Not everyone who has a seizure has another one. Your healthcare professional may decide not to start treatment until you’ve had more than one.
Seizure treatment aims to find the best therapy to stop your seizures with the fewest side effects.
Medications
Many medicines treat temporal lobe seizures. But many people can’t manage seizures fully with medicines alone. Side effects are common. They can include tiredness, weight gain and dizziness.
Discuss possible side effects with your healthcare professional when thinking about treatments. Also ask what effect your seizure medicines may have on other medicines you take. For instance, some antiseizure medicines can affect how well birth control pills work.
Dietary therapy
Following a ketogenic diet can improve seizure management. A ketogenic diet is high in fat and very low in carbohydrates. But it can be hard to follow because it allows only a very limited number of foods.
Other versions of a high-fat, low-carbohydrate diet also may be helpful but not work as well. These diets include low glycemic index and Atkins diets. Experts are still studying these diets.
Surgical or other procedures
When antiseizure medicines don’t work, there are other treatments, including:
Surgery. Epilepsy surgery is a procedure to reduce seizures and improve the quality of life of people who have epilepsy. Surgeons often do this with open surgery to remove the area of the brain where seizures begin.
Sometimes, surgeons may be able to use MRI-guided laser therapy. This is a less- invasive way to destroy the area of tissue that causes seizures.
Surgery works best if you have seizures that always start in the same place in the brain. Most often, you won’t have surgery if your seizures come from more than one area of the brain.
You also might not be able to have surgery if your healthcare team can’t find where the seizures start. Surgery also may not be an option if your seizures come from a part of the brain that affects speech, thinking, movement, memories and other important functions.
- Vagus nerve stimulation. A device placed under the skin of the chest stimulates the vagus nerve in the neck. This sends signals to the brain that lessen seizures.
- Responsive neurostimulation. Surgeons place a device on the brain or in brain tissue. The device can tell when seizure activity starts. It sends electrical stimulation to stop the seizure.
- Deep brain stimulation. Surgeons place thin wires called electrodes in certain areas of the brain to produce electrical impulses. The impulses help the body manage the brain activity that causes seizures. The electrodes attach to a pacemakerlike device placed under the skin of the chest. The device manages how much stimulation happens.
Pregnancy and seizures
People who’ve had seizures can most often have healthy pregnancies. But some medicines used to treat seizures sometimes can cause health conditions that are present at birth.
Valproic acid is a medicine for generalized seizures that has been linked with cognitive issues and neural tube defects, such as spina bifida, in babies. The American Academy of Neurology recommends against using valproic acid during pregnancy because of risks to babies.
Talk with your healthcare professional about the risks of antiseizure medicines, including the risk of health conditions present at birth. Make a plan with your health professional before you get pregnant. Pregnancy can change the way you need to take your medicine.
Some people may need to change the dosage of seizure medicine before or during pregnancy. The goal is to be on the lowest dose of the safest seizure medicine that manages seizures.
Birth control and antiseizure medicines
Some antiseizure medicines keep birth control from working as well. Check with your healthcare professional to see whether your medicine affects your birth control. You may need to try other forms of birth control.
