Epilepsy is usually treated with anti-epileptic medication prescribed by general practitioners, neurologists, and neurosurgeons.
Some people with epilepsy will experience a complete remission when treated with an anti-epileptic medication. If this does not occur, the dose of medication may be increased, or another medication may be added to the first. The general strategy is to increase the medication dose until either the seizures are controlled, or until dose-limiting side effects appear.
- Various drugs may prevent seizures or reduce seizure frequency: these include carbamazepine, clobazam, clonazepam, valproic acid, and vigabatrin, etc.
- Other drugs are commonly used to abort an active seizure or interrupt a seizure flurry; these include diazepam and lorazepam.
- Drugs used only in the treatment of refractory status epilepticus include paraldehyde and pentobarbital.
Neurosurgical operations for epilepsy can be palliative, reducing the frequency or severity of seizures; or, in some patients, an operation can be curative. Surgical treatment can be an option for epilepsy when an underlying brain abnormality, such as a benign tumor or an area of scar tissue (e.g. hippocampal sclerosis) can be identified. Surgery is usually only offered to patients when their epilepsy has not been controlled by adequate attempts with multiple medications.
Ketogenic diets are sometimes prescribed in severe cases where drugs have proven ineffective. They are high in fat and extremely low in carbohydrates, with intake of fluids often limited. Ketogenic diet is not good for the heart or kidneys and problems resulting from the diet have been reported.
Vagus nerve stimulation is a recently developed form of seizure control which uses an implanted electrical device, similar in size, shape and implant location to a heart pacemaker, which connects to the vagus nerve in the neck. Once in place, the device can be set to emit electronic pulses, stimulating the vagus nerve at preset intervals and milliamp levels.
Complementary treatments include herbal medicines, supplements, and essential oils. Magnesium and vitamin B6 exerted a positive non-specific influence on the mental states of patients with epilepsy, depression, and anxiety during an experiment.