Introduction: How Is Epilepsy Treated?

If you are diagnosed with epilepsy, the first question you and your doctor will face is whether treatment is necessary. In most cases the answer will be yes. Typically there is a significant risk of further seizures, and these seizures would interfere in some way with your life. In rare cases, however, the chance of another seizure may be so small that treatment is not recommended. For some, seizures may be subtle and tolerable. For instance, a seizure could be only a brief vision or feeling without change in alertness. In these cases treatment may not be required.

In most cases, however, your doctor will recommend treatment, which almost always means an anti-seizure drug. Surgical treatment may be beneficial in selected cases.
 

Drugs for Epilepsy

The choice of drugs for epilepsy depends first on the type of seizures you have. Most patients have what is termed partial epilepsy, meaning that the seizure starts in a particular spot on the brain. It may spread and involve other areas, or even the entire brain (a generalized tonic-clonic, or grand mal, seizure). Most available drugs treat partial epileptic seizures.
The other category of seizures is called generalized because the seizure appears to start everywhere at once. Important seizure types in this category are absence (petit mal) seizures, tonic seizures (consisting of sudden stiffening all over), and myoclonic seizures (in which the patient experiences a sudden jerk of the entire body, which can occur repeatedly). Some drugs that treat partial seizures can make generalized seizures worse, but other drugs treat both partial and generalized seizures.
 
The Old School
Potassium bromide was the first effective drug used for epilepsy and was developed in the mid-nineteenth century. It helped to control seizures but caused such severe sedation and long-term toxicity that it is no longer in use.

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