Treatment Options

Medical Management

More than 60% of patients’ seizures can be well controlled and managed with antiepileptic medications. Hoag’s specialists consider each patient’s disease and lifestyle in determining which medications to prescribe. And since many antiepileptic medications have side effects and drug interactions, Hoag specialists work closely with patients and their primary care physician to continually manage drug therapy.

Treatment options include:

  • Anticonvulsant Medications
  • Epilepsy Surgery
  • Vagus Nerve Stimulation (VNS) Therapy
  • Responsive Neurostimulation (RNS) Therapy
  • Dietary Therapy
  • Immunotherapy


Surgical Treatment

In approximately one third of patients, anticonvulsant medications cannot adequately control seizures. When seizures cannot be controlled with medication alone, Hoag offers the latest techniques in surgical intervention. Surgery can eliminate seizures in the majority of patients, and reduce seizures in most of the remainder. To locate the exact location of the brain causing seizures, Hoag neurosurgeons utilize state-of-the-art neuronavigational technology and sophisticated magnetic resonance imaging techniques to precisely reach and treat the seizure areas safely.

For non-surgical candidates and for patients whose seizures are resistant to antiepileptic medications, Hoag specialists also perform vagus nerve stimulation (VNS) surgery. Implanted under the skin below the left collarbone, the VNS generator delivers intermittent nerve stimulation to the vagus nerve to effectively block seizures from occurring in a good percentage of individuals.

Epilepsy Surgery

Epilepsy surgery began as the removal of structural abnormalities in the brain. With the addition of EEG data from preoperative and intraoperative recordings, areas of removal expanded to include tissue that was grossly normal in appearance but known to give rise to epileptiform activity.

If the information obtained during the pre-surgical evaluation consistently points towards a single area of the brain as being the site of seizure onset, then the patient may have surgery for resection of that area.
In the majority of patients with epilepsy, seizures can be well controlled with appropriate medication. However, current estimates indicate that 20 - 30% of patients with epilepsy are refractory to all forms of medical therapy. These medically intractable patients are candidates for surgical treatment in an attempt to achieve better seizure control.

Another group of patients who might benefit are those whose seizures may be relatively well controlled but who have certain characteristic presentations or lesions that strongly suggest surgical intervention might be curative.

Dietary Therapy

Some patients may benefit from a form of dietary therapy known to potentially control the occurrence of seizures. The modified Atkins diet, or MAD diet, is a variation on the traditional ketogenic diet, which requires patients to virtually eliminate carbohydrates from their daily intake. Patients are limited to 10-20 carbs per day.

Studies show that the MAD diet can greatly decrease, and in some cases eliminate, the occurrence of seizures in epileptic patients. Talk to your doctor to determine whether dietary therapy could benefit you.​​​