Neurosurgery and Brain Health Find the Best Epilepsy Treatment for You By Neurosurgery, May 23, 2015 Epilepsy is a disorder caused by abnormal bursts of electricity in the brain. These bursts create disruptions in normal brain function and lead to seizures. Living With Epilepsy Epilepsy is different for everyone, but it’s common for people living with it to feel nervous, embarrassed, or even angry. Facing the possibility of having seizures is stressful and interferes with your daily life. Understanding what triggers your seizures may help you avoid them. Getting consistent sleep and avoiding stress are also ways to reduce the frequency or intensity of seizures. To return to a normal life, it’s important to find appropriate treatment to reduce or eliminate seizures. Anti-seizure Medication and Antiepileptic Drugs This is usually the first choice to control seizure activity. Your doctor may try a few different types of medications depending on the kind of seizures you have. The most common side effects of these medications are: Sleepiness Dizziness Appetite changes Mood and behavior changes, such as nervousness, anxiety, irritability, and depression, are also common with anti-seizure medications. About a third of people with epilepsy find that antiepileptic medication doesn’t work for them. Epilepsy Surgery For adults who have tried at least two different seizure medications, your doctor may recommend epilepsy surgery. Before surgery, your doctor will do an imaging technique called brain mapping to determine the exact location where the seizures are originating. Brain mapping shows the affected areas of the brain and the areas that function normally. A neurosurgeon will remove the area of the brain that is causing the seizures. This is the most common type of surgery and has a high success rate. If the area of the brain causing trouble can’t be safely removed, the surgeon can perform a procedure that involves making small incisions in the brain to interrupt seizure activity. Implanted Stimulation Devices Another treatment option is to implant a vagus nerve stimulator. Vagus nerve stimulation may be a good choice for people who didn’t find relief with medication or can’t undergo surgery. The stimulator is implanted beneath the skin, near the collarbone, and a wire connects to the vagus nerve in your neck. The vagus nerve is one of the primary avenues for your body to carry messages to and from the brain. The device produces mild electrical signals that travel along the vagus nerve at regular intervals. It helps to reduce the frequency and duration of seizures. People with a stimulator also have the option of turning it off if it causes side effects or turning it on when they feel a seizure is coming. The stimulator may not prevent all seizures, and you may still need to take medication along with the implant. Epilepsy treatment can be tricky and involve some trial and error. Your physician will work closely with you to reduce or eliminate seizures with the best options that fit your life. Be open with your doctor about any side effects you experience or any mood changes, such as depression or anxiety, so that these can be addressed at the same time. Learn more about epilepsy treatment at the UPMC Department of Neurosurgery.