A Doctor's Perspective on Treating Epilepsy: Cured vs. Controlled

Was this helpful?

Receiving that initial epilepsy diagnosis can be extremely difficult for patients to hear. For that reason, I try to take as much time as necessary to answer every question (and those of the family, if they’re present) during that first visit.

Often, one of the first questions I’m asked is if there’s a cure for epilepsy. This question is tricky, and really depends on how you define “cured.” What I can tell them is there’s a very high chance their epilepsy can be controlled with treatment. And by controlled, I mean they will have zero seizures, have a reduced risk for injury, be able to drive, and yes, live a fairly normal life.

The treatment we typically try first is antiepileptic seizure oral medications (AEDs). These medications effectively control seizures in 70% of patients. Unfortunately, sometimes there’s initial trial and error in finding the right medication. There isn’t a seizure medication available at this time without at least one side effect, and some medications have many. In the beginning of treatment, you may experience some physical fatigue, mental fogginess, or slowness in your thinking. While side effects themselves are not entirely preventable, most of my patients learn to tolerate them and are comfortable within 1 to 3 weeks.

If two or more medications have failed to control a patient's seizures, there's a possibility the type of seizures this person is experiencing are nonepileptic. In this situation, we attempt to confirm whether or not it’s epilepsy using an electroencephalograph (EEG) to measure brain waves.

A patient who does have EEG-confirmed epilepsy, but has not responded to at least two medications, could be a candidate for brain surgery. To find out if you’re a candidate for this type of surgery, we perform an MRI (magnetic resonance imaging to get a detailed picture of your brain so we can identify what part of the brain is causing these seizures. The MRI also tells us if it’s safe for us to remove that particular area. Although this type of surgery sounds extreme and high risk, in the right hands, it’s probably one of the safest surgeries we do in neurology. It has a less than 1% risk for any complication. In fact, 70 to 80% of patients who receive epilepsy surgery remain seizure-free.

I always try to encourage my patients that people with epilepsy can lead completely normal lives--as parents, spouses, employees--as long as they take their medications and avoid extremes in their behavior and lifestyle, such as getting too little sleep, drinking too much alcohol, and letting your weight get out of control.

When you find a medication that works for you, you don’t have to worry as much about being home alone, seizing at work or in the car. In fact, in most states, you’re authorized to drive after being seizure-free for six months. I encourage my patients to live their life, but live it with moderation and remember they’re not invincible.

Was this helpful?
THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.
Explore Epilepsy
  • Learn how epilepsy and seizure symptoms can affect driving, and how epilepsy driving laws may affect you.
    August 17, 2018
  • One in 26 Americans will develop epilepsy during their lifetime and caregiving for this disorder can be scary and stressful. Seizures happen unexpectedly and not knowing how to respond can be a big challenge for caregivers. Though epilepsy presents itself in different ways for every person, there are general guidelines that can make you feel more capable and prepared as a caregiver.
    June 10, 2016
  • If you have epilepsy, it’s likely your doctor prescribed a few different medications at various dosages before you found the one that helped control your seizures best. But over time, your epilepsy treatment may not work as well as it once did. Although this can be discouraging, before worrying that you may have to start over again, there could be a simple fix, depending on why the treatment stopped being effective. Here are some things to watch out for if your epilepsy treatment doesn’t seem to be working.
    June 10, 2016
  • These basic first aid steps will help you protect and care for your loved one during a seizure.
    June 10, 2016
Recommended Reading
Next Up
  • A seizure is an abnormal burst of electrical activity in your brain that temporarily affects your awareness, sensations, thoughts or actions. Many people misunderstand seizures. Now is the time to learn the truth.
  • Having epilepsy increases your risk of developing high blood pressure and pre-diabetes. But with regular exercise, you can help manage those health problems.
  • An epileptic episode typically affects all areas of the brain. Find out what happens to the rest of your body during a seizure.
  • The effects of epilepsy can extend beyond just seizures.

  • Seizures typically only last a few seconds, but having a plan in place will help prevent injuries. Read up on seizure safety do’s and don’ts.
  • Dealing with epilepsy at work can be challenging, but a productive work life is possible.
  • Epilepsy is a complicated medical illness that causes people to have multiple seizures. Treatments are available that help most patients stop or control their seizures. However, many times a knowledge gap exists that prevents patients from optimal medical treatment. By understanding these five key factors, patients with epilepsy can take more control over their condition.
  • When medication or surgery doesn't help with epilepsy, some people turn to acupuncture.
Answers to Your Health Questions
Trending Videos