Half of children who have one seizure never have another. However, a second seizure greatly increases the chance of having more seizures, so treatment is usually considered at this point.
The first choice of treatment for epilepsy is usually medication (drugs). For most children with epilepsy, the first medication tried is successful in controlling their seizures. However, if medication does not control the seizures after a reasonable trial period, your child's doctor may suggest changing medications or adding another medication. If multiple trials of medication fail to control seizures, another kind of treatment may be considered, such as surgery, the ketogenic diet, or vagus nerve stimulation.
The various treatment options are discussed in detail in this section. Click the links on the left to read about them.
Goals of treatment
The primary goal of treatment could be:
-
complete elimination of seizures
-
reduction in frequency and intensity of seizures
-
some reduction of seizures, balanced with minimal side effects
The goals of treatment vary depending on the epilepsy syndrome, the frequency and severity of seizures, the treatment alternatives available, and the age of your child. While an adult with seizures may aim for independent living, the goals for a child may be normal developmental progression and improvements in learning and behaviour. Treatment goals may also change over time as your child and his condition are better understood, his clinical situation evolves, and advances make new treatment options available.
You should decide about treatment in consultation with your child and your child's doctor or treatment team. It is best to explain the treatment options to your child with age-appropriate information that he can understand. This may reduce his anxiety and increase his cooperation and his feeling of control over the situation.
It is important to note that medication or surgery is only one part of epilepsy treatment. Seizure control is the first step in treatment, but not the only step. Even when seizures are well controlled, children with epilepsy may still experience difficulties with self-esteem, learning, behaviour, or social adjustment. It is important to work with the treatment team to address any such problems as they arise.
These issues are discussed in detail in the "At Home and At School" section.