There is no cure for epilepsy. However, many people can become seizure-free with the right type of treatment, which may include medication, management techniques, and a healthcare team on their side.
This article discusses the outlook for people with epilepsy and how medical providers can reduce seizure activity in those with the condition.
Outlook for Epilepsy
The outlook for people with epilepsy can be positive in many cases. Medications and other treatment interventions are available and are generally effective.
In newly diagnosed people, the outlook following their diagnosis is as follows:
- 50–60% become seizure-free within a year after using medication.
- 11–20% of people will become seizure-free after using an additional seizure medication.
- 74% of children with new seizures will become seizure-free in the first two years after diagnosis.
- 25% of newly diagnosed adults and 9% of newly diagnosed children will not find proper treatment and experience uncontrolled epilepsy.
People with epilepsy have a reduced life expectancy. On average, people with a seizure disorder can expect to live 10–12 years less than those without one. That said, with treatments and management techniques, people with the condition can live relatively normal lives.
Can Seizures Be Stopped?
Six out of every 10 people with epilepsy can become seizure-free within a few years of beginning proper treatment. Many who reach this remission may never experience an epileptic episode again.
Roughly 66% of people with epilepsy can control their condition using anti-epileptic medication. Surgery is the next best option for those who don’t respond to treatment with drugs. About 70% of people who have surgery for their seizures can become seizure-free or experience only rare seizures.
Factors That Can Increase Chances of Being Seizure-Free
Having a positive outcome after an epilepsy diagnosis depends on several factors. For example, if a person responds positively to the first or second medication they try, they are more likely to become seizure-free in the future. Other factors include:
- Brain injury: People without brain injuries or abnormalities are more likely to reduce or eliminate their seizures with proper treatment.
- Normal neurological exams: Those with typical results on an electroencephalogram (EEG) or other neurological tests are less likely to experience seizures after treatment.
- Family history: People with a family history are less likely to reach seizure-free status.
- Cause: When the cause of epilepsy is unknown, the chances of becoming seizure-free are higher.
Identifying Seizure Triggers
Certain things can bring on an epileptic seizure, such as missed medications, alcohol use, stress, lack of sleep, and menstruation. People can learn to identify their triggers by keeping a seizure diary that records when the seizure happens and any factors in their life or environment that occurred. New technology is making identifying seizure triggers easier, and smartwatches and apps have been used to track and compile trigger data for individuals with epilepsy.
Many treatments for epilepsy are available. The type chosen will depend on various personal factors and how a person responds to their first-line therapy medication.
Medication is often the first choice when it comes to epilepsy treatment. There are 26 Food and Drug Administration (FDA)-approved medications to control seizures. These are usually prescribed after someone has one or two episodes during waking hours, one during sleeping hours, or an attack after which a magnetic resonance imaging scan (MRI) showed a structural problem with the brain.
Because there are many variations of epilepsy, medications are prescribed based on the type. Sex, age, and mental health status also play a role when choosing the right drug.7
Medications are prescribed based on several factors because some are viable in certain situations, and others are not. Medical providers want to get treatment right as quickly as possible and because drugs are the first and most common option, treatment according to those factors is the best method.
According to research conducted in 2018, less than 1% of people with epilepsy will undergo surgery to control their condition.
Typically, surgery is considered when:
- There is no change in seizure activity even after trying two or more medications.
- Seizures are disabling and negatively affect a person’s quality of life daily.
- Seizures occur from the same region of the brain each time, as is the case with focal epilepsy, and medication isn’t working.
- There is an abnormality in the brain where the seizures start.
- People have specific types of epilepsy, known as atonic or tonic.
- People have an increased risk of injuring themselves or experiencing status epilepticus or sudden unexpected death in epilepsy (SUDEP).
Other therapies, including implantable devices, vagus nerve stimulation, and seizure alert systems, are all options to help manage epileptic seizures.
In 30% of people, medications do not work to control seizures or cause side effects for which coping proves too difficult. If surgery is not an option in this case, devices may work to help control their epilepsy. Devices, also known as neuromodulation, are implanted into the brain. While there, they can send electrical currents that encourage the proper functioning of brain cells.
Research shows that as many as 67% of people who use neurostimulation devices can experience a reduction in seizures as well as a shorter duration of each episode that does occur. It’s important to note that the study that references these results was on a small scale.
Vagus nerve stimulation sends electrical impulses to the vagus nerve, the longest cranial nerve. It is a form of neurostimulation, and roughly 45–60% of patients who receive this therapy can expect a 50–100% reduction in seizures after six months of treatment.
Another possible therapeutic device that can alert caregivers to an attack is a seizure alert system. A person with epilepsy can wear this device to track movements and electroencephalogram (EEG) activity. Though this doesn’t help to manage the condition, it can make someone with epilepsy feel a bit safer in knowing that their caregiver will be notified if they do have a seizure.
Brain Stimulation and Seizures
Though some effective devices and therapies use brain stimulation to lessen seizure frequency, not all brain stimulation is helpful. Some treatments that utilize the changing of brain waves may bring on seizures, as is the case with some people who undergo transcranial magnetic stimulation (TMS).
Diet and Lifestyle Changes
Diet and lifestyle can play a role in seizure activity, and making specific changes in this department can help to manage epilepsy effectively. Alongside medications, the low-carbohydrate ketogenic and modified Atkins diets have shown promise in helping those with seizures control their condition. Though it’s not clear how these diets can work for epilepsy, they seem to encourage changes in neuronal metabolism, which is the process by which brain cells get their energy.
Eating the ketogenic diet is also thought to reduce seizure frequency because it dampens neuronal excitability, which is when neurons generate a large burst of electrical activity after light stimulation.
Other lifestyle changes that can help lessen the frequency of seizures include:
- Getting enough sleep
- Eliminating the use of alcohol and drugs
- Managing stress levels
- Getting regular exercise
New Treatment Breakthroughs
New treatments for epilepsy and seizures are researched all the time. The Epilepsy Therapy Project of the Epilepsy Foundation is a branch of research that aims to spread awareness about new options for those who may not have controlled seizures with medications or other therapies.
Nearly 300 clinical trials are recruiting new patients to determine the efficacy of breakthrough treatments in medications, testing, procedures, and devices.
One of the latest clinical trials to gain traction has found that gene therapy is an effective option for those who experience uncontrolled seizures due to specific genetic mutations. The study results are promising, but researchers have yet to test them on humans.
Working With Your Healthcare Provider
To find the proper treatment that works for you, you must work with a neurologist and healthcare team. They will examine your specific case, type, and other factors to determine your best possible option.
There are many types and causes of epilepsy, and their degrees of severity also vary. By working with a trusted healthcare team, you will likely find a therapy option that reduces or eliminates your seizures.
There is no cure for epilepsy, and people with the condition have an average reduced life expectancy of 10–12 years. That said, people with the disorder can live completely normal and seizure-free lives if they find the right type of therapy.
There are many options for this, including medication, surgery, implantable devices, and lifestyle interventions. To find the one that works best for you, work with your healthcare team.
FREQUENTLY ASKED QUESTIONS
What causes epilepsy?
There are many causes of epilepsy. Genetics, neurological issues, brain infections, or developmental disorders may play a role.
Are there any natural treatments for epilepsy?
Though diet and lifestyle interventions can help reduce the frequency of seizures, they are not considered standalone treatments. That is because no natural treatment seems able to reduce or eliminate attacks as well as other treatments. Medication is currently the No. 1 therapy available for those with epilepsy.
How long do people with epilepsy live?
The life expectancy of people with epilepsy is reduced. However, many people can live completely seizure-free lives with the proper treatment. On average, people may have a reduced life expectancy of roughly 10–12 years.
Source: verywellhealth.com, Angelica Bottaro, Nicholas R. Metrus, MD