How Is Epilepsy Treated?

Epilepsy is a chronic disorder in which brain cells produce abnormal electrical signals in the brain, causing repeated seizures (via Cleveland Clinic). It's one of the most common neurological disorders worldwide, affecting about 50 million people, according to the World Health Organization.

According to Cleveland Clinic, in 70% of cases, the exact cause of epilepsy seizures is unknown. Some known causes include genetics, brain infection, head injuries, and immune disorders. Also, people with a history of stroke may have an increased risk of seizures, per Healthline. Generally speaking, an imbalance in the brain's electrical rhythms causes seizures to recur in most people with epilepsy, per the American Association of Neurological Surgeons (AANS). Some people may show other symptoms depending on which part of the brain is involved in the disruption. 

Beyond causing seizures, epilepsy can be fatal. According to the Centers for Disease Control and Prevention (CDC), sudden unexpected death in epilepsy (SUDEP) is a concern for people with epilepsy. Annually, SUDEP affects approximately 1.16 people for every 1,000 people living with epilepsy. Although epilepsy has no known cure, treatment focuses on the management of symptoms (via Yale Medicine). Various treatment options are available, but they often depend on the type of epilepsy seizure a patient is having.

Types of epilepsy seizures

The signs of a seizure and what a seizure looks like typically depend on what kind of seizure it is, according to the CDC. It can sometimes be hard to tell if a person is having a seizure; some people look confused or have a blank stare, while others fall suddenly with their bodies shaking. Therefore, knowing the different types of seizures and their characteristics is crucial.

According to the Mayo Clinic, doctors classify seizures as either generalized or focal, related to how and where the abnormal brain activity begins. Focal seizures occur when abnormal electric activity is recorded in just one area of the brain. Focal seizures can be grouped into two types: seizures without loss of consciousness and seizures with impaired awareness, where the person appears to be in a dream.

On the other hand, generalized seizures involve all brain areas. According to WebMD, there are six types of generalized seizures: tonic, clonic, tonic-clonic, atonic, myoclonic, and absence.

How is epilepsy treated?

During an epilepsy diagnosis, your doctor might ask various questions about your seizures. They might also recommend a special test called an electroencephalogram (EEG), or a brain scan, according to the NHS. By checking for unusual electric activity, damage, or scarring to the brain, the test can help determine whether you have epilepsy. However, in some instances, the test might not reveal any signs. In this case, a diagnosis may still be reached by identifying certain symptoms.

According to the Epilepsy Foundation, the first step to treating epilepsy is identifying the right medicine or anti-epileptic drug (AED). Seizure medicines can successfully control seizures in about 70% of people with epilepsy. A doctor might prescribe these medications based on age, sex, the type of seizures you have, if you're pregnant or want to get pregnant, and other medical conditions (via WebMD). Treatment with medications might not work for everyone, and some people might experience various side effects, including tiredness, mood swings, memory issues, and bone thinning.

Brain surgery is another option in cases where medications don't work. According to Healthline, health experts are still researching new treatments and minimally invasive surgeries. Deep brain stimulation is one such new treatment, which involves implanting electrodes into the brain and a generator into the chest to help decrease seizures. Diet is also a possible treatment option — the ketogenic diet has been found to be particularly helpful in childhood epilepsy, but some studies say adults can benefit too (per WebMD).