Seizures

In many cases, seizures can be an isolated incident. Doctors may not begin a course of treatment unless your tests indicate a high risk of recurrence or if the seizure is followed by more seizures.

Depending on the cause, severity, and location of your seizures in the brain, there are medications, dietary plans, electrical stimulation procedures, and surgical procedures available as treatment options.

Medication for seizures

Initiating antiseizure medication is a common strategy, and a first-line treatment for controlling seizures. Some medications can stop seizures when they occur, while others can be taken daily to help prevent future episodes.

With so many kinds of antiseizure medication available, it may take time to find the right one for you. The goal is to find the one that yields the best results with the least side effects.

Seizure medication side effects can include dizziness, weight changes, mood shifts, and fatigue. More serious side effects are rare but can include damage to the liver or bone marrow.

Dietary therapy

Adopting a ketogenic diet — a high-fat and low- to no-carb food plan — may help stop or reduce the frequency of seizures. Since adhering to this kind of diet may be challenging for many patients, there are modified versions, including the modified Atkin’s diet and low glycemic index diet, which can also be beneficial in treating seizures. These diets typically work alongside medications and do not replace them. You may be required to work with a nutritionist to adhere to a specific diet.

Electrical stimulation

Several types of electrical brain stimulation are used to treat seizures. This type of treatment is known as neuromodulation. Options include:

• Deep brain stimulation. For this treatment, doctors implant electrodes in specific brain areas of your brain. The electrodes deliver electrical impulses from a small, pacemaker-like device implanted under the skin below your collarbone.
• Vagus nerve stimulation. The vagal nerve runs from the brain to the gastrointestinal system. Electrical currents are sent along the vagal nerve from a small device implanted under the skin of your chest, helping reduce the recurrence of seizures. Medication may still need to be taken.
• Responsive neurostimulation. A small device is placed on the brain's surface within the skull and is connected to two wires (electrodes), which can detect abnormal brain activity and deliver electrical impulses to the area of origin to stop the seizure.

Neuromodulation, over time, can help reduce the excitability of the epileptic areas of the brain, thereby reducing seizures and improving quality of life. This treatment does not come with the typical side effects associated with medications.

Surgical options

When other treatment options are unsuccessful, there are several other surgical options available to treat seizures. These procedures generally involve surgically removing areas of the brain where seizures originate or cutting network connections between the neurons of the right and left hemispheres of the brain. A minimally invasive technique called laser interstitial thermal therapy (LITT) using thermal energy to ablate (burn) a very focused area of the brain, can sometimes be performed, which causes minimal impact on brain function and has a shorter recovery time.