Treatment options for patients with drug-resistant epilepsy

Treatments available for drug-resistant epilepsy

Written by Dr. Frank Gilliam, director of the Epilepsy Center at the Kentucky Neuroscience Institute at the University of Kentucky. 

Dr. Frank Gilliam

Dr. Frank Gilliam

One in 26 people will develop epilepsy – a chronic disease characterized by unpredictable seizures — in their lifetime.

A seizure is a sudden surge of electrical activity in the brain that can temporarily change how a person thinks or behaves. Seizures can be scary for both the patient and the people around them, since patients can lose awareness or even become unconscious, twitch or spasm, babble, have blurry or no vision, experience difficulty breathing, and/or a host of other symptoms.

Epilepsy has numerous physical and emotional costs. People with epilepsy have problems keeping up in school or at work, can be depressed and/or socially isolated, can suffer physical injury during a seizure, and can even die from a seizure. They may not be allowed to drive, play sports or have other restrictions that affect their professional or personal lives.

It’s important to remember that not all seizures are epilepsy. A person is diagnosed with epilepsy if they have one or more seizures that were not caused by some known and reversible medical condition such as diabetes. People can develop seizures after a brain injury (like a car accident or getting hit in the head with a baseball), a stroke, or because of an infection or a brain tumor. Sometimes there is a family history of seizures, but often the cause is unknown.

If you suspect you have had a seizure, you should see your family doctor or a neurologist for an evaluation. That is likely to include a detailed conversation about what happened during your seizure, medications you are taking, preexisting illnesses or injuries, family history and more. The doctor is also likely to order blood tests that might identify treatable medical disorders, an EEG, which measures brain waves and looks for abnormalities that point to epilepsy or other neurological disorders, and possibly also a CAT scan or MRI to look for abnormal areas of the brain.

There is no cure for epilepsy, but two-thirds of all people with epilepsy are able to control their seizures with medications. The remaining one-third have what’s called “drug-resistant” or “refractory” epilepsy. In those cases, patients may be able to find relief through surgery or through devices that can help override the abnormal electrical impulses in the brain.

In the U.S., there are more than 100,000 patients who are candidates for epilepsy surgery, and only about 2,000 people have the surgery every year. Patients don’t need to suffer from the physical and emotional effects of epilepsy for 10 or 20 years. If someone has uncontrolled epilepsy for more than a year, they should seek an opinion at an accredited epilepsy center.


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