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What is the most effective treatment for epilepsy?

Epilepsy is a disorder that dates back to around 2,000 B.C. The understanding of the most

effective treatment for epilepsy has changed throughout time. The attitude and treatment of the

disorder have varied greatly over time. So, what is the most effective treatment for epilepsy? It is

imperative that society understands what treatment methods work best and what treatments

should be avoided unless other options do not yield the desired results. That is to say,

maintaining a healthy diet, like the Mediterranean or Keto diet, in addition to anti-convulsant

medications where appropriate, would be a great start in experimenting with treatment options.

On the other hand, because of the invasiveness of surgery and Vegas Nerve Stimulation devices,

these should be used as a last resort.

Epilepsy has a long and complex history. The understanding of epilepsy has changed

over time. In the early years of its discovery, many civilizations believed seizures to be the act of

demons possessing one’s body; with this in mind, the disorder became known as the “Sacred

Disease.” An exorcism usually followed in the treatment of the affliction. Epileptics were

socially isolated and feared by those who did not understand the nature of the disorder. In some

cultures, including the United States, an individual with epilepsy was prohibited from marrying

and may have undergone sterilization. In the United States, this practice continued until around

the 1950s. Also, until the 1970s, many social facilities in the U.S. had the right to deny services

to those with epilepsy (Kaculini et. al). In 2010, President Obama signed into law the Affordable

Care Act, which helped to reverse the discrimination epileptics faced in obtaining insurance for

pre-existing conditions. Although there are still many societies that act on archaic beliefs about

epilepsy, education around the area of the disorder is growing and with this change in attitude,

more epileptics will gradually feel more accepted and benefit from a rewarding social life.
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The government article, The History of Epilepsy: From Ancient Mystery to Modern

Misconception, describes the treatment of epileptics and the actions taken to treat seizures

starting at around 4,000 years ago all the way to the present. Throughout this article, it is clear

that the treatment of the individual and seizures has changed drastically in some areas throughout

this time. There are parts of the world that have not updated their methods of treating epileptic

seizures and the social environment created for the individual remains as hostile or as fearful as

4,000 years ago. This article also explores the scientific process some early thinkers used to

determine the cause of epilepsy. Some individuals tried to spread awareness about the disorder,

in that seizures were not the effects of possession by demons or evil spirits, but perhaps the result

of abnormal electric brain response to stimulation (Kaculini et. al).

The webpage, Epilepsy Surgery, published by Dayton Children’s Hospital, provides

information about epilepsy surgery, including the different functions of the brain regions. The

webpage provides information for parents about the different functions of the brain in the region

where surgery occurs that could be inhibited after surgery. The post-surgical effects depend upon

which region the surgery has taken place. It is important to note that “some types of epilepsy

surgery may lead to seizure freedom and an improved quality of life in up to 80% of people with

drug-resistant epilepsy” (Dayton Children’s). It is important to take the appropriate amount of

time needed to decide whether to move forward with the option of surgery. “Epilepsy surgery is

most effective when seizures always occur in a single location in the brain” (Mayo Clinic). Focal

Resection surgery “removes the part of the brain that is causing the seizures. This is the most

common type of epilepsy surgery” (Dayton Children’s). There are many types of epilepsy

surgery. However, these invasive options cannot “guarantee that a child will be seizure-free”

(Dayton Children’s).
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The webpage, Vegas Nerve Stimulation, provides information about the use of vegas

nerve devices and when they should be implemented into the patient’s care. Vegas Nerve

Stimulation may be utilized in the case of “focal epilepsy when surgery is not possible or does

not work” (Dayton Children’s). “In conventional vagas nerve stimulation, a device is surgically

implanted under the skin on your chest, and a wire is threaded under your skin connecting the

device to the left vagas nerve” (Mayo Clinic). The wire, “called a ‘stimulator lead,’ is then

attached onto the vagas nerve located in the neck” (Dayton Children’s). “When activated, the

device sends electrical signals along the left vagas nerve to your brainstem, which then sends

signals to certain areas in your brain. The right vagas nerve isn't used because it's more likely to

carry fibers that supply nerves to the heart” (Mayo Clinic). Nonsurgical vegas nerve devices

have “been approved in Europe to treat epilepsy, depression and pain” (Mayo Clinic).

The article, Interweaving Epilepsy and Neurodegeneration, appeals to an audience that

specializes in finding productive treatment for those with epilepsy. The article may be heavily

relied upon, in part, because the article has been peer-reviewed. The article serves to provide

information about different methods in treating epilepsy. “Temporal lobe epilepsy […] is the

most frequently acquired form contributing approximately 30% of the seizures in adults, typified

by spontaneous recurrent motor seizures, especially in the hippocampus” (Upaganlawar et. al).

The information included in the article, Interweaving Epilepsy and Neurodegeneration, “offers

some insights into the potential intervention with vitamins therapy in the management of

epilepsy” (Upaganlawar et. al). The Mediterranean and Keto diets may also have a similar effect

in reducing seizures. “The ketogenic diet resets how your body uses food. Usually, carbohydrates

in your diet (like sugars and starches) provide most of the energy. The keto diet lowers the
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number of carbs you eat and teaches your body to burn fat for energy instead” (Cleveland

Clinic).

The article, Medications in Children, published by the Epilepsy Foundation, provides

information about the benefits of certain medications and in what form they are prescribed in

liquid, swallow tablets, or chewable tablets. “The two most important factors [when]

consider[ing a medicine] are the epilepsy type and side effects” (Medications in Children). This

information provided by the Epilepsy Foundation provides guidance for parents who care for an

epileptic child at home. Medications come with side effects to which the individual may

succumb. These side-effects may be non-life-threatening or life-threatening, although the latter is

very rare. On the other hand, “the ketogenic diet has been used to reduce seizures since the

1920s. [...] Both the low sugar component and high fat component uniquely alters the

‘excitability’ of the brain, thereby reducing the tendency to generate seizures” (Cleveland

Clinic). This diet is implemented in a hospital with a “ketogenic team” (Cleveland Clinic). Both

methods of treatment have risks and benefits. These methods would be a great place to start

treatment options. This is because both methods are non-invasive and the risk of long-term

effects on the individual is significantly lower than that of surgery and vegas nerve devices.

The articles were very informative and put forth sound arguments in identifying the most

effective treatment method for those living with epilepsy. Depending on what lobe of the brain is

impacted by seizures, surgery might be an area to further explore. For some, surgery might be

needed on a drastic level. Undergoing surgery does not always guarantee that an individual will

no longer have seizures throughout their life. On the other hand, those living with moderate

epilepsy might not feel as comfortable with the idea. These individuals may have more options

open to them and should not feel rushed into making a decision on major surgery. Vegas nerve
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stimulation devices may be a better path for those seeking less invasive surgery. Vitamin E could

also develop into a new treatment approach. Dieting is a treatment that may help to reduce

seizures for any level of epilepsy, although, those living with severe seizures might be hesitant to

try this approach. Medication is a common route for epileptics, although this treatment is not

always the case.

The most effective treatment for epilepsy may be medication and lifestyle choices,

including incorporating the keto diet. Although, there are times when one’s seizures are

disproportionate to an individual's amount of medicine or diet plan; in cases such as this, the

treatment plan may incorporate brain surgery. Some areas that need to be further researched are

the long-term effects and risks of invasive treatment, such as brain surgery and vegas nerve

stimulation. Further exploring the possible outcomes of these surgeries may help to reduce the

fear experienced when contemplating these invasive treatments.

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Works Cited

Authored By: Katherine C. Nickels MDElaine Wirrell MD, NA, and Authored Date: 02/2020.

“Medications in Children.” Epilepsy Foundation, 2020,

https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/seizure-and-epilepsy-

medicines/medications-children.

Date: 10/2018, Authored. “Surgery.” Epilepsy Foundation, 2018,

https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/surgery.

“Epilepsy Surgery.” Dayton Children's, 11 Dec. 2020,

https://www.childrensdayton.org/epilepsy-surgery.

“Epilepsy Surgery.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Jan.

2021, https://www.mayoclinic.org/tests-procedures/epilepsy-surgery/about/pac-20393981.

Kaculini, Christian M, et al. “The History of Epilepsy: From Ancient Mystery to Modern

Misconception.” Cureus, Cureus, 17 Mar. 2021,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051941/.

NA, NA. “Ketogenic Diet for Epilepsy / Seizures.” Cleveland Clinic, 2022,

https://my.clevelandclinic.org/health/treatments/7156-ketogenic-diet-keto-diet-for-

epilepsy.

NA, NA. “Vagus Nerve Stimulation.” Mayo Clinic, Mayo Foundation for Medical Education and

Research, 17 Nov. 2020, https://www.mayoclinic.org/tests-procedures/vagus-nerve-

stimulation/about/pac-20384565.
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Upaganlawar, Aman B., et al. “Interweaving Epilepsy and Neurodegeneration: Vitamin E as a

Treatment Approach.” Biomedicine & Pharmacotherapy, vol. 143, 2021, p. 112146.,

https://doi.org/10.1016/j.biopha.2021.112146. Accessed 2022.