Determining the best treatments for epilepsy depends on obtaining an accurate diagnosis. Once epilepsy is confirmed, any underlying causes identified and the type determined when possible, doctors can respond with an array of therapies including medications and surgical intervention.
Specialists in different areas of medicine provide treatments for epilepsy. In addition to the primary care physician, a neurologist or epileptologists (a subspecialty focused on epilepsy) confirms the diagnosis and consults on care. The patient may also be referred to a neurosurgeon for treatment.
For about two thirds of people with epilepsy the most effective treatment options are antiepileptic medications that may be used singly or in combination. Depending on how the patient responds, the doctor may adjust dosage or change drugs. More than 20 types of antiepileptic medications are now available including ethosuximide, clonazepam, phenobarbital, and primidone. Some of these drugs cause fatigue, weight gain, dizziness and other side effects and suddenly discontinuing drug therapies can trigger sudden, severe seizures.
When seizures always begin in one area of the brain, and medication alone does not control seizures, surgery may be considered as a treatment for epilepsy. Location is critical as doctors prefer not perform surgery in areas of the brain used in everyday behavior, speech, language and the senses. In the most common surgery, a temporal lobe resection, a neurosurgeon removes the small part of the brain where seizures start. Other procedures seek to prevent seizures from spreading from one area of the brain to another.
A high fat-low carbohydrate diet may help significantly reduce seizures in children. Good nutrition with vitamin supplements such as folic acid may alleviate some dietary problems related to medications used to treat epilepsy.