Epilepsy Management

What is Epilepsy?

Dr. Kapur reading charts

Epilepsy is a disorder that results from the generation of electrical signals inside the brain, causing recurring seizures. Seizure symptoms vary. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others have full-fledged convulsions. About one in 100 people in the United States will experience an unprovoked seizure in their lifetime. However, a solitary seizure doesn't mean you have epilepsy. At least two unprovoked seizures are required for an epilepsy diagnosis. Even mild seizures may require treatment, because they can be dangerous during activities like driving or swimming. Treatment — which generally includes medications and sometimes surgery — usually eliminates or reduces the frequency and intensity of seizures. Many children with epilepsy even outgrow the condition with age.

What are the symptoms?

Seek medical advice if you experience a seizure for the first time. Also, seek immediate medical help if any of the following occurs.

What is the prognosis?

When a patient has been seizure-free for several consecutive years, it may be possible to discontinue medication, depending on the patient's age and the type of epilepsy. This is only done under the supervision of a physician. As many as three-quarters of adults who have been free of seizures for 3 years remain seizure free after discontinuing drug therapy. More than one-half of children can stop medication without developing seizures.

What is the treatment?

Most people with epilepsy can become seizure-free by using a single anti-epileptic drug. Others can decrease the frequency and intensity of their seizures. More than half the children with medication-controlled epilepsy can eventually stop medications and live a seizure-free life. Many adults also can discontinue medication after two or more years without seizures.

Half of all people newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don't provide satisfactory results, your doctor may suggest surgery or other therapies.

Surgery is most commonly done when tests show that your seizures originate in a small, well-defined area of your brain that doesn't interfere with vital functions like speech, language or hearing. In these types of surgeries, your doctor removes the area of the brain that is causing the seizures. If your seizures originate in a part of your brain that can't be removed, your doctor may recommend a different sort of surgery such as where surgeons make a series of cuts in your brain. These cuts are designed to prevent seizures from spreading to other parts of the brain. Another option is a Vagal Nerve Stimulator. Although many people continue to need some medication to help prevent seizures after successful surgery, you may be able to take fewer drugs and reduce your dosages. In some cases, surgery for epilepsy can cause complications such as permanently altering your cognitive abilities. Talk to your surgeon about his or her experience, success rates and complication rates with the procedure you're considering.