The word epilepsy means “seizure disorders,” which provides a good basic overview of this medical condition. However, epilepsy occurs on a spectrum, so every person who has this diagnosis faces their own specific challenges and seizure types.

It’s estimated that 3.4 million Americans have epilepsy, and approximately one-third of sufferers haven’t found a viable method to control their seizures. [1] As a result, it’s vital for individuals with this neurological disorder to look closely at every available treatment option.

Epilepsy has numerous symptoms that go beyond seizures, including:

• Staring for extended periods.
• Loss of awareness or consciousness.
• Temporary confusion.
• Uncontrollable jerking of the legs and arms.
• Anxiety or fear.
• Feelings of déjà vu.

Treating a medical condition that can vary dramatically between patients isn’t an easy task. Epileptics may have to try several treatment methods before they find the best results.

1. Medication

The Epilepsy Foundation points out that there are dozens of medications available, ranging from Lyrica all the way to Valium. [2] The FDA has also recently approved Epidiolex for severe cases, which is a non-psychoactive medication made from CBD oil. [3]

Each anti-epileptic medication has its own specific pros and cons. These prescriptions work by targeting the excessive electrical activity in the brain that causes seizures. Basic side effects such as drowsiness, headaches and nausea are common.

2. Ketogenic Diet

Physicians have had good success prescribing the ketogenic diet for epileptic children who haven’t responded well to medication. In most cases, this treatment method is not recommended for adults.

The ketogenic diet consists of a low-carbohydrate, high-fat approach to food. A dietician will be involved to help ensure that the proper ratio of fat to carbs is provided for each child’s specific circumstances. In the majority of cases, one gram of protein and carbohydrate can be ingested for every four grams of fat. [4]

Pros of the Ketogenic Diet

• More than 50 percent of young patients experience a drastic reduction in seizures.
• Up to 15 percent of children will become completely seizure-free.

Potential Side Effects of the Ketogenic Diet

• Sluggishness.
• Constipation.
• High cholesterol.
• Slowed growth.
• An increased risk of bone fractures and kidney stones.

3. Epilepsy Surgery

Surgery is sometimes recommended for epileptic patients who have found no success with prescription drug treatments. This method is also an option for those who are unable to tolerate the side effects of their medication.

There are several epileptic surgery options. A surgeon will select the appropriate type based on the exact form of epilepsy that the patient has. The three most common surgeries involve altering or removing part of the brain are:

1. Corpus Callosotomy: The neural connections between both sides of the brain are severed to prevent seizures that typically spread from one hemisphere to the other.
2. Resective Surgery: Surgeons have had great success with this treatment method, which requires the removal of a golf ball sized section of the brain.
3. Hemispherectomy: The most drastic surgical option removes half of the brain’s outer layer. [5]

Each successful surgery will reduce or eliminate seizures. Possible side effects such as memory problems, reduced visual field, double vision and behavioral changes make surgery much less common than other forms of treatment.

4. Modified Atkins Diet

Adults don’t tend to do well with the ketogenic diet, but a modified version of the Atkins diet has provided good results to about half the adults who’ve tried it. The nice thing about this dietary approach is that it’s much less restrictive than the ketogenic diet, yet it offers similar benefits. Up to 15 percent of patients who adopt this diet will completely eliminate their seizures, and it cuts the occurrence of seizures in half for another 35 percent of epileptics. [6]

As an added bonus, the modified Atkins diet can be used by adults and adolescents, thereby making it a good choice for families with multiple epileptic patients.

Variations between the Modified Atkins and Ketogenic Diets:

• Atkins doesn’t restrict calories and fluids.
• Atkins allows a lot more protein consumption.
• Atkins diet followers don’t have to measure and weigh their food.
• The risk of kidney stones is much lower with Atkins.

5. Stimulation of the Vagus Nerve

Attaching a battery-powered device to the vagus nerve can reduce the risk of seizures by up to 40 percent. [7] For this treatment method to work, the device must be implanted into the patient’s chest. Electrical energy is sent in bursts from the device to the brain and vagus nerve.

Interestingly, researchers aren’t certain how or why vagus nerve stimulation works. Medication is typically still necessary after the device has been placed under the patient’s skin, but the dosage might be lowered. The positive effects are believed to come from a combination of the nerve stimulation and other treatment methods.

Discuss Each Option with a Physician

Each epilepsy treatment should be closely monitored by a physician. This includes dietary changes, so don’t start the modified Atkins or ketogenic diet without consulting with your doctor first. If your current treatment isn’t providing the desired results, be sure to ask if you’re a good candidate for one of the other available options.

Sources

1. “What Is Epilepsy?” Edited by Joseph I. Sirven and Patricia O. Shafer, Epilepsy Foundation, Epilepsy Foundation of America, 21 Jan. 2014, epilepsy.com/learn/about-epilepsy-basics/what-epilepsy.
2. “Seizure Medication List.” Edited by Joseph I. Sirven and Patricia O. Shafer, Epilepsy Foundation, Epilepsy Foundation of America, 19 Mar. 2014, https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/seizure-medication-list.
3. “FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy.” S. Food and Drug Administration, U.S. Department of Health and Human Services, 25 June 2018, www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm611046.htm.
4. Kossoff, Eric. “Ketogenic Diet.” Edited by Joseph I. Sirven, Epilepsy Foundation, Epilepsy Foundation of America, 25 Oct. 2017, epilepsy.com/learn/treating-seizures-and-epilepsy/dietary-therapies/ketogenic-diet.
5. Mayo Clinic Staff. “Epilepsy Surgery.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 Aug. 2015, mayoclinic.org/tests-procedures/epilepsy-surgery/about/pac-20393981.
6. Schachter, Steven C., and Joseph I. Sirven. “Modified Atkins Diet.” Edited by Eric Kossoff and Mackenzie Cervenka, Epilepsy Foundation, Epilepsy Foundation of America, 19 Nov. 2015, epilepsy.com/learn/treating-seizures-and-epilepsy/dietary-therapies/modified-atkins-diet.
7. Mayo Clinic Staff. “Epilepsy.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 13 June 2018, mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/drc-20350098.