective against a range of seizure types. It can cause
weight loss and problems with memory and focus. In some cases, people
using this drug develop kidney stones.
Sodium or Valproic Acid (Depakote): This drug is effective
against most seizure types. Stomach problems, weight gain, tremors,
nausea, and hair loss are all side effects that can occur with this drug.
It can also cause problems with the pancreas and the liver.
Drugs are ineffective in some
cases. Surgery may be an option if
the part of the brain where the seizures originate doesn’t affect vital
functions like your speech, language, and hearing abilities. For areas of the brain
that cannot be removed, there are different surgical procedures that can
prevent seizures from spreading to other parts of the brain.
There are several types of surgery that might be used in the
case of refractory seizures. They include the following.
- temporal lobectomy: This
surgery removes the portion of the brain’s temporal lobe that is causing
- hemispherectomy: This
surgery involves deactivating one of the brain’s hemispheres by removing
the affected portions of the cerebral hemisphere. This procedure is
usually considered for children suffering from Rasmussen’s encephalitis
epilepsy, which can heavily damage a hemisphere of the brain.
- corpus callosotomy: The
brain’s primary division is into two hemispheres. These two hemispheres
use a specialized connective tissue called the corpus callosum to
communicate. This procedure partially or completely separates the corpus
callosum, minimizing or preventing communication between the hemispheres.
- vagus nerve stimulation (VNS): This
surgery involves the insertion of a small machine into the patient’s body.
Wires are run from it to the vagus nerve. The machine periodically causes
the nerve to stimulate the brain. This can suppress seizures.
If you encounter someone who is having a seizure, the Centers
for Disease Control and Prevention (CDC) offers these
tips for emergency treatment and first aid:
- Keep calm and reassure other people who may
- Prevent injury by clearing the area around
the person of anything hard or sharp. Ease the person to the floor and put
something soft and flat, like a folded jacket, under his or her head.
- Remove eyeglasses and loosen ties or
anything around the neck that may make breathing difficult.
- Begin to time the seizure with your watch.
- Call 911. Don’t hold the person down or try
to stop his or her movements.
- Contrary to popular belief, it’s not true
that a person having a seizure can swallow his tongue. Do not put
anything in the person’s mouth. Efforts to hold the tongue down can injure
the teeth or jaw.
- Turn the person gently onto one side. This
will help keep the airway clear.
- Don't attempt artificial respiration except
in the unlikely event that the person does not start breathing again after
the seizure has stopped.
- Stay with the person until the seizure ends
naturally and they are fully awake.
- Do not offer the person water or food until
- Be friendly and reassuring as consciousness
- Offer to call a taxi, friend, or relative to
help the person get home if they seem confused or unable to get home
Here are a few things you can do to help someone who is having a
seizure that involves blank staring, loss of awareness, or involuntary
blinking, chewing, or other facial movements:
- Stay calm and speak reassuringly.
- Guide them away from dangers.
- Block access to hazards, but don’t restrain
- If the person is agitated, stay a distance
away, but close enough to protect them until full awareness has returned.
Consider a seizure an emergency and call 911.
Written by: the Healthline Editorial Team
on: Oct 30, 2014: Brenda B. Spriggs, MD, MPH, MBA
This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.