Talking With Your Doctor About Epilepsy Treatment

Medically Reviewed By William C. Lloyd III, MD, FACS

One of the most important pieces of epilepsy treatment is open communication with your doctor. Here are topics to discuss with your doctor about the best course of treatment for you.

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Epilepsy is a neurological condition that causes frequent seizures. Seizures occur when there is a sudden, abnormal burst of electrical activity in the brain. Seizure symptoms vary and can last a few seconds to a few minutes. They may include:  

  • Blank staring or rapid blinking
  • Body stiffening
  • Convulsions and loss of consciousness
  • Jerking movements of the arms and legs 
  • Lip smacking

There is no cure for epilepsy. However, there are treatments that may prevent seizures or reduce the frequency and severity of seizures. Medication, surgery, and dietary changes are options. Your doctor will tailor your treatment plan to your needs based on the type of seizures you have, your age, and other factors. 

One of the most important pieces of epilepsy treatment is open communication with your doctor. Here are topics to discuss with your doctor about the best course of treatment for you.

Describe Your Symptoms

After your initial diagnosis, your doctor will want to know when you have seizure, what it looks like, and what was happening just before it began. For example, did you feel sudden panic or fear or did things look or sound differently just before your seizure? 

Ask your loved ones to carefully take note of your symptoms during a seizure. If you are taking anti-seizure medicine, also called antiepileptic or anticonvulsant drugs, tell your doctor about any side effects you experience. Side effects may include dizziness, trouble concentrating, tiredness, upset stomach, weight gain or loss, depression, and allergic reaction.

Explore Your Treatment Options

The goal of epilepsy treatment is to prevent seizures, or greatly reduce the frequency and severity of the seizures. Treatment options fall into four main categories: medicine, surgery, devices and diet.

Medicine

Medicine is the primary treatment for epilepsy. Antiepileptic medicines can limit or prevent seizures in most people. The type and dose of medicine will depend on the type of seizures you have, your age, other medical conditions, and medicine side effects. 

It may take a bit of trial and error before your doctor finds the right medicine for you. It is important to follow your doctor’s instructions carefully when taking these medicines. To be effective, antiepileptic medicines must be taken every day exactly as prescribed. If your current treatment isn’t helping, your doctor can change the dose, try a different medicine, or recommend a different type of treatment.

Surgery

When medicine isn’t helping, surgery to remove the seizure-producing areas of the brain may be an option. Neurosurgeons consider brain surgery to treat epilepsy for people who have:

  • Tried standard medicines without success or developed intolerable side effects from the medicines
  • Seizures that always start in just one part of the brain
  • Seizures in a part of the brain that can be removed without affecting critical functions, such as speech, memory or sight
  • Seizures as a result of a growth or lesion that can be removed safely


Devices

Vagus nerve stimulation (VNS) is another type of surgery that can lessen seizure frequency. In VNS, a surgeon implants a small device under the skin in the chest. The device is connected to the vagus nerve in the neck. Short bursts of electrical energy are sent from the device through the vagus nerve to the brain. Epilepsy experts are actively researching the use of other electronic devices in the treatment of seizures and epilepsy.

Diet

Lastly, some people, especially children, may benefit by eating a very high fat, low carbohydrate diet. It is called the ketogenic diet. The diet tricks the body into starvation mode where it burns stored fat for energy instead of glucose. Researchers don’t know why the diet prevents seizures, but studies have shown that it works for some children. 

Questions to Ask Your Doctor

Before starting medication treatment for epilepsy, ask your doctor these questions. 

  • When and how should I take my medicine? 
  • What do I do if I miss a dose of my medication?
  • What side effects should I look for?
  • Are there over-the-counter medications I should avoid while taking epilepsy medicine?
  • What lifestyle measures should I take to prevent seizures? How much sleep do I need at night? Can I drink alcohol?
  • How often should I see you for follow-up appointments and tests?

If you are considering surgery for epilepsy, talk with your doctor about the risks and benefits of surgery and compare it to the risks of not adequately treating your seizures.

For some people, surgery may be the appropriate choice. Also consider getting a second opinion before making a final treatment decision. Here are other questions to ask:

  • What are my specific options for surgery? What are the risks of surgery vs. not having surgery?
  • Do you typically treat patients like me (or my child)?
  • What results do you typically see? Do you have outcomes data to share?
  • At what hospital(s) do you perform surgery? What is the quality of care at these hospitals?

The Bottom Line

Ask your doctor why he or she thinks a certain treatment is right for you or your child. Ask about the side effects, risks, and how long it can take to see results.  Finding a doctor you trust is key to getting the best treatment and results.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 3
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.